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Hepatitis B and C in the context of HIV disease: implications for incarcerated populations
A C Spaulding1, M Lally, J D Rich
1Rhode Island Department of Corrections, Cranston, Rhode Island, USA.
Insights
Many incarcerated individuals have HIV and hepatitis B or C. This review discusses how these co-infections impact disease and offers treatment guidelines for hepatitis C in HIV-infected inmates.
Area of Science:
- Infectious Diseases
- Public Health
- Hepatology
Background:
- The incarcerated population experiences high rates of Human Immunodeficiency Virus (HIV) infection.
- Coinfection with viral hepatitis, specifically Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV), is common among HIV-infected inmates.
- Understanding the burden of HIV in correctional facilities requires acknowledging the significant impact of viral hepatitis coinfections.
Purpose of the Study:
- To describe the current burden of HIV coinfection with viral hepatitis in the incarcerated population.
- To elucidate the impact of HIV on the natural history of viral hepatitis, particularly chronic Hepatitis C.
- To provide guidelines for selecting appropriate candidates for treatment among coinfected inmates.
Main Methods:
- Review of existing literature on HIV and viral hepatitis coinfection in correctional settings.
- Analysis of the impact of HIV on the progression of chronic Hepatitis C.
- Development of clinical guidelines for treatment selection in coinfected individuals.
Main Results:
- HIV significantly alters the course of viral hepatitis, especially chronic Hepatitis C.
- Chronic viral hepatitis does not appear to accelerate HIV disease progression.
- Guidelines are proposed for optimizing treatment decisions in coinfected inmates.
Conclusions:
- HIV coinfection presents a complex challenge within the incarcerated population.
- Management strategies must consider the interplay between HIV and viral hepatitis.
- Targeted treatment guidelines are essential for improving outcomes in coinfected inmates.
Abstract:
HIV-infected inmates are often co-infected with hepatitis B and/or hepatitis C virus. To describe the burden of HIV in the incarcerated population today, one must consider the impact of co-infection. HIV may dramatically modify the course of viral hepatitis infection, especially chronic hepatitis C. The converse is uncertain: chronic hepatitis does not seem to accelerate HIV disease progression. In this article, we offer guidelines for selecting appropriate candidates for treatment among co-infected inmates.