Treatment of chronic hepatitis C in Canadian prison inmates

To assess sustained viral response rate and adherence to standard interferon alpha-2b and ribavirin therapy in inmates with chronic hepatitis C (HCV) in Canadian penitentiaries in the Pacific region.

A retrospective chart review of all inmates with chronic HCV who were treated with standard interferon alpha-2b and ribavirin therapy between March 2001 and October 2002.

A total of 90 male inmates were treated. The mean age at time of treatment was 40 years. There were 49 inmates with HCV genotype 1, 11 with HCV genotype 2 and 30 with HCV genotype 3. Eight inmates discontinued treatment because of intolerance to side effects. Nine inmates were stopped by the physician because of nonresponse at an average of 27 weeks. All inmates achieved at least 80% adherence of interferon and ribavirin therapy. The overall sustained virological response (SVR) was 55.9%. SVR was 31.6% for genotype 1, 100% for genotype 2 and 71.4% for genotype 3.

There was excellent SVR and adherence to treatment with interferon and ribavirin. This experience highlights an important opportunity to treat a population with a high prevalence of HCV-positive persons who may otherwise not seek treatment.