The contribution of telemedicine to hepatitis C elimination in a correctional facility
- Germán Jiménez Galán 1
- Carlos Alia Alia 1
- Milagros Vegue Gónzalez 1
- Rosa García Berriguete 1
- Francisco Fernández González 2
- Conrado M. Fernández Rodriguez 3
- Mario González Fernández 3
- Maria Luisa Gutierrez Garcia 3
- Juan Emilio Losa García 3
- María Velasco Arribas 3
- Leonor Moreno 3
- Rafael Hervás Gómez 3
- Gregorio Jesús Palacios García-Cervigón 3
- Alberto Delgado Iribarren 3
- 1 Centro Penitenciario Madrid-IV. Navalcarnero, Madrid. Spain
- 2 Hospital Universitario Gregorio Marañón. Madrid, Spain
- 3 Hospital Universitario Fundación Alcorcón. Madrid, Spain
ISSN: 2340-416, 1130-0108
Año de publicación: 2019
Volumen: 111
Número: 7
Páginas: 550-555
Tipo: Artículo
Otras publicaciones en: Revista Española de Enfermedades Digestivas
Resumen
Background: micro-elimination has been recently proposed as an efficient strategy to achieve global hepatitis C virus (HCV) elimination. The Spanish Health Ministry Strategic Plan for hepatitis C infection highlighted intervention in prisons as a priority action. However, there are important barriers associated with the specialized care provision to the penitentiary population. Aims: to assess the contribution of telemedicine for HCV elimination in a correctional facility in Spain. Methods: an open label program of HCV elimination via telemedicine was started on February 3rd, 2015 in a large penitentiary of 1,200 inmates, as an alternative to referring patients to specialists. An anonymous satisfaction survey was performed among a random sample of inmates and all participating doctors. Results: the prevalence of HCV viremia prior to program initiation was 12.4%. One hundred and thirty-one patients received DAA HCV treatment during the period 2015-2018; 42.74% had a HCV-HIV co-infection. Overall, 97% achieved a sustained virological response (SVR). A second regime of DAA successfully rescued non-responder patients and the HCV prevalence was zero at the end of the program. Satisfaction was high or very high according to 67% of inmates and all participating doctors. Conclusion: telemedicine is an effective tool for HCV elimination in penitentiary correctional facilities where referral to specialists is difficult. The extensive use of this technology should be recommended in this setting in order to facilitate equitable access to specialized care.