Pilot study using the ECHO model to enhance linkage to care for patients with hepatitis C in the custodial setting

Authors

Manuel Mendizabal, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
Pablo Testa, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
Mercedes Rojas, Virology laboratory, Hospital Universitario Austral, Pilar, Argentina
Carla S. Colaci, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
Solana Elías, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
Paula Nicolini, Servicio Penitenciario Bonaerense, Buenos Aires, Argentina
Soledad Olguín, Servicio Penitenciario Bonaerense, Buenos Aires, Argentina
Carolina Dunn, Fundación Espartanos, Buenos Aires, Argentina
Claudio Rochi, Fundación Buena Vida, Buenos Aires, Argentina
Mariano Barreiro, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
Mercedes Zirpoli, Virology laboratory, Hospital Universitario Austral, Pilar, Argentina
Federico Piñero, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
Sanjeev Arora, Department of Internal Medicine, University of New Mexico, NM, USA
Martín O´Flaherty, Department of Public Health and Policy, University of Liverpool, Liverpool, UK
Fernando Rubinstein, Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
Marcelo O. Silva, Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
Latin American Liver Research, Educational, Awareness Network (LALREAN)

Document Type

Article

Publication Date

11-2-2020

Abstract

Prisoners in most countries have a higher prevalence of HCV than the general population, but their access to treatment is very limited. Our aim was to evaluate a pilot programme using the ECHO model to enhance linkage to care in patients with HCV in 3 Argentinean prisons between October 2018 and January 2020. All inmates were invited to participate, and data were collected through a personal interview. We then estimated HCV prevalence with dried blood spot and performed a logistic regression analysis to identify risk behaviours associated with HCV infection. Finally, HCV management was assessed and monitored through ECHO. Overall, 1141 inmates agreed to participate, representing 39.7% of the total prison population. Anti-HCV prevalence was estimated at 1.58% (CI 0.93; 2.48), being significantly higher in women 2.98% (CI 1.4;5.6) than in men 1.07% (CI 0.5; 2.0); P = .03. Patients with anti-HCV were significantly older than those who tested negative, 42.3 years (CI 37.6;47.1) vs 30.1 years (CI 30.6;31.2), P < .001, respectively. Multiple logistic regression analysis, identified age OR 1.07 (CI 1.03;1.12, P = .001), history of sexually transmitted disease OR 3.08 (CI 0.97;9.82, P = .057) and intravenous drug use OR 12.6 (CI 3.31;48.53, P < .001) as risk factors associated with anti-HCV. Treatment was initiated in all the patients with specialist physician support utilizing ECHO model. In conclusion, our pilot study reported a low prevalence of anti-HCV in the studied population. Incarceration provides an ideal opportunity for testing and treating HCV. ECHO model arises as a useful tool to support assessment and treatment for inmates with chronic HCV.

Recommended Citation

Mendizabal M, Testa P, Rojas M, et al.; On behalf of the Latin American Liver Research, Educational, Awareness Network (LALREAN). Pilot study using the ECHO model to enhance linkage to care for patients with hepatitis C in the custodial setting. J Viral Hepat. 2020;27:1430–1436. https://doi.org/10.1111/jvh.13374