Perpignan Hospital, France
Dr André-Jean REMY has completed his Ph.D at the age of 31 years from University of Montpellier, France. He is department head of Hepato/Gastroenterology and Medical Jailhouse Unit of Perpignan hospital. He has published 66 papers in reputed medical journals and national/international congress, specially on viral hepatitis in inmates and drugs users.
Introduction : Treatment of hepatitis C was until 2011 dual therapy (peg-interferon and ribavirin) before two direct antiviral agents, telaprevir and boceprevir were available. At time of dual therapy only 14 % of inmates with hepatitis C were treated. Objectifs and methods : Our objective was to study in national survey, over 2011/2012, number of patients treated in MJU, with dual or triple therapy. Preliminary results : 91 MJU over 182 participated for 31550 prisoners ; hepatitis screening was systematically proposed in 100 % of MJU; 27 622 serologies C were annually realized with rate of 3.1 % positivity ; Followed patients were 1544 in 2011 and 1321 in 2012 (4.2 %); 49 % of MJU had regular hepatology consultation ; to evaluate liver fibrosis 227 FIBROSCAN* and 511 FIBROTEST were realized in 2012. In 2011, 261 patients were treated (16.9 %), in 2012, 332 patients (25 %). Triple therapy constituted 12 % of treatment in 2011, 39 % in 2012 (telaprevir 78 %, boceprevir 28 %); 42 % of the MJU introduced no treatment in 2011 (77 % any triple therapy) and 56 % in 2012 (66 % any triple therapy). Conclusions : frequent positive patients VHC in jailhouses, good screening and diagnosis and using widely not invasive methods of fibrosis but different practices for hepatitis treatment between MJU treating a lot of patients and MJU treating none. Compared with the study of 2005, percentage of treated patients was doubled but percentage of MJU involved decreases in 45 %.