Methods: Prospective data collection of HIV/HCV patients treated with DAAs in a Penitentiary Unit of a Hospital (Access to therapy was limited to available drugs, so we had to prioritize by liver function, fibrosis and extra-hepatic disease)
Results: Since February 2015, 47 (12.7% females) co-infected with undetectable HIV viral load started treatment with DAAs (32 naïve and 15 IFN-RBV pre-treated). Mean age was 45.7 years (range 30-57). A big proportion (75.6%) were cirrhotic, 26/36 with > 20 kPa FibroScan, 2 have already suffered liver decompensation and 7 (14.8%) had esophageal varices. Genotype distribution was: 21 GT1a (44.7%), 5 GT1b (10.6%) 1 GT2 (2%), 13 GT3 (27.6%), 7 GT4 (14.9%). Proposed length of treatment was 12 weeks for 33 patients (70.2%) and 24 weeks for 14. All of them received SOF, 33/47 with LED in a STR (70%), 12 with SMV (25.5%) and only one with DTV. RBV was added in 39 (83%)
On May 13, 2016: 38/47 patients had completed treatment without significant AE, but 2/38 dead after end of treatment (1 acute portal thrombosis and 1 no determined sudden dead). VR rate at the end was 100%, SVR12 was 93.9 % (31/33). Two failures were detected with SOF+LED+RBV (one g1a and one g1b). Only one abandoned in 6th week, no more gave up the clinical follow up despite prison release. After SVR24, a patient presented another acute portal thrombosis.
Pending SVR12 results will be updated at Congress.
Conclusion: Co-infected inmates show a high level of adherence and good tolerance to DAAs, achieving high cure HCV rates, but access to treatment can be too late for some of them. Public health should eliminate the barriers to access to treat HIV/HCV in prison setting.
E. Reigadas, None
T. Aldámiz, None
O. Aldecoa-Otarola, None
F. Fernandez-González, None