Hepatology

Biography

Biography: André-Jean Remy

Abstract

Introduction: Hepatitis C (HCV) rate is higher in the prisoners’ population than in the general’s one in France between 5 and 7% (INVS on 2004, PREVACAR). Prisoners accumulate risk factors before their confinement but the prison in itself represents a risk factor: Syringes or straw share, homemade tattoos, etc. Global incidence of HCV in France was 2700 and 4400 new cases per year. On the other hand HCV incidence in jailhouses was not known. Screening of HCV is systematically proposed in the entrance to detention in France but its renewal, recommended by the Methodological Guide of sanitary care is not still applied correctly. In this context, point of care testing (POCT) use could constitute an interesting alternative in classic serology and was recommended in French HCV experts report in 2014 and in national guidelines in 2015. Objective: Use HCV POCT in prison as a supplement to the classic serology to study the incidence of new HCV infections. Methods: HCV prevalence in our establishment is situated in national average around 7%. HCV serology realized by venous way was proposed to all incomers in Perpignan detention center. POCT was proposed to 3 types of prisoners: 1/refusal or impossibility of venous way 2/transfer of another penitentiary and previous negative serology 3/presence in detention 12 months old superior and previous negative serology. In case of positivity a FIBROSCAN and a complementary biological balance sheet are realized. Results: 333 HCV POCT was realized in 24 months: Group-1; 15 %, group-2; 27%, group-3; 58%. Two serologies were positive. The 2 inmates were imprisoned for more than 6 months and the viral load was positive. A patient had gone out in permission one week and a patient had never gone out of detention. The use of drugs was route of contamination in 2 cases. The calculated incidence was 3/1000 per year or potentially 470 new cases of HCV infection in France per year among the prison population (78246 prisoners on June 1st, 2015). Discussion/Conclusions: HCV POCT is useful in jailhouses because there are HCV high risk places. These routed of contamination could be more than 10% of HCV new cases. So it was also necessary to give harm reduction tools for all prisoners.