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15 June 2006

Volume 42, Number 12
Clinical Infectious Diseases 2006;42:1663–1670
© 2006 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2006/4212-0001$15.00
DOI: 10.1086/504327
MAJOR ARTICLE

Acute Hepatitis C Virus Infection in Incarcerated Injection Drug Users

Barbara H. McGovern,1,2

Alysse Wurcel,1,3,a

Arthur Y. Kim,3

Julian Schulze zur Wiesch,3,4

Ioana Bica,1,2,a

M. Tauheed Zaman,1,3

Joerg Timm,3,a

Bruce D. Walker,3,4 and

Georg M. Lauer3

1Lemuel Shattuck Hospital, 2Tufts University School of Medicine, and 3Partners AIDS Research Center/Infectious Disease Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; and 4Howard Hughes Medical Institute, Chevy Chase, Maryland

Background.The Centers for Disease Control and Prevention has emphasized the need for interventional programs regarding hepatitis C virus (HCV) infection for injection drug users, the group of persons who are at highest risk of acquiring acute infection.

Methods.We designed a pilot study to assess the feasibility of identifying injection drug users with acute HCV infection in correctional and detoxification facilities. On‐site medical providers were educated regarding risk factors and signs and symptoms of infection and were instructed to refer all patients with hepatitis to our specialty clinic.

Results.Over a 30‐month period, 21 patients received a diagnosis of acute hepatitis C, 3 received a diagnosis of hepatitis B, and 1 received a diagnosis of hepatitis A. Of the 21 patients with acute hepatitis C, 19 were identified in the prison setting shortly after incarceration. Of the 17 patients who were observed serially (mean duration of observation, 6.3 months), 8 had spontaneous virologic clearance. Early therapy with pegylated interferon was initiated for 5 patients with persistent viremia and led to a sustained virologic response in 2 individuals. All patients agreed to undergo human immunodeficiency virus counseling and testing, as well as to receive immunization for hepatitis A and B.

Conclusions.Incarceration presents a unique opportunity to identify injection drug users with acute HCV infection, to initiate counseling regarding other bloodborne pathogens, and to facilitate immunizations and HCV treatment.

Received 4 December 2005; accepted 11 February 2006; electronically published 11 May 2006.

  • (See the editorial commentary by Thomas on pages 1671–3)

Reprints or correspondence: Dr. Barbara McGovern, Lemuel Shattuck Hospital, 170 Morton St., Jamaica Plain, MA 01230 ().

Cited by

Julian Schulze zur Wiesch, Dorothea Pieper, Ingrid Stahmer, Thomas Eiermann, Peter Buggisch, Ansgar Lohse, Joachim Hauber, and Jan van Lunzen. (2009) Sustained Virological Response after Early Antiviral Treatment of Acute Hepatitis C Virus and HIV Coinfection. Clinical Infectious Diseases 49:3, 466-472
Online publication date: 1-Aug-2009.
Abstract-Full Text-PDF Version (466 kB)
Margaret Hellard, Rachel Sacks‐Davis, and Judy Gold. Hepatitis C Treatment for Injection Drug Users: A Review of the Available Evidence. Clinical Infectious Diseases 0:0, 000-000
Abstract-Full Text-PDF Version (129 kB)
Paul Strock, Joël Mossong, Karine Hawotte, Vic Arendt. (2009) Access to Treatment of Hepatitis C in Prison Inmates. Digestive Diseases and Sciences 54:6, 1325-1330
Online publication date: 1-Jul-2009.
CrossRef
Douglas R Hunt, Sammy Saab. (2009) Viral Hepatitis in Incarcerated Adults: A Medical and Public Health Concern. The American Journal of Gastroenterology 104:4, 1024-1031
Online publication date: 1-May-2009.
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Jason T. Blackard, M. Tarek Shata, Norah J. Shire, Kenneth E. Sherman. (2008) Acute hepatitis C virus infection: A chronic problem. Hepatology 47:1, 321-331
Online publication date: 1-Feb-2008.
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David L. Thomas. (2006) Editorial Commentary: Acute Hepatitis C: A Window of Opportunity. Clinical Infectious Diseases 42:12, 1671-1673
Online publication date: 15-Jun-2006.
Citation-Full Text-PDF Version (54 kB)

  • Presented in part: 41st Annual meeting of the Infectious Diseases Society of America, San Diego, California, 8–12 October 2003 (abstract 592).

  • Present affiliations: Medical Student, University of Pennsylvania Medical School, Philadelphia, Pennsylvania (A.W.); Boston Medical Center, Boston, Massachusetts (I.B.); and Zentrum für Innere Medizin, Abteilung Gastroenterologie und Hepatologie, Berufsgenossenschaftliche Kliniken Bergmannsheil, Ruhr‐Universitaet Bochum, Bochum, Germany (J.T.).

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