%0 Journal Article
%A Cuadrado, Antonio
%A Llerena, Susana
%A Cobo, Carmen
%A Pallás, José Ramón
%A Mateo, Miguel
%A Cabezas, Joaquin
%A Fortea, José Ignacio
%A Alvarez, Silvia
%A Pellón, Raúl
%A Crespo, Juan
%A Echevarría, Santiago
%A Ayesa, Rosa
%A Setién, Esther
%A Lopez-Hoyos, Marcos
%A Crespo-Facorro, Benedicto
%A Agüero, Jesus
%A Chueca, Natalia
%A Garcia, Federico
%A Calleja, Jose Luis
%A Crespo, Javier
%T Microenvironment Eradication of Hepatitis C: A Novel Treatment Paradigm.
%D 2018
%U http://hdl.handle.net/10668/12646
%X Prisons are major reservoirs of hepatitis C virus (HCV) in which a therapeutic approach has been particularly difficult so far. Our aim was to create a permanent program of HCV elimination in a prison based on a "test and treat" strategy. This open-label clinical trial was conducted in the Spanish prison "El Dueso" between May 2016 and July 2017. Viremic patients were treated with a ledipasvir-sofosbuvir regimen (8-12 weeks) according to the 2015 Spanish Guidelines. A teleconsultation program was established to follow-up patients from the hospital. Non-responders were submitted for a phylogenetic analysis and offered retreatment. An evaluation of new cases of HCV infection was performed every 6 months and upon release in all inmates. 847 (99.5%) inmates accepted to participate. HCV antibodies were present in 110 (13.0%) and 86 (10.2%) had detectable viremia. Most of them were genotype 1 or 3 (82.6%) and had  A sustained "test-and-treat" strategy against HCV in prisons is feasible and beneficial. Spreading this strategy should entail a public health impact.
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