{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:43:29Z","timestamp":1774917809994,"version":"3.50.1"},"reference-count":31,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Penitentiaries have a higher burden of communicable diseases compared to the general population. Prisoners should be tested for hepatitis C virus (HCV) and have direct access to treatment. We analysed the HCV cascade of care in two penitentiaries in Brescia, Northern Italy. At admission, prisoners are offered a voluntary screening for HCV, while patients with known infections are tested with an HCVRNA measurement. We performed an observational retrospective study including all the subjects admitted to the penitentiaries from 1 January 2015 to 31 October 2021. We conducted a descriptive analysis. During the study period, 5378 admissions were registered, and 2932 (54.5%) screenings were performed. Hepatitis C virus antibody positivity was found in 269 tests (9.2%). Hepatitis C virus RNA was detectable in 169 people. During the study period, 77 treatments with direct-acting antivirals (DAAs) were administered. Follow-up was available in 45 patients, and sustained virological response (SVR) was documented in 44 of them. Retention in care occurred in less than half of the prisoners after release. Our data demonstrate poor screening adherence that could benefit from educational programs. Treatment rates could be improved with test-and-treat programs. More efforts are needed to eliminate HCV as a public threat by 2030. Dedicated local networks, including infectious diseases (ID) departments, substance abuse services and prisons, could mitigate these issues.<\/jats:p>","DOI":"10.3390\/ijerph21010104","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T08:57:32Z","timestamp":1705481852000},"page":"104","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Chronic Hepatitis C Cascade of Care in Prisoners\u2014Is There Still Some Work to Do? Analysis of Two Large Penitentiaries in Northern Italy"],"prefix":"10.3390","volume":"21","author":[{"given":"Anna","family":"Cambianica","sequence":"first","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy"},{"name":"Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Marchese","sequence":"additional","affiliation":[{"name":"Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Pennati","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy"},{"name":"Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Faustinelli","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy"},{"name":"Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Migliorati","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy"},{"name":"Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Roda","sequence":"additional","affiliation":[{"name":"Unit of Prison Health, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angiola","family":"Spinetti","sequence":"additional","affiliation":[{"name":"Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Zaltron","sequence":"additional","affiliation":[{"name":"Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1866-314X","authenticated-orcid":false,"given":"Simona","family":"Fiorentini","sequence":"additional","affiliation":[{"name":"Unit of Microbiology and Virology, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnaldo","family":"Caruso","sequence":"additional","affiliation":[{"name":"Unit of Microbiology and Virology, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-9100","authenticated-orcid":false,"given":"Eugenia","family":"Quiros-Roldan","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy"},{"name":"Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9161-7804","authenticated-orcid":false,"given":"Francesco","family":"Castelli","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy"},{"name":"Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4395-5379","authenticated-orcid":false,"given":"Emanuele","family":"Foc\u00e0","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Sciences, Section of Infectious and Tropical Diseases, University of Brescia, 25123 Brescia, Italy"},{"name":"Division of Infectious and Tropical Diseases, ASST Spedali Civili Hospital, 25123 Brescia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"ref_1","unstructured":"European Centre for Disease Prevention and Control, European Monitoring Centre for Drugs and Drug Addiction (2018). Public Health Guidance on Prevention and Control of Blood-Borne Viruses in Prison Settings, ECDC and EMCDD."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1136\/jech.2006.051599","article-title":"Evidence-based policy and practice: Correlates of hepatitis C virus seropositivity in prison inmates: A meta-analysis","volume":"62","author":"Vescio","year":"2008","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_3","unstructured":"European Monitoring Centre for Drugs and Drug Addiction (2012). Prisons and Drugs in Europe: The Problem and Responses, EMCDDA."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Snow, K.J., Young, J.T., Preen, D.B., Lennox, N.G., and Kinner, S.A. (2014). Incidence and correlates of hepatitis C virus infection in a large cohort of prisoners who have injected drugs. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-830"},{"key":"ref_5","unstructured":"Italia (2023, January 28). Legge n. 8. 28 Febbraio 2020. Available online: https:\/\/www.gazzettaufficiale.it\/eli\/gu\/2020\/02\/29\/51\/so\/10\/sg\/pdf."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1170","DOI":"10.1016\/j.jhep.2020.08.018","article-title":"EASL recommendations on treatment of hepatitis C: Final update of the series","volume":"73","author":"Pawlotsky","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"St\u00f6ver, H., Meroueh, F., Marco, A., Keppler, K., Saiz De La Hoya, P., Littlewood, R., Wright, N., Nava, F., Alam, F., and Walcher, S. (2019). Offering HCV treatment to prisoners is an important opportunity: Key principles based on policy and practice assessment in Europe. BMC Public Health, 19.","DOI":"10.1186\/s12889-018-6357-x"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.jhep.2013.03.008","article-title":"Hepatitis C virus reinfection among prisoners with sustained virological response after treatment for chronic hepatitis C","volume":"59","author":"Marco","year":"2013","journal-title":"J. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1093\/epirev\/mxy001","article-title":"Active Case Finding for Communicable Diseases in Prison Settings: Increasing Testing Coverage and Uptake among the Prison Population in the European Union\/European Economic Area","volume":"40","author":"Tavoschi","year":"2018","journal-title":"Epidemiol. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Falla, A.M., Hofstraat, S.H.I., Duffell, E., Hahn\u00e9, S.J.M., Tavoschi, L., and Veldhuijzen, I.K. (2018). Hepatitis B\/C in the countries of the EU\/EEA: A systematic review of the prevalence among at-risk groups. BMC Infect. Dis., 18.","DOI":"10.1186\/s12879-018-2988-x"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Busschots, D., Kremer, C., Bielen, R., Koc, \u00d6.M., Heyens, L., Nevens, F., Hens, N., and Robaeys, G. (2022). Hepatitis C prevalence in incarcerated settings between 2013\u20132021: A systematic review and meta-analysis. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-14623-6"},{"key":"ref_12","first-page":"5","article-title":"Verso una politica sanitaria di screening e linkage to care per l\u2019eliminazione dell\u2019infezione da epatite C in Italia","volume":"2","author":"Kondili","year":"2020","journal-title":"Infezioni Med."},{"key":"ref_13","unstructured":"Ministero della Salute, Ministero della Giustizia (2022, December 17). Linee di Indirizzo per Gli Interventi del Servizio Sanitario Nazionale a Tutela della Salute dei Detenuti e Degli Internati Negli Istituti Penitenziari, e dei Minorenni Sottoposti a Provvedimento Penale. Available online: http:\/\/www.ristretti.it\/commenti\/2008\/febbraio\/pdf2\/linee_carcere.pdf."},{"key":"ref_14","first-page":"2142","article-title":"Blood born viral infections, sexually transmitted diseases and latent tuberculosis in italian prisons: A preliminary report of a large multicenter study","volume":"16","author":"Sagnelli","year":"2012","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Gardini, I., Bartoli, M., Conforti, M., Mennini, F.S., and Marcellusi, A. (2019). Estimation of the number of HCV-positive patients in Italy. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0223668"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Fiore, V., De Vito, A., Pontali, E., Lucania, L., Madeddu, G., and Babudieri, S. (2021). Chronic viral hepatitis in the italian prison setting: Prevalence, outcomes, literature needs and perspectives. Healthcare, 9.","DOI":"10.3390\/healthcare9091186"},{"key":"ref_17","unstructured":"Agenzia Italiana del Farmaco (AIFA) (2023, January 28). Registri AIFA per il Monitoraggio dei Farmaci Anti-HCV, Available online: https:\/\/www.aifa.gov.it\/aggiornamento-epatite-c."},{"key":"ref_18","unstructured":"Agenzia Italiana del Farmaco (AIFA) (2023, January 28). Determina 8 Ottobre 2019 (n. 1454\/2019), Available online: https:\/\/www.aifa.gov.it\/documents\/20142\/847506\/Determina_1454-2019_HCV.pdf\/3f01e631-acd0-907d-a66a-4a76ab781632?t=1571314830432."},{"key":"ref_19","first-page":"3","article-title":"Eliminazione dell\u2019epatite C cronica in Italia. Strategie di screening gratuito","volume":"34","author":"Kondili","year":"2021","journal-title":"Not. Dell\u2019istituto Super. Sanit\u00e0"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"103055","DOI":"10.1016\/j.drugpo.2020.103055","article-title":"HCV testing and treatment initiation in an Italian prison setting: A step-by-step model to micro-eliminate hepatitis C","volume":"90","author":"Fiore","year":"2021","journal-title":"Int. J. Drug Policy"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"7824","DOI":"10.3748\/wjg.v22.i34.7824","article-title":"Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes","volume":"22","author":"Petruzziello","year":"2016","journal-title":"World J. Gastroenterol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1002\/hep.26387","article-title":"Incidence and prevalence of hepatitis C in prisons and other closed settings: Results of a systematic review and meta-analysis","volume":"58","author":"Larney","year":"2013","journal-title":"Hepatology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1080\/20477724.2016.1253532","article-title":"Impact of HIV infection in patients infected with chronic HCV (genotypes 1a and 3a): Virological and clinical changes","volume":"110","author":"Behzadpour","year":"2016","journal-title":"Pathog. Glob. Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/j.jhep.2017.07.025","article-title":"Hepatocellular carcinoma risk following direct-acting antiviral HCV therapy: A systematic review, meta-analyses, and meta-regression","volume":"67","author":"Waziry","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1016\/S0140-6736(16)30379-8","article-title":"Clinical care of incarcerated people with HIV, viral hepatitis, or tuberculosis","volume":"388","author":"Rich","year":"2016","journal-title":"Lancet"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1111\/jvh.12998","article-title":"A systematic review on models of care effectiveness and barriers to Hepatitis C treatment in prison settings in the EU\/EEA","volume":"25","author":"Vroling","year":"2018","journal-title":"J. Viral Hepat."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/j.dld.2020.02.012","article-title":"Hepatitis C virus infection in jail: Difficult-to-reach, not to-treat. Results of a point-of-care screening and treatment program","volume":"52","author":"Masarone","year":"2020","journal-title":"Dig. Liver Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1639","DOI":"10.1038\/s41395-018-0157-x","article-title":"Microenvironment Eradication of Hepatitis C: A Novel Treatment Paradigm","volume":"113","author":"Cuadrado","year":"2018","journal-title":"Am. J. Gastroenterol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1111\/jvh.13376","article-title":"HCV micro-elimination in two prisons in Milan, Italy: A model of care","volume":"27","author":"Giuliani","year":"2020","journal-title":"J. Viral Hepat."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.drugpo.2018.06.017","article-title":"Treatment with direct-acting antivirals in a multicenter cohort of HCV-infected inmates in Italy","volume":"59","author":"Pontali","year":"2018","journal-title":"Int. J. Drug Policy"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"8011","DOI":"10.3748\/wjg.v19.i44.8011","article-title":"Addicts with chronic hepatitis C: Difficult to reach, manage or treat?","volume":"19","author":"Zanini","year":"2013","journal-title":"World J. Gastroenterol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/1\/104\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:49:01Z","timestamp":1760104141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/21\/1\/104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,17]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["ijerph21010104"],"URL":"https:\/\/doi.org\/10.3390\/ijerph21010104","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,17]]}}}