{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T04:01:13Z","timestamp":1768881673629,"version":"3.49.0"},"reference-count":20,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gastroenterology Insights"],"abstract":"<jats:p>Background &amp; Aims: Hepatitis C virus (HCV) infection remains one of the most significant and lethal infectious diseases worldwide. Since the approval of the first direct-acting antiviral agent in 2013, the therapeutic landscape has changed dramatically, with SVR rates exceeding 95%. The WHO set the ambitious goal of achieving global HCV elimination in 2030. High-risk populations remain among the most challenging yet essential groups to treat in order to reach this objective. The aim of this study is to describe two distinct approaches targeting high-risk populations to advance HCV elimination. Methods: An observational study was conducted from April 2017 to August 2025, including patients evaluated and treated at Porto\u2019s correctional facility and Porto\u2019s addiction centers. All patients received DAA therapy, and the primary outcome was sustained virological response at 12 weeks post-treatment. Results: A total of 124 patients from the prison setting were included. Their mean age was 43.0 \u00b1 8.4 years, and all were males. Treatment with DAA resulted in an SVR of 99.2%. In addition, 43 patients from the addiction centers were included, with a mean age of 54.9 \u00b1 5.9 years, and the majority were males (86%). These patients achieved an SVR 12 of 97.7%. Conclusions: In two distinct and difficult-to-reach high-risk populations, we demonstrated that a tailored approach involving on-site evaluation and treatment of HCV infection is highly effective and may be crucial to achieving HCV elimination.<\/jats:p>","DOI":"10.3390\/gastroent17010006","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T14:58:54Z","timestamp":1768834734000},"page":"6","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reaching the Unreachable: Hepatitis C virus (HCV) Microelimination in Prisons and Addiction Centers"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0332-3844","authenticated-orcid":false,"given":"Rui","family":"Gaspar","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, 4200 Porto, Portugal"}]},{"given":"Rui","family":"Morgado","sequence":"additional","affiliation":[{"name":"Estabelecimento Prisional do Porto, Le\u00e7a do Balio, 4465-051 Porto, Portugal"}]},{"given":"Jorge","family":"Tavares","sequence":"additional","affiliation":[{"name":"Estabelecimento Prisional do Porto, Le\u00e7a do Balio, 4465-051 Porto, Portugal"}]},{"given":"Paula","family":"Portela","sequence":"additional","affiliation":[{"name":"Centro de Respostas Integradas do Porto Central, Porto, 4050-040 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9387-9872","authenticated-orcid":false,"given":"Guilherme","family":"Macedo","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, 4200 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"293","DOI":"10.7326\/M13-1133","article-title":"Chronic hepatitis C virus infection in the United States, National Health and Nutrition Examination Survey 2003 to 2010","volume":"160","author":"Denniston","year":"2014","journal-title":"Ann. Intern. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1111\/liv.14779","article-title":"Progress towards hepatitis C virus elimination in high-income countries: An updated analysis","volume":"41","author":"Gamkrelidze","year":"2021","journal-title":"Liver Int."},{"key":"ref_3","unstructured":"European Union HCV Collaborators (2017). Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030: A modelling study. Lancet Gastroenterol. Hepatol., 2, 325\u2013336."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1111\/jvh.12936","article-title":"Hepatitis C among vulnerable populations: A seroprevalence study of homeless, people who inject drugs and prisoners in London","volume":"25","author":"Aisyah","year":"2018","journal-title":"J. Viral Hepat."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2018). EASL Recommendations on Treatment of Hepatitis C 2018. J. Hepatol., 69, 461\u2013511.","DOI":"10.1016\/j.jhep.2018.03.026"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Fiore, V., Manca, V., Colpani, A., De Vito, A., Maida, I., Madeddu, G., and Babudieri, S. (2023). Facing HCV as a Major Public Healthcare Threat in Italy: Epidemiology and Micro-Elimination Pathways among Underserved Populations. Healthcare, 11.","DOI":"10.3390\/healthcare11142109"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1007\/s00705-022-05382-1","article-title":"Global prevalence of hepatitis C in prisoners: A comprehensive systematic review and meta-analysis","volume":"167","author":"Salari","year":"2022","journal-title":"Arch. Virol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S168","DOI":"10.1093\/infdis\/jiac446","article-title":"HCV Microelimination for High-risk Special Populations","volume":"228","author":"Huang","year":"2023","journal-title":"J. Infect. Dis."},{"key":"ref_9","unstructured":"Enggist, S., M\u00f8ller, L., Galea, G., and Udesen, C. (2014). Prisons and Health, WHO Regional Office for Europe."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1093\/cid\/ciy210","article-title":"Demonstration of near-elimination of hepatitis C virus among a prison population: The Lotus Glen Correctional Centre hepatitis C treatment project","volume":"67","author":"Bartlett","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.4254\/wjh.v12.i12.1314","article-title":"HIPPOCRATES\u00ae project: A proof of concept of a collaborative program for hepatitis C virus micro-elimination in a prison setting","volume":"12","author":"Gaspar","year":"2020","journal-title":"World J. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/S0140-6736(11)61097-0","article-title":"Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: Results of systematic reviews","volume":"378","author":"Nelson","year":"2011","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e1192","DOI":"10.1016\/S2214-109X(17)30375-3","article-title":"Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: A multistage systematic review","volume":"5","author":"Degenhardt","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/S2468-1253(19)30085-8","article-title":"The contribution of injection drug use to hepatitis C virus transmission globally, regionally, and at country level: A modelling study","volume":"4","author":"Trickey","year":"2019","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e1208","DOI":"10.1016\/S2214-109X(17)30373-X","article-title":"Global, regional, and country-level coverage of interventions to prevent and manage HIV and hepatitis C among people who inject drugs: A systematic review","volume":"5","author":"Larney","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1186\/s12954-021-00519-y","article-title":"Therapy of chronic hepatitis C in people who inject drugs: Focus on adherence","volume":"18","author":"Frankova","year":"2021","journal-title":"Harm Reduct. J."},{"key":"ref_17","unstructured":"(2020). European Association for the Study of the Liver; Clinical Practice Guidelines Panel: Chair:; EASL Governing Board Representative; Panel Members. EASL recommendations on treatment of hepatitis C: Final update of the series. J. Hepatol., 73, 1170\u20131218."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (2018). EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosis. J. Hepatol., 69, 406\u2013460.","DOI":"10.1016\/j.jhep.2018.08.009"},{"key":"ref_19","unstructured":"European Association for the Study of the Liver (2018). EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma. J. Hepatol., 69, 182\u2013236."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1002\/hep.510240201","article-title":"An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group","volume":"24","author":"Bedossa","year":"1996","journal-title":"Hepatology"}],"container-title":["Gastroenterology Insights"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7422\/17\/1\/6\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T15:21:38Z","timestamp":1768836098000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7422\/17\/1\/6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,19]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["gastroent17010006"],"URL":"https:\/\/doi.org\/10.3390\/gastroent17010006","relation":{},"ISSN":["2036-7422"],"issn-type":[{"value":"2036-7422","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,19]]}}}