A hepatitis C virus (HCV) screening and treatment program was conducted in Hungarian
prisons on a voluntary basis. After HCV-RNA testing and genotyping for anti-HCV positives,
treatments with direct-acting antiviral agents were commenced by hepatologists who
visited the institutions monthly. Patients were supervised by the prisons' medical
staff. Data were retrospectively collected from the Hungarian Hepatitis Treatment
Registry, from the Health Registry of Prisons, and from participating hepatologists.
Eighty-four percent of Hungarian prisons participated, meaning a total of 5779 individuals
(28% of the inmate population) underwent screening. HCV-RNA positivity was confirmed
in 317/5779 cases (5.49%); 261/317 (82.3%) started treatment. Ninety-nine percent
of them admitted previous intravenous drug use. So far, 220 patients received full
treatment and 41 patients are still on treatment. Based on the available end of treatment
(EOT) + 24 weeks timepoint data, per protocol sustained virologic response rate was
96.8%. In conclusion, the Hungarian prison screening and treatment program, with the
active participation of hepatologists and the prisons' medical staff, is a well-functioning
model. Through the Hungarian experience, we emphasize that the "test-and-treat" principle
is feasible and effective at micro-eliminating HCV in prisons, where infection rate,
as well as history of intravenous drug usage, are high.
