[Reasons for not initating HCV treatment in prison: a subanalysis of the EPIBAND study].

2011 
Objective: This sub-analysis was designed within the framework of the EPIBAND study to establish the reasons why prison patients do not initiate HCV treatment. Methods: Epidemiological, prospective, multicentre study conducted in 26 centres. We present the results from those patients included in the EPIBAND study who did not initiate HCV treatment for different reasons. Results: A total of 195 patients were evaluated (average age 39±6.6 years, 86.7% male and 96.9% Spanish nationality). The reasons why this population did not initiate HCV treatment were secondary ones relating to the patient (41%), medical reasons (30.8%), and the prison environment (3.6%). 47.5% of patients reported lack of awareness and motivation, and 18.8% did not initiate treatment as a result of adverse events. Immunological status (35%) as well as psychiatric and neurological disorders (28.3%) were the main medical reasons for contraindication. Aspects associated to prison environment such as impending release or change of prison (64.4%) were among the various reasons that influenced treatment initiation. Conclusions: Lack of motivation and awareness in patients as well as adverse events were the main reasons for not initiating therapy. These factors are subjective, modifiable aspects that depend on patient education and adequate medical care.
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