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Detection, stratification, and treatment of hepatitis C positive prisoners in the United Kingdom prison estate: Development of a pathway of care to facilitate the elimination of hepatitis C in a London prison

Connoley, D; Francis-Graham, S; Storer, M; Ekeke, N; Smith, C; Macdonald, D; Rosenberg, W; (2020) Detection, stratification, and treatment of hepatitis C positive prisoners in the United Kingdom prison estate: Development of a pathway of care to facilitate the elimination of hepatitis C in a London prison. Journal of Viral Hepatitis , 27 (10) pp. 987-995. 10.1111/jvh.13336. Green open access

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Abstract

The United Kingdom is committed to eliminating hepatitis C virus (HCV) infection by 2025. The prison estate provides an opportunity to identify and treat HCV‐positive individuals in a high‐prevalence environment. We designed and implemented a pathway of care within a London prison to diagnose, stratify and link HCV‐positive prisoners into care. This study was a two‐phase case study of a HCV care pathway. New arrivals to the prison were offered blood‐borne virus screening with dried blood spot testing at their secondary health check. Those with active infection completed disease stratification tests and were reviewed at a weekly hospital‐based multidisciplinary team meeting to determine management. In Phase‐2, the pathway was redesigned to improve testing and the referral of HCV‐positive prisoners into treatment. Over the 30‐month evaluation period, 12,946 people were received in the prison. During Phase‐1, 19.6% of new arrivals completed blood‐borne virus testing, with 7.3% identified as HCV‐positive. Just 8.3% of HCV‐positive individuals were treated or referred for treatment in Phase‐1. During Phase‐2, 30% of new receptions completed BBV testing and 3.9% were identified as HCV‐positive. Linkage into care was improved, with 38.9% treated or referred during the second phase. Poor access to testing and referral to treatment limit the effectiveness of care provision for prisoners with HCV. Elimination of HCV in prisons requires local service configuration to ensure high uptake of testing, with all HCV‐positive cases then offered treatment during custody or referral on to treatment after release.

Type: Article
Title: Detection, stratification, and treatment of hepatitis C positive prisoners in the United Kingdom prison estate: Development of a pathway of care to facilitate the elimination of hepatitis C in a London prison
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/jvh.13336
Publisher version: https://doi.org/10.1111/jvh.13336
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
URI: https://discovery.ucl.ac.uk/id/eprint/10099254
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