Evaluating peer-supported screening as a hepatitis C case-finding model in prisoners

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Evaluating peer-supported screening as a hepatitis C case-finding model in prisoners

Authors

Crowley, D.,Murtagh, R.,Cullen, W.,Keevans, M.,Laird, E.,McHugh, T.,McKiernan, S.,Miggin, S. J.,O'Connor, E.,O'Reilly, D.,Betts-Symonds, G.,Tobin, C.,Van Hout, M. C.,Lambert, J. S.

Citation
2019
Harm Reduction Journal

16

42
Type
Prospective cohort
Virus targets
Hepatitis C
Other targets
HIV
Interventions
HCV testing and linkage to Care
Linkage to care
Screening and diagnosis
Testing
Setting
National
Target populations
Incarcerated populations (current and former)
Country of development
Ireland
Target location
Ireland
DOI
https://doi.org/10.1186/s12954-019-0313-7
Testing strategy
Laboratory-based antibody test,Laboratory-based PCR/RNA (confirmatory) test
Laboratory-based antibody test
Laboratory-based PCR/RNA (confirmatory) test
Countries of included studies
Ireland

Health outcomes

Linkage to care

Testing strategy

Laboratory-based antibody test,Laboratory-based PCR/RNA (confirmatory) test

Abstract

Background: Hepatitis C Virus (HCV) infection is endemic in prison populations, and HCV management in prisons is suboptimal. Incarceration is a public health opportunity to target this cohort. Community peer support increases HCV screening and treatment uptake. Prison peer workers have the potential to support the engagement of prisoners with health services and reduce stigma. This study's primary aim is to evaluate peer-supported screening as a model of active HCV case finding with a secondary aim to describe the HCV cascade among those infected including linkage to care and treatment outcomes. Method(s): An observational study was conducted in a medium-security Irish male prison housing 538 inmates, using a risk-based questionnaire, medical records, peer-supported screening, laboratory-based HCV serology tests and mobile elastography. Result(s): A prison peer-supported screening initiative engaged large numbers of prisoners in HCV screening (n = 419). The mean age of participants was 32.8 years, 92% were Irish and 33% had a history of injecting drug use. Multiple risk factors for HCV acquisition were identified including needle sharing (16%). On serological testing, 87 (21%) were HCV Ab +ve and 50 (12%) were HCV RNA +ve of whom 80% were fibroscaned (25% showing evidence of liver disease). Eighty-six percent of those with active infection were linked with HCV care, with 33% undergoing or completing treatment. There was a high concordance with HCV disclosure at committal and serological testing (96% for HCV Ab +ve and 89% for HCV Ab -ve). Conclusion(s): Peer-supported screening is an effective active HCV case-finding model to find and link prisoners with untreated active HCV infection to HCV care. Copyright © 2019 The Author(s).

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22 Jan 2021