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

Desmond Crowley1,2, Ross Murtagh3, Walter Cullen3

  • 1Irish College of General Practitioners, Lincoln Place, Dublin 2, Ireland. doctordes@hotmail.com.

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|July 7, 2019
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Summary

Peer-supported screening effectively identifies Hepatitis C Virus (HCV) infections in prisons. This model successfully links infected prisoners to essential HCV care and treatment.

Keywords:
HCVHepatitis C virusPWIDPeer-supportPrisonScreening

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Area of Science:

  • Hepatology
  • Public Health
  • Infectious Diseases

Background:

  • Hepatitis C Virus (HCV) infection is prevalent in correctional facilities, with suboptimal management.
  • Incarceration presents a critical public health opportunity for HCV intervention.
  • Peer support models have proven effective in enhancing HCV screening and treatment uptake in community settings.

Purpose of the Study:

  • To evaluate peer-supported screening as an active case-finding strategy for HCV within a prison population.
  • To describe the HCV cascade of care, including linkage to treatment and outcomes, among infected prisoners.

Main Methods:

  • An observational study was conducted in an Irish male prison.
  • Methods included risk-based questionnaires, medical record review, peer-supported screening, HCV serology, and mobile elastography.
  • The study involved 538 inmates, with 419 participating in the screening initiative.

Main Results:

  • The initiative screened 419 prisoners, identifying 21% as HCV antibody-positive and 12% as HCV RNA-positive.
  • Among those with active infection, 86% were linked to HCV care, and 33% commenced or completed treatment.
  • A high concordance (96%) was observed between HCV disclosure at committal and serological testing.

Conclusions:

  • Peer-supported screening is an effective model for active HCV case finding in prisons.
  • This approach successfully identifies and links prisoners with untreated HCV infection to necessary care.