Prospective Evaluation of Blood Borne Virus Testing in Custody Suites in North-East England

Drug-related crime is a common reason for arrest. Therefore, some arrested individuals are at risk of hepatitis C virus infection (HCV). We present the outcomes of a blood borne virus (BBV) testing programme in custody suites in North-East England. Individuals reviewed in healthcare departments of three custody suites were offered dry blood spot BBV testing for HCV, hepatitis B (HBV) and human immunodeficiency virus (HIV) between July 2021 and June 2024. Data were collected prospectively on numbers tested, virology results and treatment outcomes. In total, 582 had BBV testing (508 [87%] valid HCV antibody and HCV RNA tests). Overall, 13% (64) had a detectable HCV antibody and 6% (31) had detectable HCV RNA indicating active HCV infection. Of these, 12 (39% of HCV RNA positive; 2.3% of all tested) were newly identified infections. Twenty-four individuals (77%) commenced antiviral treatment. Six individuals did not start antiviral treatment because of non-engagement, and one is in treatment workup. Of the 33 HCV antibody-positive, but RNA-negative individuals, 20 (61%) had previous antiviral treatment and achieved SVR, nine (27%) were thought to have spontaneously cleared the infection and four (12%) were on treatment at the time of testing. There were no cases of HBV or HIV identified. Dry blood spot testing for BBVs in custody suites is feasible and identifies a high proportion with active HCV infection, with the majority commencing antiviral treatment. Viral hepatitis services should consider expanding BBV testing to custody suites to help work towards HCV elimination.