Best practice guidelines for viral hepatitis service delivery in prisons

Viral hepatitis constitutes a major health burden among people living in prison globally. There is poor access to prison-based viral hepatitis services, and people living in prison are rarely prioritised for care, undermining global elimination efforts. This Review is a narrative summary of the first Global Guidelines for Viral Hepatitis Service Delivery in Prisons, which included a systematic review and an expert-led GRADE process to develop best practice recommendations for viral hepatitis management in prisons. 703 articles were included, underpinning the development of 30 recommendations across eight domains: policy, testing, treatment, continuity of care, prevention and harm reduction, education, minority populations and special considerations, and monitoring and evaluation. Quality of evidence and strength of recommendations were rated as A1 (n=5), B1 (n=7), C1 (n=10), D1 (n=7), and expert opinion (n=1). The guidelines aim to standardise a global approach to prison-based viral hepatitis elimination efforts with consistent policy, practice, and reporting.