Treating prisoners for HCV necessary to eliminate disease worldwide

Due to incarceration driving transmission of hepatitis C, treating inmates with the disease would significantly boost WHO’s goal of eliminating viral hepatitis worldwide by 2030, according to presentations at the 5th International Symposium on Hepatitis Care in Substance Abusers.

“It is clear from our modelling that incarceration is a very important driver of HCV transmission in many settings. It is unlikely that it will be controlled without focusing prevention and control measures on incarcerated individuals and those being released from prison,” Peter Vickerman, BSc, DPhil, infectious diseases modeling professor at Bristol University, United Kingdom, said in a press release.

Vickerman presented a model analysis that mirrored HCV transmissions in prison environments in Thailand, Ukraine, Scotland and Australia. He suggested prisons could largely be responsible for HCV incidence in these countries and prevention programs and treatment of soon-to-be-released prisoners could lower the infection rate.

“If we can turn prisons around, and use them to treat [HCV] rather than facilitate its spread, then we can save lives, reduce the overall burden of disease and take concrete steps towards disease elimination,” Andrew Lloyd, MD, professor of infectious diseases at the University of New South Wales in Australia, said in a press release.

In a separate presentation, Lloyd discussed a pilot program where trained nurses performed evaluations on inmates with HCV before they developed severe fibrosis. Most patients received direct-acting antiviral prescriptions without ever seeing a specialist. The program — deemed “safe and effective”, according to Lloyd — was designed to allow inmates to receive treatment and was implemented in 34 prisons in New South Wales. Treating inmates with DAA medications could help stop prisons from acting as “incubators” of HCV, according to Lloyd.

“Despite residual challenges, prison health services are well placed to deliver treatment to many people with HCV and make a major contribution to the global elimination strategy,” Lloyd wrote. – by Janel Miller

Reference:

Lloyd A, et al. Workshop 3: HCV Testing and Care in Prisons. Presented at: 5th International Symposium on Hepatitis Care in Substance Users; Sept. 7-9, 2016; Oslo, Norway.

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