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High HCV burden in Canadian prisons requires increased attention
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In a recent commentary, experts argued that the high estimated burden of hepatitis C virus affecting incarcerated Canadians warrants an increased focus on prevention efforts and linkage to community programs upon release.
“Incarcerated individuals are more likely to be infected with [HCV] and more likely to continue the transmission cycle because of their involvement in risky behaviors such as sharing needles,” Fiona G. Kouyoumdjian, MD, MPH, PhD, postdoctoral fellow at the Center for Research on Inner City Health at St. Michael’s Hospital in Toronto, said in a press release. “Time in custody is a unique opportunity for health care workers to offer prevention activities to people who may otherwise be difficult to reach.”
Fiona G. Kouyoumdjian
Using a recent analysis from the Public Health Agency of Canada, Kouyoumdjian and co-investigator Kathryn E. McIsaac, MSc, PhD, also of the Center for Research on Inner City Health, estimated that 17.2% of the 150,977 people in provincial and territorial facilities and 17.8% of the 13,758 people in federal custody have chronic HCV infection. Taken in the context of the national HCV burden, this would imply that between one in eight and one in nine of all Canadians with chronic HCV spend time in a correctional facility annually.
Because this population is associated with a high prevalence of injection drug use, Kouyoumdjian and McIsaac wrote that prevention efforts are necessary to limit ongoing transmission within this significant population. Although not currently implemented in Canadian correctional facilities, they suggested prison needle exchange programs as a more effective primary prevention effort than bleach decontamination of syringes. Systematic screening, individual initiation of HCV treatment, and linkage to community care once released also were suggested by the investigators as worthwhile efforts to improve the national burden of HCV.
“Any strategy addressing [HCV] in Canada should include a focus on people who experience incarceration,” Kouyoumdjian said in the release. “Identifying and managing [HCV] in incarcerated individuals can prevent the progression of the disease in infected individuals, and can have a positive effect in society, by reducing transmission rates and health care costs.” – by Dave Muoio
Disclosure: The researchers report no relevant financial disclosures.
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