Consensus recommendations on the management of hepatitis C in Australia's prisons

Abstract

Introduction:Prison settings represent the highest concentration of prevalent hepatitis C cases in Australia due to the high rates of incarceration among people who inject drugs. Highly effective direct-acting antiviral (DAA) therapies for hepatitis C virus (HCV) infection are available to people incarcerated in Australian prisons. However, multiple challenges to health care implementation in the prison sector present barriers to people in prison reliably accessing hepatitis C testing, treatment, and prevention measures.

Contribution of prison-based hepatitis C treatment initiations to overall treatment uptake in Victoria, Australia

“…In the state of Victoria, the estimated hepatitis C infection prevalence is 0.65%, 4 but estimated at 20% in prison among approximately 7000 incarcerated individuals. 2 , 5 , 6 In Victoria, following a positive HCV RNA test, DAAs can be prescribed to people by general practitioners, specialists and by nurse practitioners. In 14 Victorian prisons, opt-in viral hepatitis screening is offered at reception.…”

“… 15 , 16 But in the absence of prison needle and syringe programs and high coverage of opioid agonist therapy, incident infection and reinfection in prisons can be minimised through more convenient and streamlined point-of-care testing at reception. 6 …”