HCV Management in the Incarcerated Population: How Do We Deliver on This Important Front?

Crespo, Javier; Llerena, Susana; Cobo, Carmen; Cabezas, Joaquín; Cuadrado, Antonio

doi:10.1007/s11901-019-00472-2

Cited by 3 publications

(3 citation statements)

References 49 publications

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“…Bringing quickly actionable HCV testing closer to incarcerated people has been increasingly advocated in recent years. [33][34][35] The primary results reported here align with recent similar research. A study undertaken in HMP Wormwood Scrubs, England, reduced time from screening to treatment from 3 months, for those tested by DBS, to 1 week, by implementing PoC RNA testing and augmenting it with a streamlined care pathway.…”

Section: Discussionsupporting

confidence: 91%

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Mixed-methods evaluation of point-of-care hepatitis C virus RNA testing in a Scottish prison

et al. 2023

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ObjectivesHepatitis C virus (HCV) poses a global public health threat. Prisons are a focus of prevention efforts due to high infection burdens. Expedition of treatment for incarcerated people is critical, as many are short-term sentenced. We evaluated point-of-care (PoC) HCV RNA testing in a maximum-security Scottish prison and assessed its impact on transition to treatment. We also evaluated costs and determinants of implementation.DesignMixed-methods evaluation of a single-centre care pathway pilot using National Health Service (NHS) data from 2018 to 2021. Descriptive statistics and survival analysis were undertaken. Cost analysis was assessed from a provider perspective. Healthcare staff participated in semistructured interviews and thematic analysis with a deductive approach was undertaken to identify implementation determinants.SettingA large maximum-security Scottish prison health centre administered by the NHS.Participants296 incarcerated NHS patients (all men) and six NHS staff members (two men and four women).InterventionsHCV testing using the Cepheid GeneXpert platform with Xpert HCV VL Fingerstick assay.Outcome measuresThe main outcome was survival (in days) from HCV test to treatment initiation. Secondary outcomes were cost-per-cure obtained and implementation determinants.ResultsDuring the pilot, 167 Xpert tests were administered, with an 84% completion rate, and treatment transition was superior for those who received it (p=0.014). Where PoC tests were administered, shorter survival to treatment was observed (19 vs 33 days: adjusted HR (aHR) 1.91 (1.03–3.55), p=0.040; 19 vs 50 days; aHR 3.76 (1.67–8.46), p=0.001). PoC was costlier than conventional testing. In qualitative analysis, most facilitators were observed among characteristics of individual domain while most barriers were noted in the inner setting.ConclusionsIntegrating PoC HCV RNA diagnosis into nurse-led HCV care in a maximum-security prison health centre shortens survival to HCV treatment. However, there are cost implications to this approach and multiple determinants that impact on implementation should be addressed.

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Section: Discussionsupporting

confidence: 91%

“…Bringing quickly actionable HCV testing closer to incarcerated people has been increasingly advocated in recent years 33–35. The primary results reported here align with recent similar research.…”

Section: Discussionsupporting

confidence: 86%

Mixed-methods evaluation of point-of-care hepatitis C virus RNA testing in a Scottish prison

et al. 2023

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“…37 Testing strategies should also be quick and accessible. 38 The traditional approach of onsite venipuncture and specimen shipment for diagnostic laboratory testing at a distant site typically has turnaround times of 1-2 weeks. In the latter context, reflex testing offers the significant advantage of avoiding repeated cycles of testing and results over many weeks.…”

Section: Ensuring Access To Hcv Diagnosis and Testingmentioning

confidence: 99%

Hepatitis C elimination among people incarcerated in prisons: challenges and recommendations for action within a health systems framework

Akiyama

Kronfli

Cabezas

et al. 2021

The Lancet Gastroenterology & Hepatology

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Telemedicine efficiently improves access to hepatitis C management to achieve HCV elimination in the penitentiary setting

Cuadrado

Cobo²,

Mateo³

et al. 2021

International Journal of Drug Policy

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HCV Management in the Incarcerated Population: How Do We Deliver on This Important Front?

Cited by 3 publications

References 49 publications

Mixed-methods evaluation of point-of-care hepatitis C virus RNA testing in a Scottish prison

Mixed-methods evaluation of point-of-care hepatitis C virus RNA testing in a Scottish prison

Hepatitis C elimination among people incarcerated in prisons: challenges and recommendations for action within a health systems framework

Telemedicine efficiently improves access to hepatitis C management to achieve HCV elimination in the penitentiary setting

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