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Volume 30, Supplement - Infectious Diseases and Carceral Health

SUPPLEMENT ISSUE
Prevention

Advancing Hepatitis C Elimination through Opt-Out Universal Screening and Treatment in Carceral Settings, United States

Maeve McNamaraComments to Author , Nathan Furukawa, and Emily J. Cartwright
Author affiliations: Emory University, Atlanta, Georgia, USA (M. McNamara, E.J. Cartwright); Centers for Disease Control and Prevention, Atlanta (N. Furukawa, E.J. Cartwright); Veterans Affairs Atlanta Health Care System, Decatur, Georgia, USA (E.J. Cartwright)

Main Article

Table 1

Real-world examples of opt-out screening for hepatitis C virus in prisons and jails used to advance hepatitis C elimination in carceral settings, United States*

Reference Institution Years Population Policy Outcome
(19)†
 Pennsylvania state prisons
 2004–2012
 101,727 persons entering state prison
 Universal opt-out testing at intake; diagnostic testing offered to persons with positive screening tests and subsequent evaluation for HCV therapy (only seropositivity rates reported).
 A total of 101,727 persons were tested for HCV; of those, 18,454 (18.1%) were HCV positive.
(25)
 Washington state prisons
 2012–2016
 24,567 persons entering state prison
 Universal opt-out, laboratory-based HCV testing
 A total of 24,567 (83%) persons were screened for HCV; of those, 4,921 (20%) were HCV positive. Of the 4,921 HCV-positive patients, 2,403 (49%) had hepatitis C virus RNA testing; 1,727 of 2,403 (72%) had HCV viremia.
(51)‡
 NYC jails
 2014–2017
 121,371 persons with >1 admission to the NYC jail system
 Opt-out HCV testing for a subset of jail entrants
 A total of 40,219 (33%) persons were tested for HCV; of those, 4,665 (12%) were positive for HCV viremia and 248 (5%) were treated.
(52) Durham County, NC, jail in collaboration with Durham Department of Public Health Dec 2012–Mar 2014 669 persons entering local jail (5.6% of all entrants) Opt-out HCV testing for a subset of jail entrants A total of 669 (5.6%) persons were tested for HCV; of those, 88 (13.2%) were HCV positive. Of those 88 patients, 81 (92.0%) were tested for HCV RNA; 66 of 81 (81.5%) had HCV viremia. Of the 66 with viremia, 18 (27.3%) were referred to post-release medical care, 10 (55.6%) of whom attended their first appointment.

*HCV positive refers to a positive or reactive test for HCV antibodies, indicating current or prior exposure to HCV. Viremia is defined as a positive serum HCV RNA test. HCV, hepatitis C virus; NYC, New York, NY. †Does not include any data on RNA testing or HCV viremia. ‡Excluded persons who completed DAA treatment, started DAA treatment in the community, or who did not complete medical intake; this study only includes data for RNA testing and HCV viremia and excludes information on HCV antibody testing.

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Page created: December 31, 2023
Page updated: March 31, 2024
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