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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)

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Table 2

Real-world examples of direct-acting antiviral treatment in prisons and jails that advance hepatitis C elimination through opt-out universal screening and treatment in carceral settings, United States*

Reference Institution Years Population Policy Outcome
(53)
 Vermont Department of Corrections
 2018–2020
 HCV-infected patients (n = 217) in Vermont state prisons; 76% had opioid use disorder, 67% had a psychiatric comorbidity, and 9% had cirrhosis.
 DAA treatment was initiated for all persons with positive HCV antibody and RNA tests.
 A total of 217 (59%) persons started DAA treatment; of those, 129 (92%) completed treatment and 182 (84%) achieved documented SVR. Presence of psychiatric comorbidity and receipt of MOUD was not significantly associated with achieving SVR12.
(51) NYC jails, services provided by Correctional Health Services Jan 2014–Oct 2017 HCV-infected patients (n = 269) who were treated with DAA therapy while in NYC jail. DAA treatment was initiated in all persons with sentence lengths greater than anticipated duration of therapy. Treatment was continued for all persons who were on DAAs in the community at the time of entry. A 7-day supply of medication was given to persons returning to the community before treatment completion. 269 persons, 88 (33%) persons continued DAA treatment started in the community and 118 (67%) persons started DAA treatment prescribed in jail. SVR data is available for 195 (72%) persons; of those, 172 (88%) achieved SVR12.

*DAA, direct-acting antiviral; HCV, hepatitis C virus; MOUD, medications for opioid use disorder (such as naltrexone or buprenorphine); NYC, New York, NY; SVR, sustained virologic response; SVR12, sustained virologic response 12 months after completing treatment (no detectable HCV RNA in blood).

Main Article

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