Long-term outcomes of a decentralized, nurse-led, statewide model of care for hepatitis C among people in prison in Victoria, Australia

Prisons provide a key strategic opportunity to upscale hepatitis C testing and treatment in a high prevalence setting and are crucial for elimination efforts. A decentralized, statewide nurse-led model of care offering hepatitis C treatment for people in prison was implemented in Victoria, Australia...

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Bibliographic Details
Published in:	Clinical infectious diseases
Main Authors:	MacIsaac, Michael B, Papaluca, Timothy, McDonald, Lucy, Craigie, Anne, Edwards, Amy, Layton, Chloe, Gibson, Annabelle, Winter, Rebecca J, Iyer, Kiran, Sim, Abigail, Evans, Sophia, Kumaragama, Kavindu, Howell, Jessica, Desmond, Paul, Iser, David, Scott, Nick, Hellard, Margaret, Stoové, Mark, Wilson, David, Pedrana, Alisa, Doyle, Joseph S, Holmes, Jacinta A, Thompson, Alexander J
Format:	Journal Article
Language:	English
Published:	United States 16-09-2024
Subjects:	persons who inject drugs direct acting antiviral Hepatitis C virus elimination prison
Online Access:	Get full text
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Summary:	Prisons provide a key strategic opportunity to upscale hepatitis C testing and treatment in a high prevalence setting and are crucial for elimination efforts. A decentralized, statewide nurse-led model of care offering hepatitis C treatment for people in prison was implemented in Victoria, Australia in 2015. The program provides hepatitis C care to all 14 adult prison sites in the jurisdiction. We prospectively evaluated treatment uptake between 1 November 2015 and 31 December 2021. Data on all people in prison treated were recorded in a clinical database. The primary outcomes were i) total number of people in prison with hepatitis C treated; ii) total number of DAA treatment courses. 3,133 DAA treatment courses were prescribed to 2,768 people in prison. The proportion of total Victoria DAA prescriptions the program was responsible for increased from 6% in 2016 to a peak of 23% in 2020. Of those treated, median age was 39 years, 91% were male and 9% had cirrhosis. Few (20%) had previously engaged in hepatitis C care in the community and at first treatment course in prison, only 6% had previously accessed hepatitis C treatment. Complete follow up data were available for 1,757/2,768 (63%) treated, with 1,627/1,757 (93%) achieving SVR12. A decentralized, nurse-led, statewide model of care was highly effective in treating large numbers of people in prison with hepatitis C and achieved high rates of SVR12. Nurse-led prison programs are playing a crucial role in eliminating hepatitis C as a public health threat in Australia.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1058-4838 1537-6591 1537-6591
DOI:	10.1093/cid/ciae471