A Report On Phase One Of The Prison Based Hepatitis C Seek And Treat Project In Ireland.

Author: Lambert JS, Crowley D, Cullen W, Keevans M, Kelly E, McHugh T, Mc Kiernan S, Miggin S, Murphy C, Van Hout MC

Theme: Epidemiology & Public Health Research Year: 2017

Background: People who inject drugs (PWID) account for over 85% of Hepatitis C Virus (HCV) infections in developed countries globally. There are an estimated 30,000-50,000 people chronically infected with HCV in Ireland with 80% having a history of injecting drug use (IDU). 43% of Irish male prisoners report a history of injecting drug use with Irish female prisoners reporting even higher rates (60%).The prevalence of HCV infection in Irish prisoners with a history of IDU is 81%. The Irish National HCV strategy (2014) identifies prisons as a key location to screen and treat HCV infection. Recent advances in HCV treatment have made HCV infection both curable and preventable. The challenge of engaging this marginalised patient group in HCV services remains. This project is the prison “Seek and Treat” component of a larger European based HepCare project aimed at engaging hard to reach, high risk patient cohorts with HCV care.
Methods: A descriptive report of phase one of the Irish prison based “Seek and Treat “project.
Results: Phase one was successfully completed within a ten-month time frame. It consisted of 10 focus groups (prisoners, local and senior clinical and operational staff and prison officers) which identified the blocks and enablers to HCV care in the Irish Prison Service. Data collected informed the planning and implementation of a mass HCV screening program involving operational and clinical staff utilising Red Cross Volunteers as peer support workers. 203 prisoners were screened, 167 who had not screened previously. Phase 2 will involve the fibroscanning and treatment of all prisoners known to be chronically infected.
Conclusion: This Irish based “Seek and Treat” model of prisoner HCV care has been shown to increase identification of HCV infected prisoners. The complexities of prison environments require a planned and coordinated approach to HCV care to optimise outcomes.

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