Theme: Models of Care Year: 2024
Background: In November 2022 The Hepatitis C (HCV) Inreach service in Cork Prison was developed under the governance of Cork University Hospital (CUH). There are now two pathways through which HCV treatment can be accessed in Cork Prison – the Inreach service for individuals who fit the inclusion criteria, or alternatively individuals can also be treated in the prison once they have been reviewed by the Hepatology service in CUH.
Description of model of care/intervention/program: All Prisoners who availed of screening between September 2022 and February 2024 were included in the audit. A database is maintained of all individuals treated for HCV. A review of this was conducted.
Effectiveness: 250 Prisoners were screened for HCV in Cork Prison between September 2022 and February 2024. 11.6% (n=29) were antibody positive, of which 86.2% (n=25) were HCV positive. To date 92% (n=23) of these have been commenced on treatment.
82.6% (n=19) have commenced treatment in the prison through the Inreach pathway and 13% (n=3) through the CUH pathway. 1 individual was treated in CUH outpatients after release from the prison. A sustained virological response (SVR) has been achieved by 56.5% (n=13). 1 individual has been lost to follow up and 1 individual failed therapy. The remaining individuals are awaiting SVR (n=8).
Conclusion and next steps: The Inreach service has provided direct access to treatment while individuals are in custody. Engagement from the prison staff and healthcare staff in the prison is essential. Identified barriers include early release from the prison and a shortage of staff for screening in the prison. Implementation of a standardised screening programme in prison setting is required to optimize the screening and subsequent treatment of individuals infected with HCV.
Disclosure of Interest Statement:
No pharmaceutical grants or funding from any sources were received in the development of this study.