Background:
National Health Service England (NHSE) plans to eliminate hepatitis C virus (HCV) by 2025. To support this programme, a partnership between Gilead Sciences, Practice Plus Group (PPG) and the Hepatitis C Trust (HCT) was formed in 2019. PPG currently provides healthcare to 52 male prisons and 5 female prisons in England. Although the focus of the programme was HCV, there is an unmet need regarding hepatitis B virus (HBV) and hepatitis D virus (HDV) testing and linkage to care pathways.
Description of intervention:
Gilead Sciences and PPG created a pilot project to investigate and optimise the screening and linkage to care (SLTC) of patients with HBV and with HDV in 3 prisons and 1 immigration removal centre (IRC). The aims were to benchmark these prisons and IRC in terms of the prevalence of HBV and HDV and to determine what changes were required to optimise the SLTC pathways.
Effectiveness:
The prison electronic patient record system did not have a dedicated data entry for HDV so this was created for the pilot project. For the HBV data, an audit revealed several errors and potential confusion regarding the recording of HBV blood test results. Additional data monitoring and validation was initiated. Initial results for the first two months of the project are shown in Figure 1.
Conclusion and next steps:
In the first 2 months of the pilot, the prevalence of HBV in the 3 prisons was 0.45% (which is similar to that of the general population in the UK) compared to 1.00% in the IRC. In the IRC, the prevalence of HDV antibodies in the HBV positive patients was 8% (1/12). Initial results indicate that more work is needed to improve and optimize HBV and HDV testing and linkage to care in prisons and IRCs. |