National Prisons Hepatitis Network – Facilitating enhanced infrastructure and scale-up of HCV treatment in Australian prisons: towards national elimination

Author: Sheehan Y, Byrne M, Lloyd AR

Theme: Models of Care Year: 2019

Australia is making good progress towards elimination of hepatitis C virus (HCV) infection. Along with
existing universal access to HCV testing, the 2016 listing of direct-acting antiviral (DAA) therapies on
the Australian Pharmaceutical Benefits Scheme (PBS) allowed universal access to highly subsidized
treatments for all individuals with HCV infection, including specific arrangements for prisoners.
Australian prisons have a high prevalence (~20%), ongoing transmissions (~10% per annum), and
relatively low treatment rates (less than 1% of those eligible in the interferon era). Against this
backdrop, prisons been identified as a key venue for HCV treatment scale-up.
Description of model of care/intervention:
The National Prisons Hepatitis Network was established to facilitate cross-jurisdictional
communication and knowledge exchange amongst key stakeholders to enhance efforts to scale-up
HCV testing and treatment in Australian prisons.
Led by an Executive Committee, stakeholders engage in regular communication and hold an annual
meeting to set national priorities, identify successes and key challenges, and to plan national
initiatives and collaborative research.
Several initiatives have been instigated by the Network, including: a national dashboard of prison
hepatitis services and DAA treatments; a national prisons hepatitis education project; and advocacy
at local and national levels for key infrastructure. In the first year of DAA access, 6% of all those
treated in Australia commenced in the prison sector. Across the country several prisons have
reported micro-elimination. Steady improvements in DAA treatment access are evident across the
majority of the ~100 prisons nationally.
Conclusion and next steps:
The NPHN has proven a successful platform for collaborative efforts, and for establishment of
national agendas to support the elimination goals. Improved surveillance remains an as yet
unrealized goal for the Network. This Australian initiative may serve as a template for other
countries and for formation of an international network.
Disclosure of Interest Statement:
The National Prisons Hepatitis Network receives funding from the Eliminate C Initiative, and has
received funding from AbbVie Pty Ltd. and Gilead Sciences for the development of the National
Prisons Education Project.

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