SCREENING AND LINKAGE TO CARE FOR BBVS IN IRCS IN ENGLAND

Author: Abraham K, Royal N, Missen L, Taylor C, Gaskin N

Theme: Models of Care Year: 2025
Background:
In the UK, there are 7 Immigration Removal Centres (IRCs) with ~18,000 individuals being detained in 2024. Prevalence of blood borne viruses (BBV) in IRCs is poorly understood but people in UK foreign national prisons have been shown to have higher BBV prevalence than in the general prison population. As a result of this IRCs are potentially an important place to test for BBVs. Barriers to BBV testing include fast turnover of residents and hesitancy to treat due to risk of deportation.

Description:
As part of National Health Service England (NHSE) plans to eliminate HCV in England by 2025, Practice Plus Group (PPG) and Gilead Sciences formed a partnership in 2019 to optimise HCV test and treat in their secure settings.

Following a successful pilot in 2022, opt-out BBV screening has been implemented at 3 IRCs where PPG provides healthcare (with a population of ~1200) and the Hepatitis C Trust provide an IRC support worker who attends sites to support staff and individuals. Data have been reviewed to ascertain offer and uptake of screening and HCV prevalence in 2024.

Effectiveness:
The number of residents tested for HCV within 7 days of entry to the IRC and the proportion of the population who have a documented test for HCV within the past 12 months were comparable to the overall prison population. Linkage to care was high with 86% of eligible patients initiating treatment for HCV in 2024. HCV antibody prevalence was 2.7% and HCV RNA prevalence was 0.66% of total population.

Conclusion:
This pilot demonstrates that HCV screening in IRCs is feasible and increases likelihood of identifying positive cases of HCV with testing and linkage to care being comparable to prison sites in England.
 Updated data on prevalence and testing for HBV and HIV will be available at the conference.
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