Theme: Epidemiology & Public Health Research Year: 2024
Background: In South African correctional centres hepatitis B (HBV) and hepatitis C virus (HCV) testing and treatment is not routinely provided. We aimed to assess the feasibility of integrating viral hepatitis services in an HIV programme at a correctional services facility in Cape Town, South Africa from June 2021 to March 2022.
Methods: We provided virtual training to clinical and project support staff. HBV and HCV point-of-care (POC) tests, HBV vaccines, direct acting antivirals (DAAs) and antiretroviral medications were procured. Confirmatory testing was performed using a private laboratory. Operational meetings and virtual support sessions with hepatologists supported implementation and clinical management. All data was analyzed using descriptive statistics. Thematic analysis was used to identify challenges and successes.
Results: Overall, 765 people participated, with no one declining. HBV, HBV-HIV and HCV prevalence was 3.9% (30/765); 1.2% (9/765) and 0.5% (3/665), respectively. For HBV, 14 were monitored, 13 were placed on treatment and 3 were released prior to work-up. For HCV, 3 initiated DAAs, with 2 lost to follow-up. Overall, 27.3% (201/735) of eligible participants received at least one HBV vaccine; 5 declined vaccination and 38 were released prior to vaccination. Further, 48.8% (98/201) received two and 26.9% (54/201) received three doses. Nine cases were discussed with hepatologists and two required referral to a tertiary clinic. No clinical adverse events were reported. One hundred HCV POC tests that were ordered and received at the central store were unaccounted for at the implementing site, resulting in not all participants receiving HCV testing.
Conclusion: There was notable viral hepatitis burden in the facility. Services were feasibly integrated and accessed by people in the facility. Enhanced procurement systems, use of the public laboratory system, increased access to DAAs and HBV vaccine and coordinated referrals for people released from facilities could enable successful hepatitis service expansion.