Viral Hepatitis Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Northumbria University, Sutherland Building, Ellison Place, Newcastle upon Tyne, United Kingdom.
Public Health England, PHE North East, Waterfront 4, Newcastle upon Tyne, United Kingdom.
G4S Health Services, Chelmsford, United Kingdom.
NHS England (Cumbria and the North East), Darlington, United Kingdom.
Department of Infection and Tropical Medicine, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle-upon-Tyne, NE1 4LP, UK.
Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
With recent advances in anti-viral therapy there is an opportunity to eliminate HCV from the UK population. HCV is common in incarcerated individuals, with previous estimates suggesting ~7% of the UK prison population is anti-HCV antibody positive. Increasing diagnosis and treatment of HCV in prison is a priority in seeking to eliminate transmission in the general population. Thus the study aimed, to assess the impact implementation of: 1. A universal offer of blood borne virus testing (UOBBVT) using dry blood spot testing for prisoners at reception to increase diagnosis; 2. Telemedicine clinics (TC) within North East England (NEE) prisons to increase HCV treatment rates. UOBBVT was initially implemented at Her Majesty's Prison (HMP) Durham, commencing March 2016. From March 2016 to February 2017, 2,831 of 4,280 (66%) new receptions were offered BBV testing. Of these, 1,495 (53% of offered) accepted BBV testing, of whom 95 (6.4%) were HCV antibody positive, with 47 of those 95 (49.5%) HCV RNA positive, suggesting a prevalence of active infection in the tested population of 3.1% (95% CI 2.4% to 4.2%). Between August 2015 and October 2017, 80 individuals were seen in the TC and 57 (71%) commenced antiviral therapy. Of those with known outcome (n=29), 100% achieved sustained virological response. In the year prior to implementation, only 4 patients received HCV treatment. In conclusion,a universal offer of BBV testing to inmates presenting at HMP reception coupled with linkage into specialist care via TC can substantially increase rates of testing, diagnosis and treatment of HCV in this high prevalence population.