Theme: Models of Care Year: 2022
Background:
HCV prevalence in Italian prisons is not well known and HCV Ab screening is not mandatory at the
access in prisons. When HCV infection is diagnosed, prisoners are poorly linked to care because of
several difficulties. Many authorizations of different authorities are required to start and complete a
diagnostic and therapeutical pathway and the stay of the patient in the same prison is not ensured.
We work in Caserta Province, a high HCV prevalence area and we expected the same evidence in the
1300 prisoners in four prisons of that area.
Description of model of care/intervention:
We contacted and involved all the authorities who rule the prisoners’ life, planned a complete training
of all personnel of prisons (clinicians, nurses, probation officers) about the state of the art of HCV
infection, control and elimination possibility.
We applied to all prisoners, not tested for HCV Ab, a counselling and then an oral HCV testing
(Oraquick®) and we obtained a whole HCV Ab+ prevalence of Caserta prisoners. Than a fast track of
blood sample collection, evaluation and treatment assignment was performed by a unique Statement
subscribed by Prisons and Health authorities of the Province.
Effectiveness, conclusion and next steps:
The HCV Ab+ prevalence detected in Caserta Province prisons was 9.6%.
From 2016 to 2018, 5 prisoners only were diagnosed for HCV infection and linked to care, in an
evaluation length from 6 to 18 months. 2 of them not completed the treatment because of prison
transfer. On 2019, in the six months after the statement subscription, 60 prisoners were diagnosed,
evaluated and linked to HCV care in a maximum length of 30 days. All completed the treatment with
98.3% SVR 24.
A well definite pathway and the personnel training resulted the successful approach for prisoner
linkage to HCV care.
Disclosure of Interest Statement:
No conflict of interest with this activity. This activity received an unrestricted grant from the 2018
Gilead Fellowship.