Comprehensive HCV Service Delivery Model for Achieving Micro-Elimination of Hepatitis C Among the Incarcerated Population of Haryana and Chandigarh, India

Author: Kanudeep Kaur Ruby Jain Vivek Kumar Suman . Praveen Boora Usha Gupta Veena Singh Rajashree Sen Virendra Singh Sanjay Sarin Sonjelle Shilton Virendra

Theme: Epidemiology & Public Health Research Year: 2022

The need for a comprehensive HCV service delivery model for the high-risk groups such as prisoners
was felt to achieve the 2030 global targets for elimination of hepatitis C virus (HCV).
Description of model of care/intervention:
Participants were screened in 9 prisons at Haryana and 1 prison at Chandigarh either at the time of
incarceration or via screening camps using anti-HCV rapid diagnostic tests (RDT). For all participants
found HCV RDT+ reflex blood draw was used for HCV RNA and pre-investigations. APRI and FIB-4
scores were used to determine the liver staging (non-cirrhotic is APRI <2 & FIB-4 <3.5 and cirrhotic is
APRI >2 & FIB-4 >3.5). Prison medical officers initiated all the non-cirrhotic patients on treatment on
site and cirrhotic cases via telemedicine with the gastroenterologists at the tertiary hospitals. Test of
cure (SVR12) was assessed with HCV RNA test done 12 weeks after treatment completion.
15,274 inmates were screened from April 2021 to May 2022. Of the 4.4% (n=683) HCV antibodypositive, 97.9% (n=669) completed an RNA test. Of those who had RNA completed, 76% (n=465)
were HCV RNA+, of those 80.4% (n=374) initiated treatment, 79.5% (n=284) completed treatment,
35.9% (n=102) had a SVR cure assessment, and SVR was achieved in 89.2% (n=91) patients. The
median days and IQR for turnaround time from RDT screening to RNA results is 4 days, IQR 3-7 (n=
617) and for initiation on treatment after receipt of RNA results is 10 days, IQR 5-21 (n= 231).
Conclusion and next steps:
Post the FIND activities this model was transitioned to government partners for delivery of HCV
services in prisons. This HCV care model proved to be effective in delivering the complete HCV care
within the prison setting using existing prison medical staff and could be replicable to increase
access of HCV care.
Disclosure of Interest Statement:

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