Hepatitis C Care Cascade in British Columbia Provincial Correctional Centres Prior to Launch of a Continuous Quality Improvement Project

Author: Sofia Bartlett Amanda Yu Pamela Young Mo Korchinski Nancy Desrosiers Roy Ang Zahida Esmail Deanna Romm Daryl Luster Deb Schmitz Maria Alvarez Ruth Elwood Martin Daryl Jane Buxton Jason Wong Sara Young Naveed Janjua

Theme: Epidemiology & Public Health Research Year: 2022

Increased hepatitis C virus (HCV) screening and treatment among people who are incarcerated
(PWAI) is key for elimination efforts to be successful. The aim of this analysis was to determine the
baseline levels of HCV screening, diagnosis, and treatment in all 10 British Columbia (BC) Provincial
Correctional Centres (PCCs) prior to the launch of a Continuous Quality Improvement (CQI) project in
October 2021.
Data from BC Centre for Disease Control (BCCDC) Public Health Laboratory (PHL) (where >95% of all
anti-HCV testing and >99% of all RNA and genotype tests in BC are conducted) were used to estimate
HCV testing from BC PCCs between January 1 2021 and December 31 2021. Number of admissions to
PCCs were provided by BC Corrections, while number of unique clients offered HCV testing and
number of unique clients receiving HCV medications were provided by Correctional Health Services
In 2021, 66% (6075/9179) of admissions to BC PCCs were offered an HCV test. Of those offered a
test, 18% (1108/6075) accepted anti-HCV testing, with 22% (240/1108) testing positive. 478 people
had HCV RNA testing performed in BC PCCs, of whom 39% (187/478) had RNA detected, and
subsequently 60% (112/187) were genotyped. Among people genotyped, 69% (77/112) received
HCV medications in custody (41% of all HCV RNA positive).
A substantial proportion of people entering BC PCCs do not accept or receive HCV screening. As the
anti-HCV test positivity observed was over 20%, enhancing screening uptake is warranted. However,
more HCV RNA tests performed than people with anti-HCV results indicates many were diagnosed
before admission. Encouragingly, over 60% were HCV RNA negative, indicating substantial HCV
treatment or spontaneous clearance in this population. The HCV care cascade will continue to be
monitored, to determine the impact of the CQI project on treatment initiation and linkage to care
after release.
Disclosure of Interest Statement:

SB has spoken and consulted for Gilead Sciences Canada Inc &
AbbVie Canada, all personal payments received from commercial entities were given directly to
BCCDC Foundation for Public Health as an unrestricted donation. SB has received unrestricted,
investigator initiated funding through her institution from Gilead Sciences Canada Inc. All other
authors have nothing to declare.

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