Hepatitis C Treatment Among Men Leaving Prison Who Have Histories of Injecting Drug Use in Victoria, Australia

Author: Ashleigh Stewart Rebecca Winter Anna Wilkinson Reece Cossar Paul Dietze Alex Thompson Michael Curtis Mark Stoové Shelley Walker Shelley

Theme: Epidemiology & Public Health Research Year: 2022

Background: Declining treatment numbers among some populations challenge efforts to eliminate
HCV in Australia. HCV prevalence and incidence is disproportionately higher among people with a
history of incarceration, indicating a population requiring a renewed approach to eliminate HCV. We
present data on HCV testing and treatment uptake among a cohort of men released from prison who
have a history of injecting drug use and incarceration in Victoria, Australia.
Methods: Participants were men leaving prison with a history of injecting drug use. Baseline and
follow-up interview (3-, 12-, 24-months after prison release) data on HCV testing and treatment was
linked with data on DAA prescriptions recorded in Australia’s subsidised prescription medication
program (Pharmaceutical Benefits Scheme). We report serial cross-sectional descriptive statistics
detailing engagement in HCV testing and treatment, and dispensed DAA treatments by prescription
schedule (i.e., dispensed in the community or in prison) recorded March 2016–December 2018.
Results: Data for 400 men were included. At baseline, 95% (n=392/400) reported ever being tested
for HCV: of those, two-thirds (66%, n=258/392) reported a positive last test result. Across follow-up,
men who had an HCV test since their last interview increased from 30% (n=84/277) at three-months
to 72% (n=164/228) at 24-month follow-up. Of the men reporting an HCV test, positive results were
reported by 48% (n=40/84) at three-months, 64% (n=99/155) at 12-months, and 58% (n=96/164) at
24-months. A total of 438 DAA prescriptions were dispensed March 2016–December 2018 among
154 men, with 65% (n=284/438) recorded as a prescription schedule relating to DAA treatment
dispensed in prison.
Conclusion: Findings highlight men who inject drugs with a history of incarceration have successfully
accessed HCV testing and treatment. Ongoing review of the delivery of services in both prison and
community settings may be required to ensure continued HCV testing and treatment uptake among
this population.
Disclosure of Interest Statement: Professor Mark Stoové has received investigator-initiated funding
from Gilead Sciences, AbbVie, and Bristol Myers Squibb for research unrelated to this work.
Professor Dietze has received investigator-driven funding from Gilead Sciences for work related to
hepatitis C treatment and an untied educational grant from Indivior for work related to the
introduction of buprenorphine/naloxone into Australia. He has also served as an unpaid member of
an Advisory Board for an intranasal naloxone product.

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