Marked Reduction In The Prevalence Of Hepatitis C Viremia In The Prison Setting During 2nd Year Of Traphepc (Treatment As Prevention For Hepatitis C) Program In Iceland

Author: Fridriksdottir RH , Fridjonsdottir H, Alexiusdottir K, Karlsdottir B, Tomasdottir A, Bjornsdottir Th, Finnbogadottir AM, Olafsdottir B, Tyrfingsson Th, Runarsdottir V, Bergmann OM, Bjornsson ES, Johannsson B , Sigurdardottir B , Heimisdottir M , Olafsson S, Gottfredsson M

Theme: Epidemiology & Public Health Research Year: 2018

Background: Hepatitis C virus (HCV) infection is common among prisoners due to high rates of incarceration of people who inject drugs (PWID). In Iceland a nationwide treatment effort was launched in 01/2016, where all HCV patients are offered treatment, including an outreach nurse-led program within the penitentiary system. Methods: Starting in 06/2016 nurses visit the two main prisons on a regular basis offering all inmates testing for hepatitis C and HIV. All infected inmates are offered treatment with direct acting antivirals (DAAs) while incarcerated and linked to care with the TraP HepC program outside the prison if released. We compared the prevalence of HCV viremia among prisoners in June 2016 and in January 2018, 19 months after the start of the penitentiary program. Results: At the initiation of the program, 59 (84%) out of a total of 68 inmates were tested for HCV. Of tested inmates, 17 (29%) were PCR positive, all previously diagnosed, and of which 16 accepted treatment. During subsequent screening of new inmates during the first nineteen months of the program, 21 additional patients were identified and initiated on treatment, for a total of 39 treatment initiations in 37 inmates. In January 2018, two years into TraP HepC, 75 (89%) out of the current total of 84 inmates have been tested for HCV. Of tested inmates 5 (7%) were PCR positive, a 76% drop in prevalence within the prison population in Iceland. Conclusion: Testing and treatment for HCV is well accepted and can be delivered safely and effectively in the prison setting. The TraP HepC program has resulted in a significant reduction in prevalence of HCV viremia in this high-risk population but continued surveillance is essential. Dislosure of interest: Gilead Sciences provides DAAs for the TrapHepC program in support of an epidemiological study.

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