Hepatitis B and Hepatitis C Virus Case Finding in Prisons

Summary

The project aimed to assess the feasibility of blood spot testing for HBV and HCV in a category B and C prison and to evaluate the number of prisoners seen and treated in the liver clinic.

A walk-in service was provided in HM Prison Elmley to test for hepatitis B and C, followed by clinic appointments at Maidstone Hospital in all positive cases: 160 prisoners were tested for HCV antibodies of which 33.75% were positive, and those that were positive for Hepatitis C virus then went on to be tested for HCV RNA where 23.75% were RNA positive. The results highlight that HCV testing in prisons has the potential to vastly increase the number of people who are identified as HCV positive. 

Challenge

There is a high incidence of chronic hepatitis B and C in the UK prison population and this is predominantly related to the prevalence of previous IV drug usage in prisoners. Prisoners have restricted opportunities for access to counselling and testing for viral hepatitis and the delays in obtaining formal blood test results often interfere with disease assessment, as does the prison service’s policy of regularly moving prisoners from prison to prison.

HM Prison Elmley – the largest of a local cluster of prisons - has approximately 1,000 male inmates, in whom the total prevalence of chronic viral hepatitis is estimated to be 20-25%. The liver clinic at Maidstone Hospital wanted to optimise case finding in viral hepatitis C (and B) in the largest local prisons with a blood spot test carried out in the prison itself with the results notified directly to the team’s hepatitis clinic to expedite the referral process. 

Objectives

To assess the feasibility of blood spot testing for HCV (and HBV) in category B and C prisons. A secondary objective was to evaluate the number of these prisoners subsequently seen and treated in the liver clinic.

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QiC Hepatitis C Finalist 2015
Best diagnosis & testing programme
Hepatitis B and Hepatitis C Virus Case Finding in Prisons
by Maidstone and Tunbridge Wells NHS Trust

Contacts

George Bird

Job title:
Consultant Physician and Honorary Senior Lecturer
Place of work:
Maidstone and Tunbridge Wells NHS Trust, Department of Gastroenterology, Maidstone Hospital, Hermitage Lane, Maidstone, Kent ME16 9QQ
Telephone:
01622 224235
Email:
GBird@nhs.net


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