Feasibility of hepatitis C virus testing and linkage in community supervision offices: Great potential but persistent challenges
Persons involved with the justice system have an elevated risk of hepatitis C virus (HCV) yet remain marginalized from treatment. Efforts to eliminate HCV will require targeted interventions within the justice system effective at providing diagnosis and treatment. We implemented a novel HCV screenin...
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Published in | The International journal of drug policy Vol. 103; p. 103668 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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Elsevier B.V
01.05.2022
Elsevier Science Ltd |
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Abstract | Persons involved with the justice system have an elevated risk of hepatitis C virus (HCV) yet remain marginalized from treatment. Efforts to eliminate HCV will require targeted interventions within the justice system effective at providing diagnosis and treatment.
We implemented a novel HCV screening and treatment intervention for persons under community supervision in Rhode Island, USA during April 2018––March 2020. Participants received rapid point-of-care HCV antibody testing onsite and referral to community laboratory and treatment services as indicated. We assessed the HCV care cascade to identify areas for improvement.
Overall, 483 individuals were screened for HCV antibody; 85 (18%) were positive. A minority of participants with positive HCV antibody tests (n=25/85, 29%) presented to community laboratories for confirmatory testing. Among participants that received HCV viral load results and linked to a treatment provider (n=12), four initiated treatment, three had record of completing treatment, and two were confirmed to have achieved cure.
Linkage to HCV viral load testing and treatment was challenging in this community supervision population, with substantial loss to follow-up at each step of the HCV cascade. Community supervision remains an important venue for case identification but substantial barriers to accessing HCV treatment exist. Innovative HCV diagnosis and treatment strategies are needed for community supervision populations. |
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AbstractList | Background: Persons involved with the justice system have an elevated risk of hepatitis C virus (HCV) yet remain marginalized from treatment. Efforts to eliminate HCV will require targeted interventions within the justice system effective at providing diagnosis and treatment. Methods: We implemented a novel HCV screening and treatment intervention for persons under community supervision in Rhode Island, USA during April 2018––March 2020. Participants received rapid point-of-care HCV antibody testing onsite and referral to community laboratory and treatment services as indicated. We assessed the HCV care cascade to identify areas for improvement. Results: Overall, 483 individuals were screened for HCV antibody; 85 (18%) were positive. A minority of participants with positive HCV antibody tests (n=25/85, 29%) presented to community laboratories for confirmatory testing. Among participants that received HCV viral load results and linked to a treatment provider (n=12), four initiated treatment, three had record of completing treatment, and two were confirmed to have achieved cure. Conclusion: Linkage to HCV viral load testing and treatment was challenging in this community supervision population, with substantial loss to follow-up at each step of the HCV cascade. Community supervision remains an important venue for case identification but substantial barriers to accessing HCV treatment exist. Innovative HCV diagnosis and treatment strategies are needed for community supervision populations. Persons involved with the justice system have an elevated risk of hepatitis C virus (HCV) yet remain marginalized from treatment. Efforts to eliminate HCV will require targeted interventions within the justice system effective at providing diagnosis and treatment. We implemented a novel HCV screening and treatment intervention for persons under community supervision in Rhode Island, USA during April 2018--March 2020. Participants received rapid point-of-care HCV antibody testing onsite and referral to community laboratory and treatment services as indicated. We assessed the HCV care cascade to identify areas for improvement. Overall, 483 individuals were screened for HCV antibody; 85 (18%) were positive. A minority of participants with positive HCV antibody tests (n=25/85, 29%) presented to community laboratories for confirmatory testing. Among participants that received HCV viral load results and linked to a treatment provider (n=12), four initiated treatment, three had record of completing treatment, and two were confirmed to have achieved cure. Linkage to HCV viral load testing and treatment was challenging in this community supervision population, with substantial loss to follow-up at each step of the HCV cascade. Community supervision remains an important venue for case identification but substantial barriers to accessing HCV treatment exist. Innovative HCV diagnosis and treatment strategies are needed for community supervision populations. BACKGROUNDPersons involved with the justice system have an elevated risk of hepatitis C virus (HCV) yet remain marginalized from treatment. Efforts to eliminate HCV will require targeted interventions within the justice system effective at providing diagnosis and treatment. METHODSWe implemented a novel HCV screening and treatment intervention for persons under community supervision in Rhode Island, USA during April 2018--March 2020. Participants received rapid point-of-care HCV antibody testing onsite and referral to community laboratory and treatment services as indicated. We assessed the HCV care cascade to identify areas for improvement. RESULTSOverall, 483 individuals were screened for HCV antibody; 85 (18%) were positive. A minority of participants with positive HCV antibody tests (n=25/85, 29%) presented to community laboratories for confirmatory testing. Among participants that received HCV viral load results and linked to a treatment provider (n=12), four initiated treatment, three had record of completing treatment, and two were confirmed to have achieved cure. CONCLUSIONLinkage to HCV viral load testing and treatment was challenging in this community supervision population, with substantial loss to follow-up at each step of the HCV cascade. Community supervision remains an important venue for case identification but substantial barriers to accessing HCV treatment exist. Innovative HCV diagnosis and treatment strategies are needed for community supervision populations. |
ArticleNumber | 103668 |
Author | Beckwith, Curt G Cady, Treniece Jacka, Brendan P Dickerson, Collin Bazerman, Laurie B Martin, Johanna Patry, Emily Moody, Marc Boudreau, Matthew Compere, Hacheming |
AuthorAffiliation | 4 Rhode Island Department of Corrections, Pawtucket, Rhode Island, USA 3 The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA 1 Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA 2 Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA |
AuthorAffiliation_xml | – name: 3 The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA – name: 1 Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA – name: 2 Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA – name: 4 Rhode Island Department of Corrections, Pawtucket, Rhode Island, USA |
Author_xml | – sequence: 1 givenname: Brendan P orcidid: 0000-0002-5910-853X surname: Jacka fullname: Jacka, Brendan P organization: Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA – sequence: 2 givenname: Laurie B surname: Bazerman fullname: Bazerman, Laurie B organization: Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA – sequence: 3 givenname: Collin surname: Dickerson fullname: Dickerson, Collin organization: The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA – sequence: 4 givenname: Marc surname: Moody fullname: Moody, Marc organization: Rhode Island Department of Corrections, Pawtucket, Rhode Island, USA – sequence: 5 givenname: Johanna surname: Martin fullname: Martin, Johanna organization: Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA – sequence: 6 givenname: Emily surname: Patry fullname: Patry, Emily organization: Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA – sequence: 7 givenname: Treniece surname: Cady fullname: Cady, Treniece organization: Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA – sequence: 8 givenname: Hacheming surname: Compere fullname: Compere, Hacheming organization: Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA – sequence: 9 givenname: Matthew surname: Boudreau fullname: Boudreau, Matthew organization: Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA – sequence: 10 givenname: Curt G surname: Beckwith fullname: Beckwith, Curt G email: cbeckwith@lifespan.org organization: Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island, USA |
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Snippet | Persons involved with the justice system have an elevated risk of hepatitis C virus (HCV) yet remain marginalized from treatment. Efforts to eliminate HCV will... Background: Persons involved with the justice system have an elevated risk of hepatitis C virus (HCV) yet remain marginalized from treatment. Efforts to... BACKGROUNDPersons involved with the justice system have an elevated risk of hepatitis C virus (HCV) yet remain marginalized from treatment. Efforts to... |
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SubjectTerms | Antibodies Care cascade Community Cure Diagnostic tests Drug policy Feasibility Feasibility Studies HCV elimination healthcare access Hepacivirus Hepatitis Hepatitis C Hepatitis C - diagnosis Hepatitis C - epidemiology Hepatitis C Antibodies Humans Intervention Justice Laboratories Mass Screening - methods Medical diagnosis Medical screening Supervision |
Title | Feasibility of hepatitis C virus testing and linkage in community supervision offices: Great potential but persistent challenges |
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