Outcomes of a nurse-led model of care for hepatitis C assessment and treatment with direct-acting antivirals in the custodial setting

Overton, Kristen; Clegg, Jacqueline; Pekin, Frances; Wood, James M.; McGrath, Colette; Lloyd, Andrew R.; Post, Jeffrey J.

doi:10.1016/j.drugpo.2019.02.013

Cited by 43 publications

(30 citation statements)

References 30 publications

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“…Previous DAA-based studies have observed high cure rates among current and former prison inmates that are consistent with our results, such as a recent report from New South Wales (NSW) (ITT 57%, mITT 92%). The lower ITT SVR in this study (42%) compared to the NSW can be explained by our two-fold higher release rates [41]. Similarly, although Pontali et al have reported a higher ITT SVR (91%) in an Italian prison, only 6% of their patients discontinued treatment due to release.…”

Section: Hcv Treatment Outcomescontrasting

confidence: 61%

Continuum of hepatitis C care cascade in prison and following release in the direct-acting antivirals era

et al. 2020

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Background People with criminal justice involvement contribute remarkably to the rising hepatitis C virus (HCV) burden; however, the continuum of care is a major barrier to prison-based programs. We aimed to evaluate a comprehensive HCV care model in an Iranian provincial prison. Methods Between 2017–2018, in the Karaj Central Prison, newly admitted male inmates received HCV antibody testing and venipuncture for RNA testing (antibody-positive only). Participants with positive RNA underwent direct-acting antiviral (DAA) therapy (Sofosbuvir/Daclatasvir). Sustained virological response was evaluated at 12 weeks post-treatment (SVR12). Results Overall, from 3485 participants, 182 (5.2%) and 117 (3.4%) tested positive for HCV antibody and RNA, respectively. Among 116 patients who were eligible for treatment, 24% (n = 28) were released before treatment and 72% (n = 83) initiated DAA therapy, of whom 81% (n = 67/83) completed treatment in prison, and the rest were released. Of total released patients, 68% (n = 30/44) were linked to care in community, and 70% (n = 21/30) completed treatment, including 60% (n = 12/20) and 90% (n = 9/10) among those who were released before and during treatment, respectively. The overall HCV treatment uptake and completion were 89% (n = 103/116) and 85% (n = 88/103), respectively. From people who completed treatment, 43% (n = 38/88) attended for response assessment and all were cured (SVR12 = 100%). Conclusions Integrated HCV care models are highly effective and can be significantly strengthened by post-release interventions. The close collaboration of community and prison healthcare systems is crucial to promote high levels of treatment adherence. Future studies should investigate the predictors of engagement with HCV care following release.

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Section: Hcv Treatment Outcomescontrasting

confidence: 61%

Continuum of hepatitis C care cascade in prison and following release in the direct-acting antivirals era

et al. 2020

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“…These ndings may suggest a lower risk of reinfection or treatment failure in the Iranian community compared to the United States. In a Scottish research, SVR assessment showed similar results for people who initiated treatment in community and prison (63% vs. 61%) (35). However, we observed slightly better ITT outcomes for those who commenced therapy in community (45% vs. 35%).…”

Section: Discussionsupporting

confidence: 57%

Continuum of Hepatitis C Care Cascade in Prison and Following Release in the Direct-acting Antivirals Era

Hariri

Sharafi

Sheikh

et al. 2020

Preprint

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Background People with criminal justice involvement contribute remarkably to the rising hepatitis C virus (HCV) burden; however, the continuum of care is a major barrier to prison-based programs. We aimed to evaluate a comprehensive HCV care model in an Iranian provincial prison. Methods Between 2017–2018, in the Karaj Central Prison, newly admitted male inmates received HCV antibody testing and venipuncture for RNA testing (antibody-positive only). Participants with positive RNA underwent direct-acting antiviral (DAA) therapy (Sofosbuvir/Daclatasvir). Sustained virological response was evaluated at 12 weeks post-treatment (SVR12). Results Overall, from 3,485 participants, 182 (5.2%) and 117 (3.4%) tested positive for HCV antibody and RNA, respectively. Among 116 patients who were eligible for treatment, 24% (n = 28) were released before treatment and 72% (n = 83) initiated DAA therapy, of whom 81% (n = 67/83) completed treatment in prison and the rest were released. Of total released patients, 68% (n = 30/44) were linked to care in community, and 70% (n = 21/30) completed treatment, including 60% (n = 12/20) and 90% (n = 9/10) among those who were released before and during treatment, respectively. The overall HCV treatment uptake and completion were 89% (n = 103/116) and 85% (n = 88/103), respectively. From people who completed treatment, 43% (n = 38/88) attended for response assessment and all were cured (SVR = 100%). Conclusions Integrated HCV care models are highly effective and can be significantly strengthened by post-release interventions. The close collaboration of community and prison healthcare systems is crucial to promote high levels of adherence to treatment. Future studies should investigate the predictors of engagement with HCV care following release.

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“…Use of POC testing was also associated with shorter time between the steps of patient admission, testing, clinical assessment, and treatment initiation. Finally, barriers to treatment initiation can be improved by employing nurse-led models of HCV care to reduce the need for specialist physicians [32] , [33] . One nurse-led treatment model involving 14 prisons in Australia resulted in a 96% SVR12 rate, while requiring specialist consultation in only 18% of cases [32] .…”

Section: Discussionmentioning

confidence: 99%

The hepatitis C virus care cascade in the New York City jail system during the direct acting antiviral treatment era, 2014–2017

et al. 2020

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Background High patient turnover presents challenges and opportunity to provide hepatitis C virus (HCV) care in US jails (remand facilities). This study describes the HCV care cascade in the New York City (NYC) jail system during the direct-acting antiviral (DAA) treatment era. Methods Patients admitted to the NYC jail system from January 2014 through December 2017 were included in this retrospective cohort analysis. We describe rates of screening, diagnosis, linkage to jail-based care, and treatment among the overall cohort, and among subgroups with long jail stays (≥120 days) or frequent stays (≥10 admissions). The study protocol was approved by a third-party institutional review board (BRANY, Lake Success, NY). Findings Among the 121,371 patients in our analysis, HCV screening was performed in 40,219 (33%), 4665 (12%) of whom were viremic, 1813 (39%) seen by an HCV clinician in jail, and 248 (5% of viremic patients) started on treatment in jail. Having a long stay (adjusted risk ratio [aRR] 8·11, 95% confidence interval [CI] 6·98, 9·42) or frequent stays (aRR 1·51, 95% CI 1·04, 2·18) were significantly associated with being seen by an HCV clinician. Patients with long stays had a higher rate of treatment (14% of viremic patients). Sustained virologic response at 12 weeks was achieved in 147/164 (90%) of patients with available virologic data. Interpretation Jail health systems can reach large numbers of HCV-infected individuals. The high burden of HCV argues for universal screening in jail settings. Length of stay was strongly associated with being seen by an HCV clinician in jail. Treatment is feasible among those with longer lengths of stay. Funding None.

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Outcomes of a nurse-led model of care for hepatitis C assessment and treatment with direct-acting antivirals in the custodial setting

Cited by 43 publications

References 30 publications

Continuum of hepatitis C care cascade in prison and following release in the direct-acting antivirals era

Continuum of hepatitis C care cascade in prison and following release in the direct-acting antivirals era

Continuum of Hepatitis C Care Cascade in Prison and Following Release in the Direct-acting Antivirals Era

The hepatitis C virus care cascade in the New York City jail system during the direct acting antiviral treatment era, 2014–2017

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