Sector News
23 February 2018

ASHM has held a Hepatitis C Treatment in Prisons Forum in Brisbane aimed at bringing together health professionals from across Queensland – who work in correctional settings and provide in-reach services for viral hepatitis – to discuss models-of-care, challenges and solutions in moving towards the elimination of hepatitis C from Queensland correctional centres.

Prison populations have a high prevalence of hepatitis C worldwide, with results from the most recent National Prison Entrants’ Blood-borne Virus Survey indicating a prevalence of 22% across Australian prisons (1). Prior to the release of new, direct-acting antivirals (DAA) in March 2016, treatment uptake was extremely low in Australian correctional centres (2). Improved treatment options now provide an opportunity to scale up treatment in the prison setting, however Queensland has seen a variable treatment uptake across its fourteen correctional centres. One outstanding example has been Lotus Glen Prison in Cairns where a rapid DAA scale-up program has been successful in clearing the estimated HCV prevalence from approximately 12% to 1% in less than 12 months. Similar success was reported by the team from Capricornia prison during the Forum.

The Forum was attended by 57 Queensland participants, as well as two interstate guest speakers, where current models-of-care were presented by different services, followed by discussion and planning sessions. The Forum was successful in bringing together those providing treatment and management for HCV in Queensland correctional centres, and in producing practical recommendations to improve service provision throughout Queensland. ASHM anticipates running a similar event in 2019.

 

Further education opportunities for health professionals working in correctional settings

 

Lotus Glen is Australia’s first hepatitis C-free prison

In Cairns’ Lotus Glen Prison, a rapid DAA scale-up program has been successful in reducing the estimated HCV prevalence from approximately 12% to 1%. How?

At the 2017 Australasian Viral Hepatitis Elimination Conference (AVHEC) Dr Darren Russell presented on A regional prison cleared of hepatitis C in less than 12 months

Key elements:

  • Nurse-led model: Clinical nurse consultant (CNC) liver commenced a nurse-led clinic with portable Fibroscan in association with health promotion officer
  • A champion to help make it possible: Hepatitis health promotion officer at Cairns Sexual Health Service increased education and communication to staff; Sexual Health Service organised a successful education day to all staff with liver CNC
  • Cairns Hospital Pharmacy agreed to dispense; CNC liver did the pathology when required
  • 95 per cent tested upon entering prison
  • Everyone is treated without delay
  • Follow-up testing to ensure no reinfection: so far, no reinfections in the prison
  • Read the abstract

 

Other links to related prison research

 

References

1. Butler, T. and Simpson, M. National Prison Entrants’ Blood-borne Virus Survey Report 2004, 2007, 2010, 2013, and 2016. Kirby Institute (UNSW Sydney). 2017

2. Hepatitis C Virus Infection Consensus Statement Working Group. Australian recommendations for the management of hepatitis C virus infection: a consensus statement (August 2017). Melbourne: Gastroenterological Society of Australia, 2017.