Introduction There is a high prevalence of hepatitis C virus (HCV) among inmates in UK prisons. Treatment of prisoners in hospital clinics proved to be logistically complex and expensive and resulted in high levels of treatment failures. Our aim was to establish specialist hepatitis C treatment clinics entirely within prison facilities and to evaluate their efficacy.

Methods Clinics were established in two prisons, HMP High Down (Capacity of 1103 inmates) and HMP Downview (capacity of 364 inmates) and run twice a month. The specialist team collaborated with the prison healthcare team to diagnose, investigate and treat HCV entirely within the prison setting. Link nurses would refer inmates with positive antibodies for further investigation including detailed virology and ultrasound scan. Suitable patients were offered treatment and monitired for progress and side effects.

Results 163 inmates with an average age of 40 were referred to the clinic. 62.6% were females and 37.4% were males. 73 patients received genotyping, 50.68% were genotype 1, 43.84% were genotype 3, 2.74% were genotype 2 and 2.74% were genotype 4. Out of the patients who completed treatment data is available on 58%. To date, 85% of patents who completed treatment tested negative after completion of treatment (EOT). 100% of patients who received follow-up testing acheived a sustained viral response (SVR) at 6 months. 9.5% of patients withdrew from treatment because they left prison. 1 patient withdrew as a result of side-effects (severe thrombocytopenia).

Conclusion An in-prison treatment service reduced the number of failed attendances at our hospital service. We were very successful in completing therapy for patients serving longer sentences in prison with good eradication rates. As the prison population is mobile, more effective collaboration between different prisons and community teams are needed to improve treatment and follow up of HCV infected prisoners.

Disclosure of Interest None Declared

References

1. Department of Health. Hepatitis C Strategy for England, 2002. http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4059510.pdf (accessed 21 October 2012).

2. Skipper C, Guy JM, Parkes J, Roderick P, Rosenberg WM. Evaluation of a prison outreach clinic for the diagnosis and prevention of hepatitis C: implications for the national strategy. Gut 2003; 52: 1500–1504.

3. Vescio MF, Longo B, Babudieri S, Strnini G, Carbonara S, Rezza G, Monarca R. Correlates of hepatitis C virus seropositivity in prison inmates: a meta-analysis. J Epdemiol Community Health 2008; 62: 305–313.