Adults on probation disproportionately impacted by hepatitis C
Compared with the general population, adults on probation are disproportionately impacted by hepatitis C, but they rarely receive care, complete treatment or achieve viral suppression, according to a study.
“Prior to the COVID-19 pandemic, hepatitis C virus-associated mortality had surpassed that of all other nationally notifiable infectious diseases combined in the United States,” Kevin F. Kamis, MPH, a researcher at the Public Health Institute at Denver Health, and colleagues wrote. “Despite constituting the largest segment of the correctional population, individuals on probation remain largely unstudied with respect to HCV testing and linkage-to-care.”
Kamis and colleagues implemented an HCV testing and navigation program at an adult probations department in Denver. As they describe in the study, adults were tested at a local probation department with a rapid point-of-care HCV antibody (Ab) assay, followed by a lab-based HCV RNA assay if they were anti-HCV positive. Participants also received harm-reduction counseling. If they tested positive, they were linked to a patient navigator in person or via telephone.
Of the 417 people tested, 13% were HCV Ab positive and 65% of those tested for HCV RNA had detectable HCV RNA. According to Kamis and colleagues, adults on probation had a higher HCV seroprevalence than the general population (13% vs 2%). However, their rates of linkage-to-care (15%), completion of HCV treatment (12%) and successful test-of-cure (8%) were all low.
“This study indicates that HCV disproportionately impacts adults on probation and prioritizing support for testing and linkage-to-care could improve health in this population,” the authors wrote. “Co-localization of HCV treatment within probation programs would reduce the barrier of attending a new institution and could be highly impactful.”