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Article
Publication date: 1 March 2008

R. G. Batey, T. Jones and C. McAllister

Prison populations in Western countries are characterised by a high hepatitis C prevalence. This reflects a high rate of imprisonment for drug related offences. Prison…

Abstract

Prison populations in Western countries are characterised by a high hepatitis C prevalence. This reflects a high rate of imprisonment for drug related offences. Prison entrants who are HCV‐negative face a significant risk of acquiring hepatitis C. Effective prevention strategies and successful treatment of a significant percentage of hepatitis C‐positive inmates could reduce the risk of transmission in the prison context significantly. Several reports of treating hepatitis C in prisoners in major facilities have been published. We report our experience of establishing a liver clinic service in two regional prisons in New South Wales, Australia. Liver biopsy requirements to access treatment in Australia meant that only 46 of 196 reviewed patients were able to commence treatment in our 5‐year experience. Treatment completion rate was 61% and end of treatment viral response was 57%. The removal of liver biopsy requirements in Australia in April 2006 has freed up access to treatment and our results encourage further effort to optimise the process of assessment and treatment in this high‐risk population.

Details

International Journal of Prisoner Health, vol. 4 no. 3
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 1 February 2008

Emanuele Pontali and Franco Ferrari

Correctional facilities host a disproportionately high prevalence of HBV, HCV and HIV infection. We evaluated the prevalence of HBV and/or HCV co‐infection among…

Abstract

Correctional facilities host a disproportionately high prevalence of HBV, HCV and HIV infection. We evaluated the prevalence of HBV and/or HCV co‐infection among HIV‐infected inmates entering our correctional facility. Over a 30‐month period, 173 consecutive HIV‐infected inmates entered our institution and were evaluated. HCV co‐infection was observed in more than 90% of the tested HIV‐infected inmates, past HBV infection in 77.4% and active HBV co‐infection in 6.7%; triple coinfection (HIV, HCV and HBs‐Ag positivity) was seen in 6.1% of them. Given the observed high prevalence of co‐infection, testing for HBV and HCV in all HIV‐infected inmates at entry in any correctional system is recommended to identify those in need of specific care and/or preventing interventions.

Details

International Journal of Prisoner Health, vol. 4 no. 2
Type: Research Article
ISSN: 1744-9200

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Book part
Publication date: 24 September 2010

Alicia Suarez

Hepatitis C virus (HCV) is highly prevalent in the United States, yet is largely culturally invisible. This study examines what people know about their illness, both…

Abstract

Hepatitis C virus (HCV) is highly prevalent in the United States, yet is largely culturally invisible. This study examines what people know about their illness, both before and after diagnosis, and the relationship to race. The data are from in-depth interviews in 2004 with 53 persons, mostly white or African American, with HCV in the southeastern United States. The respondents have varying educational backgrounds, family incomes, and possible modes of transmission of HCV. Regardless of whether the diagnosis of HCV came as a surprise, respondents had a range of reactions including fear, shock, sadness, and ambivalence. Knowledge of the disease postdiagnosis varies as some people have expert knowledge, moderate knowledge, or inaccurate to no knowledge of the disease. Minority respondents have less knowledge of HCV than whites. This racial disparity in knowledge has profound implications for people with HCV and the larger society.

Details

The Impact of Demographics on Health and Health Care: Race, Ethnicity and Other Social Factors
Type: Book
ISBN: 978-1-84950-715-8

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Article
Publication date: 22 March 2013

Stephanie E. Perrett, Noel Craine and Marion Lyons

This paper aims to describe the strategies being put in place to develop blood borne virus (BBV) services across prisons in Wales, UK, in response to the recommendations…

Abstract

Purpose

This paper aims to describe the strategies being put in place to develop blood borne virus (BBV) services across prisons in Wales, UK, in response to the recommendations for prisons within the Welsh Government's Blood Borne Viral Hepatitis Action Plan for Wales.

Design/methodology/approach

A task and finish group was established to ensure multidisciplinary engagement between healthcare and custody staff. A service improvement package was developed focusing on awareness raising and/or development of clinical services for prisoners, prison officers and prison healthcare staff.

Findings

Prison healthcare staff have undergone training in BBVs and are being supported to deliver clinical services to prisoners. Training has been delivered in pre/post test discussion and dried blood spot testing; care pathways have been established between prison and community specialists for treatment referrals. An e‐learning module is being rolled out to raise awareness amongst custody staff and encourage occupational hepatitis B vaccination. Literature on “liver health” has been produced to be given to every prisoner across Wales.

Social implications

It is envisaged that BBV services will become a routine part of prison care in Wales. Data on activity are being collected for evaluation and it is hoped that tackling BBVs in prisons will help reduce rates of infection both within prisons and in the wider community.

Originality/value

This paper describes new initiatives that have been established to tackle BBVs across Welsh prisons and will be relevant to any prison healthcare staff looking to develop similar services.

Details

International Journal of Prisoner Health, vol. 9 no. 1
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 15 August 2016

Katharina Kieslich, Jeonghoon Ahn, Gabriele Badano, Kalipso Chalkidou, Leonardo Cubillos, Renata Curi Hauegen, Chris Henshall, Carleigh B Krubiner, Peter Littlejohns, Lanting Lu, Steven D Pearson, Annette Rid, Jennifer A Whitty and James Wilson

New hepatitis C medicines such as sofosbuvir underline the need to balance considerations of innovation, clinical evidence, budget impact and equity in health…

Abstract

Purpose

New hepatitis C medicines such as sofosbuvir underline the need to balance considerations of innovation, clinical evidence, budget impact and equity in health priority-setting. The purpose of this paper is to examine the role of public participation in addressing these considerations.

Design/methodology/approach

The paper employs a comparative case study approach. It explores the experience of four countries – Brazil, England, South Korea and the USA – in making coverage decisions about the antiviral sofosbuvir and involving the public and patients in these decision-making processes.

Findings

Issues emerging from public participation ac tivities include the role of the universal right to health in Brazil, the balance between innovation and budget impact in England, the effect of unethical medical practices on public perception in South Korea and the legitimacy of priority-setting processes in the USA. Providing policymakers are receptive to these issues, public participation activities may be re-conceptualized as processes that illuminate policy problems relevant to a particular context, thereby promoting an agenda-setting role for the public.

Originality/value

The paper offers an empirical analysis of public involvement in the case of sofosbuvir, where the relevant considerations that bear on priority-setting decisions have been particularly stark. The perspectives that emerge suggest that public participation contributes to raising attention to issues that need to be addressed by policymakers. Public participation activities can thus contribute to setting policy agendas, even if that is not their explicit purpose. However, the actualization of this contribution is contingent on the receptiveness of policymakers.

Details

Journal of Health Organization and Management, vol. 30 no. 5
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 16 November 2015

Rocio Martin-Santos, Elfi Egmond, Myriam Cavero, Zoe Mariño, Susana Subira, Ricard Navines, Xavier Forns and Manuel Valdes

The purpose of this paper is to provide a comprehensive overview of the current knowledge regarding chronic hepatitis C (CHC) infection, antiviral therapy, depression, and…

Abstract

Purpose

The purpose of this paper is to provide a comprehensive overview of the current knowledge regarding chronic hepatitis C (CHC) infection, antiviral therapy, depression, and gender.

Design/methodology/approach

CHC and its treatment options were reviewed examining their relationship with depression and gender.

Findings

CHC is a high prevalent chronic infection worldwide, being similar in men and women. However, the infection shows many gender differences in terms of innate response, genetic variability (i.e. IL-28B), route of transmission (i.e. intravenous drug use), disease progression (i.e. fibrosis), lifetime period (i.e. pregnancy), and risk factors (i.e. HIV). Both the hepatitis C infection and antiviral treatment (especially when using the pro-inflammatory cytokine interferon α), are highly associated with depression, where female gender constitutes a risk factor. It seems that the new direct-acting antiviral combinations produce fewer neuropsychiatric side effects. In fact, the presence of depression at baseline is no longer a limitation for the initiation of antiviral treatment. Antidepressant drugs have been recommended as current depression and prophylactic treatment in risk subgroups. However, caution should be exercised due to the risk of drug-drug interactions with some antiviral drugs. Women should be counselled prenatal, during and after pregnancy, taking into account the clinical situation, and the available evidence of the risks and benefits of antiviral and antidepressant treatments. Multidisciplinary approach shows cost-efficacy results.

Originality/value

The paper clarifies the complex management of CHC therapy and the importance of individualizing treatment. The results also underline the need for an integrated multidisciplinary approach.

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Article
Publication date: 13 June 2016

Laurent Getaz, Alejandra Casillas, Sandrine Motamed, Jean-Michel Gaspoz, Francois Chappuis and Hans Wolff

The environmental and demographic characteristics of closed institutions, particularly prisons, precipitate morbidity during hepatitis A virus (HAV) outbreaks. Given the…

Abstract

Purpose

The environmental and demographic characteristics of closed institutions, particularly prisons, precipitate morbidity during hepatitis A virus (HAV) outbreaks. Given the high prevalence of chronic liver disease and other risk factors in the prison setting, the purpose of this paper is to examine HAV-immunity and its associated factors in this population.

Design/methodology/approach

The cross-sectional study was conducted in 2009: a serology screening for HAV IgG was carried out among 116 inmates in Switzerland’s largest pre-trial prison. Other participant characteristics were collected through a structured face-to-face questionnaire with a physician.

Findings

In terms of significant demographics, Africa (53.5 percent) and the Balkans/Eastern Europe (36.2 percent) were the main regions of origin; a minority of inmates were from Western Europe (6.9 percent), Latin America (2.6 percent) or Asia (0.9 percent). The authors identified hepatitis A antibody-negative serology (lack of immunity) in five out of 116 prisoners (4.3 percent, 95 percent CI 1.4-9.7). Among participants of European origin alone, five out of 50 inmates were hepatitis A antibody-negative (10 percent, 95 percent CI 3.3-21.8), whereas the 66 inmates from other all continents were hepatitis A antibody-positive (immune) (p=0.026).

Originality/value

In this prison population composed of mostly African migrants, hepatitis A immunity was high. This reaffirms that region of origin is highly associated with childhood immunity against HAV. HAV vaccination should take into account a patient’s area of origin and his/her risk factors for systemic complications, if ever infected. This targeted strategy would offer herd immunity, and seek out the most vulnerable individuals who are potentially at risk of new exposure in this precarious setting.

Details

International Journal of Prisoner Health, vol. 12 no. 2
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 9 September 2014

Sarah Larney, Curt G. Beckwith, Nickolas D. Zaller, Brian T. Montague and Josiah Rich

The purpose of this paper is to consider the potential benefits and challenges of applying a strategy of “seek, test, treat and retain” (STTR) to hepatitis C virus (HCV…

Abstract

Purpose

The purpose of this paper is to consider the potential benefits and challenges of applying a strategy of “seek, test, treat and retain” (STTR) to hepatitis C virus (HCV) in the US criminal justice system.

Design/methodology/approach

The authors draw on the published literature to illustrate how each component of STTR could be applied to HCV in the US criminal justice system, and describe challenges to the implementation of this strategy.

Findings

The burden of morbidity and mortality associated with chronic HCV infection in the USA is increasing and without significantly increased treatment uptake, will likely continue to do so for several decades. The authors argue that the US criminal justice system is an ideal focus for HCV case finding and treatment due to a high prevalence of infection and large volume of individuals in contact with this system. STTR would identify large numbers of HCV infections, leading to opportunities for secondary prevention and primary care. Important challenges to the implementation of STTR include treatment costs and training of prison medical providers.

Originality/value

This paper highlights opportunities to address HCV in the US criminal justice system.

Details

International Journal of Prisoner Health, vol. 10 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

Content available
Article
Publication date: 11 September 2017

Meghan D. Morris, Brandon Brown and Scott A. Allen

Worldwide efforts to identify individuals infected with the hepatitis C virus (HCV) focus almost exclusively on community healthcare systems, thereby failing to reach…

Abstract

Purpose

Worldwide efforts to identify individuals infected with the hepatitis C virus (HCV) focus almost exclusively on community healthcare systems, thereby failing to reach high-risk populations and those with poor access to primary care. In the USA, community-based HCV testing policies and guidelines overlook correctional facilities, where HCV rates are believed to be as high as 40 percent. This is a missed opportunity: more than ten million Americans move through correctional facilities each year. Herein, the purpose of this paper is to examine HCV testing practices in the US correctional system, California and describe how universal opt-out HCV testing could expand early HCV detection, improve public health in correctional facilities and communities, and prove cost-effective over time.

Design/methodology/approach

A commentary on the value of standardizing screening programs across facilities by mandating all facilities (universal) to implement opt-out testing policies for all prisoners upon entry to the correctional facilities.

Findings

Current variability in facility-level testing programs results in inconsistent testing levels across correctional facilities, and therefore makes estimating the actual number of HCV-infected adults in the USA difficult. The authors argue that universal opt-out testing policies ensure earlier diagnosis of HCV among a population most affected by the disease and is more cost-effective than selective testing policies.

Originality/value

The commentary explores the current limitations of selective testing policies in correctional systems and provides recommendations and implications for public health and correctional organizations.

Details

International Journal of Prisoner Health, vol. 13 no. 3/4
Type: Research Article
ISSN: 1744-9200

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Article
Publication date: 12 June 2017

Emanuele Pontali, Roberto Ranieri, Elena Rastrelli, Maria Donata Iannece, Anna Maria Ialungo, Serena Dell’Isola, Alfonso Liberti, Pietro Rosario, Rodolfo Casati, Giulio Starnini and Sergio Babudieri

The purpose of this paper is to give a description of the clinical conditions and patient demographics of inpatient admissions of human immunodeficiency virus…

Abstract

Purpose

The purpose of this paper is to give a description of the clinical conditions and patient demographics of inpatient admissions of human immunodeficiency virus (HIV)-infected inmates in three hospital wards that provide hospital care for inmates in Italy.

Design/methodology/approach

This is a retrospective review of hospital medical admissions of patients living with HIV from January 1 to December 31, 2014, in three Italian referral centers for hospitalization of inmates.

Findings

A total of 85 admissions for 85 different HIV-infected inmates occurred in 2014 in the three centers participating to the study. Most patients (54.1 percent) were co-infected with hepatitis C. Discharge diagnosis largely varied ranging from common HIV-related co-morbidities to completely independent diagnosis. The most commonly observed discharge diagnoses were chronic hepatitis C, liver cirrhosis, opiate dependence and thrombocytopenia.

Originality/value

Discharge diagnosis between HIV-infected inmates and HIV-infected patients in freedom are strikingly and significantly different. A large number of hospitalized HIV-infected inmates were affected by chronic viral hepatitis and liver cirrhosis; this is probably a direct consequence of the high prevalence of HCV and/or HBV co-infections in the inmate population in Italy. In addition, a significantly lower proportion of cancer diagnosis was observed among inmates; this is possibly justified by the fact that in our Italian settings when HIV infection is at advanced stages or if cancer treatment is started those affected are released from prison and can continue their diagnostic and treatment follow-up in freedom.

Details

International Journal of Prisoner Health, vol. 13 no. 2
Type: Research Article
ISSN: 1744-9200

Keywords

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