Hepatitis C Testing and Linkage to Care Among Adults on Probation in a Large US City.

Autor: Kamis KF; Public Health Institute at Denver Health, Denver Health and Hospital Authority, Denver, Colorado, USA., Wyles DL; Division of Infectious Diseases, Denver Health Medical Center and University of Colorado School of Medicine, Denver, Colorado, USA., Minturn MS; Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA., Scott T; LGBTQ+ Health Services, Denver Health and Hospital Authority, Denver, Colorado, USA., McEwen D; Public Health Institute at Denver Health, Denver Health and Hospital Authority, Denver, Colorado, USA., Hurley H; Public Health Institute at Denver Health, Denver Health and Hospital Authority, Denver, Colorado, USA.; Division of Infectious Diseases, Denver Health Medical Center and University of Colorado School of Medicine, Denver, Colorado, USA.; Center for Addiction Medicine, Denver Health and Hospital Authority, Denver, Colorado, USA., Prendergast SJ; Denver Adult Probation, Colorado Judicial Branch, Denver, Colorado, USA., Rowan SE; Public Health Institute at Denver Health, Denver Health and Hospital Authority, Denver, Colorado, USA.; Division of Infectious Diseases, Denver Health Medical Center and University of Colorado School of Medicine, Denver, Colorado, USA.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2021 Dec 16; Vol. 9 (2), pp. ofab636. Date of Electronic Publication: 2021 Dec 16 (Print Publication: 2022).
DOI: 10.1093/ofid/ofab636
Abstrakt: Background: Despite constituting the largest segment of the correctional population, individuals on probation remain largely unstudied with respect to hepatitis C virus (HCV) testing and linkage to care. We implemented an HCV testing and patient navigation program at an adult probation department.
Methods: Adults were tested at a local probation department with a rapid point-of-care HCV antibody (Ab) assay followed by a laboratory-based HCV ribonucleic acid (RNA) assay if anti-HCV positive. All individuals received counseling rooted in harm reduction principles. Individuals testing positive for HCV Ab were immediately linked to a patient navigator in person or via telephone. The patient navigator assisted patients through cure unless the patient was lost to follow-up. Study participation involved an optional survey and optional point-of-care human immunodeficiency virus test.
Results: Of 417 individuals tested, 13% were HCV Ab positive and 65% of those tested for HCV RNA (34 of 52) had detectable HCV RNA. Of the 14 individuals who linked to an HCV treatment provider, 4 completed treatment, as measured by pharmacy fill documentation in the electronic medical record, and 1 obtained sustained virologic response. One hundred ninety-three individuals tested for HIV; none tested positive.
Conclusions: The study cohort had a higher HCV seroprevalence than the general population (13% vs 2%), but linkage to care, completion of HCV treatment, and successful test-of-cure rates 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. Colocalization of HCV treatment within probation programs would reduce the barrier of attending a new institution and could be highly impactful.
(© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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