Case study: HCV micro-elimination in prison

Abstract

Abstract The presentation will explore the concept of HCV micro-elimination in prison settings end its application in the context of French prisons. Hepatitis C is a chronic pathology of the liver and can significantly affect quality of life, with significant mortality rates. Hepatitis C is of great relevance for prison population due to the overlap of risk factors for both incarceration and HCV infection, including substance use disorders. Historically, HCV interferon-based therapy has not always been offered to people in prison due to various factors, including homelessness, active injecting drug use, and liver disease. With the advent of direct-acting antivirals, almost 100% of patients are experiencing successful HCV treatment, with no medical contra-indication for incarcerated individuals, drug users and/or individuals on opioid substitution treatment. Approaches based on HCV test and treat have proven to be successful in prison settings to achieve micro-elimination and to offer HCV appropriate care to individuals belonging to socially-deprived groups and characterised by limited access to care when in the community. The elimination of hepatitis C in prison, among people who use drugs, also requires effective Harm Reduction programmes, an important tool to prevent re-infections.