O65 Impact of a ‘high intensity test and treat’ initiative for HCV in Low Newton Prison

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Background Hepatitis C virus infection (HCV) is common in prisons in the UK with estimates suggesting a prevalence of approximately 7%. One of the goals of NHS England is to eliminate HCV from the country by 2025. In order to facilitate elimination of HCV from prisons, funding was available to conduct high intensity test and treat (HITT) initiatives in prisons with the aim of testing >95% of residents for HCV and treating >90% of those with active HCV, which is considered ‘elimination’. We describe the outcomes of a HITT conducted in Low Newton prison, in County Durham, which houses 307 female residents. Methods A Blood borne virus (BBV) testing weekend was conducted in January 2020 following detailed planning from a multidisciplinary team. The testing weekend was well publicised among residents. All residents were offered BBV testing using fingerpick dry blood spot testing for HCV antibody/RNA, HIV, HBsAg and Syphilis. A small incentive was given to all those tested. All HCV RNA positive were offered a clinic review 10 days after testing to commence treatment with a pangenotypic antiviral. Results Of the 307 residents in the prison at the time of the event, 305 (99%) accepted BBV testing. A total of 98 (32%) were HCV antibody positive, of these 23 were HCV RNA detected (23% of HCV Ab pos and 8% of all tested) in keeping with active HCV. One resident was HIV positive (known) and 4 had positive syphilis serology. None were HBsAg positive. Of the 23 HCV RNA positive residents, 3 were already on antiviral treatment, 17 commenced antivirals and 3 were released before treatment could be initiated (contact planned in the community). One patient was suspected of having cirrhosis. Of the 75 HCV antibody positive but RNA negative residents 40 (53%) were known to have received antiviral treatment already and achieved sustained virological response and 10 (13%) were currently on treatment. Feedback from residents and staff on the way the HITT was conducted was good. A point of care HCV RNA testing machine is now being used to identify HCV infection among new residents to try and maintain ‘elimination’. Conclusions A high intensity test and treat weekend coupled with quick access to antiviral treatment for HCV is a highly effective way to ‘eliminate’ HCV within a prison. However, these sessions require meticulous planning in order to be successful. Acknowledgment All the staff and residents of HMP Low Newton and the Hepatitis C Trust.