Hepatitis C virus point-of-care RNA testing: Experience from screening an entire high-security Australian prison population over 3 days

Objective

Point-of-care testing for hepatitis C virus (HCV) in high-risk populations is key to diagnosing and eliminating HCV. We aimed to test all occupants for HCV in an entire prison.

Methods

All consenting participants at the Brisbane Women’s Correctional Centre were tested for HCV over 3 days using fingerstick samples. Participants with HCV were linked to care by a Nurse Practitioner experienced in HCV management.

Results

211 of 244 participants of the prison population at the time (86%) consented and were tested. 17 participants (8%) had HCV, of who 14 commenced antiviral therapy ≤1 week of testing, 1 was later approved for antiviral therapy in consultation with a physician, and 2 due for release were followed-up and linked to care in the community. Education and counselling provided before testing was rated as very good or excellent by 47% of participants.

Conclusions

Testing occupants in a high-security prison of this size is feasible and can provide an overview of HCV infectivity. Testing combined with linkage to care will support the elimination of HCV in this high-risk population.

Implications for public health

Point-of-care testing for HCV in prisons with dedicated clinicians, resources, and partnerships, particularly at prison entry, can contribute to eliminating HCV in Australia by 2030.