Nadine Kronfli1, Blake Linthwaite2, Fiona Kouyoumdjian3, Marina B Klein4, Bertrand Lebouché5, Giada Sebastiani2, Joseph Cox6. 1. Chronic Viral Illness Services, McGill University Health Centre, Montreal, Quebec, Canada. Electronic address: nadine.kronfli@mail.mcgill.ca. 2. Chronic Viral Illness Services, McGill University Health Centre, Montreal, Quebec, Canada. 3. Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada; Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada. 4. Chronic Viral Illness Services, McGill University Health Centre, Montreal, Quebec, Canada; CIHR Canadian HIV Trials Network, Vancouver, British Columbia, Canada. 5. Chronic Viral Illness Services, McGill University Health Centre, Montreal, Quebec, Canada; Department of Family Medicine, McGill University, Montreal, Quebec, Canada. 6. Chronic Viral Illness Services, McGill University Health Centre, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Abstract
BACKGROUND: While the burden of chronic hepatitis C virus (HCV) infection is significantly higher among people in prisons compared to the general population, testing and treatment uptake remain suboptimal. The aim of this systematic review was to synthesize evidence on the effectiveness of interventions to increase HCV testing, linkage to care and treatment uptake among people in prisons. METHODS: We searched Medline (Ovid 1996-present), Embase (Ovid 1996-present), and the Cochrane Central Register of Controlled Trials for English language articles published between January 2007 and November 2017. Studies evaluating interventions to enhance HCV testing, linkage to care and treatment uptake for people in prison were included. Two independent reviewers evaluated articles selected for full-text review. Disagreements were resolved by consensus. RESULTS: A total of 475 unique articles were identified, 29 were eligible for full text review, and six studies were included. All but one study was conducted in the pre-direct-acting antiviral (DAA) era; no studies were conducted in low- or middle-income countries. Of the six studies, all but one focused on testing. Only two were randomised controlled trials; the remaining were single arm studies. Interventions to enhance HCV testing in prison settings included combination risk-based and birth-cohort screening strategies, on-site nurse-led opt-in screening clinics with pre-test counselling and education, and systematic dried blood spot testing. All interventions increased HCV testing, but risk of study bias was high in all studies. Interventions to enhance linkage to care included facilitated referral for HCV assessment and scheduling of specialist appointments; however, risk of study bias was critical. CONCLUSIONS: There is a lack of recent data on interventions to improve the HCV care cascade in people in prisons. With the introduction of short-course, well-tolerated DAAs, rigorous controlled studies evaluating interventions to improve testing, linkage and treatment uptake for people in prison are necessary. Crown
BACKGROUND: While the burden of chronic hepatitis C virus (HCV) infection is significantly higher among people in prisons compared to the general population, testing and treatment uptake remain suboptimal. The aim of this systematic review was to synthesize evidence on the effectiveness of interventions to increase HCV testing, linkage to care and treatment uptake among people in prisons. METHODS: We searched Medline (Ovid 1996-present), Embase (Ovid 1996-present), and the Cochrane Central Register of Controlled Trials for English language articles published between January 2007 and November 2017. Studies evaluating interventions to enhance HCV testing, linkage to care and treatment uptake for people in prison were included. Two independent reviewers evaluated articles selected for full-text review. Disagreements were resolved by consensus. RESULTS: A total of 475 unique articles were identified, 29 were eligible for full text review, and six studies were included. All but one study was conducted in the pre-direct-acting antiviral (DAA) era; no studies were conducted in low- or middle-income countries. Of the six studies, all but one focused on testing. Only two were randomised controlled trials; the remaining were single arm studies. Interventions to enhance HCV testing in prison settings included combination risk-based and birth-cohort screening strategies, on-site nurse-led opt-in screening clinics with pre-test counselling and education, and systematic dried blood spot testing. All interventions increased HCV testing, but risk of study bias was high in all studies. Interventions to enhance linkage to care included facilitated referral for HCV assessment and scheduling of specialist appointments; however, risk of study bias was critical. CONCLUSIONS: There is a lack of recent data on interventions to improve the HCV care cascade in people in prisons. With the introduction of short-course, well-tolerated DAAs, rigorous controlled studies evaluating interventions to improve testing, linkage and treatment uptake for people in prison are necessary. Crown
Authors: Nadine Kronfli; Camille Dussault; Sofia Bartlett; Dennaye Fuchs; Kelly Kaita; Kate Harland; Brandi Martin; Cindy Whitten-Nagle; Joseph Cox Journal: Can Liver J Date: 2021-08-09
Authors: David Ortiz-Paredes; Afia Amoako; Taline Ekmekjian; Kim Engler; Bertrand Lebouché; Marina B Klein Journal: Front Public Health Date: 2022-06-24
Authors: Nadine Kronfli; Roy Nitulescu; Joseph Cox; Erica Em Moodie; Alexander Wong; Curtis Cooper; John Gill; Sharon Walmsley; Valérie Martel-Laferrière; Mark W Hull; Marina B Klein Journal: J Int AIDS Soc Date: 2018-11 Impact factor: 5.396
Authors: Desmond Crowley; Ross Murtagh; Walter Cullen; Mary Keevans; Eamon Laird; Tina McHugh; Susan McKiernan; Sarah Jayne Miggin; Eileen O'Connor; Deirdre O'Reilly; Graham Betts-Symonds; Ciara Tobin; Marie Claire Van Hout; John S Lambert Journal: Harm Reduct J Date: 2019-07-05