Prisons could unlock hep C-free future

September 08, 2016

(Thursday, 8 September 2016: Oslo) Prisons provide one of the most significant opportunities to drive down the prevalence of hepatitis C, and help reach global WHO elimination goals, says new research presented at the 5th International Symposium on Hepatitis Care in Substance Users today.

"On the downside, it is clear that prisons act as incubators of hepatitis C, driving the epidemic both within the prison system and in the community at large," said Professor Andrew Lloyd of the University of New South Wales in Australia who leads hepatitis research in the prison system in that country.

"On the plus side, they also offer a unique environment to cure people of the disease and address the risk behaviour that fuels transmission. If we can turn prisons around, and use them to treat hepatitis C rather than facilitate its spread, then we can save lives, reduce the overall burden of disease and take concrete steps towards disease elimination."

Hepatitis C - virus which if left untreated can lead to cirrhosis and liver cancer - affects approximately 64-103 million people around the world, resulting in around 700 000 deaths per year. The World Health Organisation (WHO) has prioritised the disease, setting ambitious targets to reach elimination by 2030.

In high income countries 80% of new infections are in people who use drugs. Prisoners have a particularly high prevalence of hepatitis C with as many as 1 in 6 inmates carrying the disease in parts of Europe and the US, reflecting the fact that imprisonment and injecting drug use are closely linked. This high prevalence means that use of non-sterile injecting equipment whilst in prison carries a high risk of transmission.

A new modelling analysis - presented at INHSU 2016 and led by Professor Peter Vickerman at Bristol University's Division of Global Public Health - looked at hepatitis C transmission in scenarios mimicking four global settings: Scotland, Australia, Ukraine and Thailand. It found that prison could contribute massively to overall HCV transmission, whereas introducing prevention programs in prison and amongst individuals transitioning back to the community could significantly reduce these infections. The study is published as part of a recent Lancet-commissioned report on drugs and health.

Additional modelling studies in the UK have also shown that treatment with new highly effective therapies could also have a substantial impact, and could be cost-effective if continuity of care is ensured.

"It is clear from our modelling that incarceration is a very important driver of HCV transmission in many settings. It is unlikely that it will be controlled without focusing prevention and control measures on incarcerated individuals and those being released from prison," said Professor Vickerman.

So far, Australia is one of the only countries to look at the mass scale up of new hepatitis C treatment combined with prevention programs in a prison setting. Health experts at INHSU 2016 say the evidence indicates it is now time for other countries to follow their lead.

"The high level of mobility between prison and the community means that the health of prisoners should be a major public-health concern," said President of the International Network of Hepatitis C in Substance Users (INHSU), Associate Professor Jason Grebely, the Kirby Institute, UNSW Australia.

"Scaling up harm reduction programs and introducing testing and treatment strategies could potentially reduce and even reverse hepatitis C transmission and help us reach the WHO elimination goals. Yet, screening and treatment for hepatitis C is rarely made available to inmates.

If we are serious about treating this disease, we need to seize the opportunity prisons present and make testing, treatment and prevention in this setting a priority."

This symposium is the leading international conference focused on the management of hepatitis among substance users. It is organised by the International Network for Hepatitis in Substance Users (INHSU). The symposium is held biennially and was first held in Zurich, Switzerland, in 2009, Brussels, Belgium, in 2011, Munich, Germany, in 2013 and Sydney, Australia, in 2015.


Absence of NSPs in prisons makes HCV prevention difficult

Incarceration may contribute substantially to HCV transmission among PWID

High HCV incidence is observed in Australian prisons

Risk behaviours for HCV acquisition in the prison are high

International Network for Hepatitis C in Substance Users

Related Hepatitis Articles from Brightsurf:

Busting Up the Infection Cycle of Hepatitis B
Researchers at the University of Delaware have gained new understanding of the virus that causes hepatitis B and the ''spiky ball'' that encloses its genetic blueprint.

Liver cancer: Awareness of hepatitis D must be raised
Scientists from the University of Geneva (UNIGE) and the Geneva University Hospitals (HUG) have studied the most serious consequence of chronic hepatitis: hepatocellular carcinoma.

Hepatitis B: New therapeutic approach may help to cure chronic hepatitis B infection
Researchers at Helmholtz Zentrum München, Technical University of Munich (TUM) and the German Center for Infection Research (DZIF) have developed a novel therapeutic approach to cure chronic hepatitis B.

Anti-hepatitis medicine surprises
A new effective treatment of hepatitis C not only combats the virus, but is also effective against potentially fatal complications such as reduced liver functioning and cirrhosis.

Nanotechnology delivers hepatitis B vaccine
X-ray imaging shows that nanostructured silica acts as a protective vehicle to deliver intact antigen to the intestine so that it can trigger an immune response.

Checkmate for hepatitis B viruses in the liver
Researchers at Helmholtz Zentrum München and the Technical University of Munich, working in collaboration with researchers at the University Medical Center Hamburg-Eppendorf and the University Hospital Heidelberg, have for the first time succeeded in conquering a chronic infection with the hepatitis B virus in a mouse model.

How common is Hepatitis C infection in each US state?
Hepatitis C virus infection is a major cause of illness and death in the United States and injection drug use is likely fueling many new cases.

New strains of hepatitis C found in Africa
The largest population study of hepatitis C in Africa has found three new strains of the virus circulating in the general population in sub-Saharan Africa.

High stability of the hepatitis B virus
At room temperature, hepatitis B viruses (HBV) remain contagious for several weeks and they are even able to withstand temperatures of four degrees centigrade over the span of nine months.

Findings could lead to treatment of hepatitis B
Researchers have gained new insights into the virus that causes hepatitis B -- a life-threatening and incurable infection that afflicts more than 250 million people worldwide.

Read More: Hepatitis News and Hepatitis Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to