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High rate of hepatitis C reinfection following antiviral treatment in the North East England Prisons

Lookup NU author(s): Dr Ewan Hunter, Professor Stuart McPhersonORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley-Blackwell Publishing Ltd, 2020.

For re-use rights please refer to the publisher's terms and conditions.


To achieve elimination of hepatitis C (HCV), a critical group to prioritise for diagnosisand treatment is the prison population, where HCV prevalence is high. A universaloffer of blood-borne virus testing (UOBBVT) programme and a new treatment pathwaywere introduced to seven North East England (NEE) Prisons. Our aim was toassess: (a) the proportion of individuals with active HCV commencing direct-actingantivirals (DAAs); (b) the outcomes following DAA treatment; (3) the reinfection ratefollowing sustained virological response (SVR).Data were collected prospectively on BBVT uptake, HCV positivity, HCV treatmentoutcomes and reinfection from March 2016 onwards. 8538 individuals hadBBV testing. In total, 612 (7.2%) and 374 (4.4%) were HCV antibody positive andHCV RNA positive, respectively. Ultimately, 266 (71%) individuals commencedDAAs. Overall 111 achieved a documented SVR (42%), 17 (6%) failed treatment, 30(11%) were still on treatment or had not reached 12 weeks post-treatment at timeof analysis, and 108 (41%) were lost to follow-up. In those with a known outcome(n = 128), 87% achieved SVR. Worryingly, of those who achieved SVR, 21 (19%) weresubsequently identified as having been reinfected (median time from SVR to documentedreinfection 13 (range 7-25) months). The reinfection rate was 0.406 cases perperson-year follow-up. In conclusion, Implementation of a UOBBVT programme andnew treatment pathway resulted in increased diagnosis and treatment of HCV in theNEE prison population. However, the high HCV reinfection rate suggests a need toimprove harm reduction approaches.

Publication metadata

Author(s): Bhandari R, Morey S, Hamoodi A, Thompson C, Jones D, Hewett M, Hunter E, Taha Y, McPherson S

Publication type: Article

Publication status: Published

Journal: Journal of Viral Hepatitis

Year: 2020

Volume: 27

Issue: 4

Pages: 449-452

Print publication date: 01/04/2020

Online publication date: 21/11/2019

Acceptance date: 28/10/2019

Date deposited: 09/02/2020

ISSN (print): 1352-0504

ISSN (electronic): 1365-2893

Publisher: Wiley-Blackwell Publishing Ltd


DOI: 10.1111/jvh.13240


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