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Perspective

The Importance of Prisons in Achieving Hepatitis C Elimination: Insights from the Australian Experience

1
Behaviours and Health Risks/Disease Elimination Programs, Burnet Institute, Melbourne 3004, Australia
2
Department of Gastroenterology, St Vincent’s Hospital Melbourne, Melbourne 3065, Australia
3
School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
4
Department of Medicine, University of Melbourne, Melbourne 3010, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Robert Flisiak
Viruses 2022, 14(3), 497; https://doi.org/10.3390/v14030497
Received: 31 December 2021 / Revised: 25 February 2022 / Accepted: 25 February 2022 / Published: 28 February 2022
(This article belongs to the Special Issue Ways to Eliminate Viral Hepatitis as a Global Health Threat)
Following the availability of highly effective direct-acting antivirals (DAAs) to treat hepatitis C infection, the uptake of treatment by people living with hepatitis C rose dramatically in high- and middle-income countries but has since declined. To achieve the World Health Organization’s (WHO) 2030 target to eliminate hepatitis C as a public health threat among people who inject drugs, an increase in testing and treatment is required, together with improved coverage of harm reduction interventions. The population that remains to be treated in high- and middle-income countries with high hepatitis C prevalence are among the most socially disadvantaged, including people who inject drugs and are involved in the criminal justice system, a group with disproportionate hepatitis C prevalence, compared with people in the wider community. Imprisonment provides an unrivalled opportunity for screening and treating large numbers of people for hepatitis C, who may not access mainstream health services in the community. Despite some implementation challenges, evidence of the efficacy, acceptability, and cost-effectiveness of in-prison hepatitis treatment programs is increasing worldwide, and evaluations of these programs have demonstrated the capacity for treating people in high numbers. In this Perspective we argue that the scale-up of hepatitis C prevention, testing, and treatment programs in prisons, along with the investigation of new and adapted approaches, is critical to achieving WHO elimination goals in many regions; the Australian experience is highlighted as a case example. We conclude by discussing opportunities to improve access to prevention, testing, and treatment for people in prison and other justice-involved populations, including harnessing the changed practices brought about by the COVID-19 pandemic. View Full-Text
Keywords: hepatitis C virus; prisons; people who inject drugs; disease elimination hepatitis C virus; prisons; people who inject drugs; disease elimination
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MDPI and ACS Style

Winter, R.J.; Holmes, J.A.; Papaluca, T.J.; Thompson, A.J. The Importance of Prisons in Achieving Hepatitis C Elimination: Insights from the Australian Experience. Viruses 2022, 14, 497. https://doi.org/10.3390/v14030497

AMA Style

Winter RJ, Holmes JA, Papaluca TJ, Thompson AJ. The Importance of Prisons in Achieving Hepatitis C Elimination: Insights from the Australian Experience. Viruses. 2022; 14(3):497. https://doi.org/10.3390/v14030497

Chicago/Turabian Style

Winter, Rebecca J., Jacinta A. Holmes, Timothy J. Papaluca, and Alexander J. Thompson. 2022. "The Importance of Prisons in Achieving Hepatitis C Elimination: Insights from the Australian Experience" Viruses 14, no. 3: 497. https://doi.org/10.3390/v14030497

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