Themed Collections: World Hepatitis Day 28th July 2023

Hepatitis B virus (HBV) and C virus (HCV) infections are a major public health issue globally. The World Health Organization estimates that an estimated 58 million people have chronic HCV infection, with 1.5 million new infections each year and 290 000 deaths, mostly from cirrhosis and hepatocellular carcinoma (1). The focus of this year’s World Hepatitis Day is ‘We’re not waiting’, described as ‘a call to accelerate elimination efforts of viral hepatitis now and the urgent need for testing and treatment for the real people who need it’ (https://www.worldhepatitisday.org/.) This is particularly relevant to imprisoned populations across the world who not only have higher rates of Hepatitis B and C than populations in the community, (2) but are less likely to be able to access effective prevention and treatment.

In this theme issue, WEPHREN is highlighting work being done in prisons across England to tackle hepatitis B and C infections and also the global work undertaken by INHSU Prisons.

Listen to Mo speak about his experience with Hepatitis C

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UKHSA and Hepatitis C Trust work in prisons in England

There’s a great deal being done in England and the blog, Taking a place-based approach to tackling hepatitis in prisons - UK Health Security Agency (blog.gov.uk) outlines the multiagency, multifaceted work in prisons there. In addition, the Hepatitis C Trust does a great deal of work in valuable prisons in England and the organisation has shared a number of resources they have prepared for Hepatitis. They have been running a writing and an art competition and we hope we will be able to showcase the winning entries when they are announced!

From the local to the global: from INHSU Prisons

Scaling up hepatitis C virus (HCV) testing and treatment services in all carceral settings worldwide will be essential to achieving national and international HCV elimination by 2030. In many high-income countries, the wide availability of direct acting antivirals has resulted in a decline in community-based treatment uptake due to fewer eligible (or “warehoused”) patients. Countries on track for HCV elimination have thus shifted their focus to carceral settings, a strategy which has proven to be successful for many reasons. First, due to the criminalization of drug use in most countries, people who inject drugs – those at highest risk of HCV acquisition – experience high rates of incarceration. Second, the high throughput of high-risk populations means that scaling up HCV services has the potential to increase the number of new diagnoses and treatment initiations. Third, ongoing risky behaviours are prevalent due to the relative absence of prison-based harm reduction services, underscoring incarceration itself as a risk factor for HCV transmission and acquisition. Fourth, people who are incarcerated experience significant health care gaps due to lower rates of engagement in community models of care pre- or post-incarceration, meaning that this “hardly reached” population can be easily reached during their incarceration. Finally, studies have now shown that prison hepatitis programs are feasible, cost-effective, acceptable to all prison stakeholders including those who are incarcerated, and result in reduced HCV incidence. So, what is the world waiting for? It’s time to put correctional settings on the international HCV elimination agenda.

Nadine Kronfli, on behalf of INHSU Prisons

Further resources:

Resources from INHSU Prisons: https://inhsu.cmail19.com/t/t-e-zduaiy-jhjuzijdl-r/ 

Infographic with updated hepatitis C prevalence estimate:  Measuring progress towards the elimination of viral hepatitis as a public health problem in England (publishing.service.gov.uk)

Here is the link to the Hepatitis C Press Notice  

Report on hepatitis D: Hepatitis D in England and the UK - GOV.UK (www.gov.uk)