Faculty Collaboration Database

The Hepatitis C virus treatment cascade at an urban postincarceration transitions clinic. J Viral Hepat 2016 Jun;23(6):473-8

Date

02/10/2016

Pubmed ID

26856967

Pubmed Central ID

PMC4850086

DOI

10.1111/jvh.12512

Scopus ID

2-s2.0-84964596724 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

Transitions clinics, which provide medical care to individuals who have been released from incarceration, reach a population at high risk for hepatitis C Virus (HCV) infection. We used the HCV treatment cascade to describe HCV care at an urban postincarceration transitions clinic, identifying gaps in care and determining reasons for lapses in care. In this retrospective cohort study, we reviewed electronic health records for all formerly incarcerated individuals receiving care at the Bronx Transitions Clinic. HCV treatment cascade measures included the following: detection of HCV antibodies, confirmation of chronic infection, specialist referral, specialist evaluation, initiation of treatment, completion of treatment and achievement of SVR. We recorded reasons for lapses in care. Of 451 patients accessing care, 317 (70%) were screened for HCV antibodies, and 106 (33%) tested positive. Of the 106 antibody-positive patients, 93 (88%) were evaluated for HCV viremia and 84 (79%) were confirmed to have chronic HCV infection; 19% of the total sample had chronic HCV infection. Of these 84 with chronic HCV, 48 (57%) received specialist referral, 30 (36%) were evaluated, 8 (10%) initiated treatment, and 5 (6%) completed treatment and achieved SVR. Some treatment lapses occurred because patients were deemed unstable for treatment (12%) or were re-incarcerated (5%). Chronic HCV infection was common among transitions clinic patients. Few were treated and cured. Patients lost contact with providers before consideration for antiviral therapy. Referral to specialty providers was a gap in care. Increasing HCV treatment in this population will likely require intensive delivery models.

Author List

Hawks L, Norton BL, Cunningham CO, Fox AD

Author

Laura C. Hawks MD, MPH Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Antiviral Agents
Female
Health Services Research
Hepatitis C, Chronic
Humans
Male
Middle Aged
New York City
Prisons
Retrospective Studies
Transitional Care