Screening for hepatitis C virus in the Dartmoor prison population: an observational study.
BACKGROUND
Prisons are a potential setting for hepatitis C screening. This study describes prisoner flows through such screening for all prisoners entering Dartmoor prison between 1 January 1998 and 30 June 2001.


METHODS
We identified numbers at each step of the screening pathway, from screening to result, referral, biopsy and outcome. We describe the proportions of those screened who were seropositive; seropositives who were confirmed virus-positive; virus-positive cases attending for biopsy; and virus-positive cases eligible for treatment.


RESULTS
Of 3034 entries into Dartmoor, 12 per cent were screened, with 16 per cent of these seropositive. Seventynine per cent of seropositive prisoners with a polymerase chain reaction result were confirmed virus-positive, and 27 per cent of these prisoners had a biopsy. Two prisoners were eligible for treatment.


CONCLUSIONS
Screening uptake is low. Attrition rates are high, especially at the referral interface between the prison and specialist care. Finally, the yield of individuals eligible for treatment is low, at 7/1000 tested.
Horne
J A
JA
South West Dorset PCT, Hillfort House, Poundbury Road, Dorchester DT1 2PN. jane.horne@nhs.net
Clements
A J
AJ
Drennan
P
P
Stein
K
K
Cramp
M E
ME
D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D016174:Hepacivirus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D016133:Polymerase Chain Reaction; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D011330:Prisons; D012017:Referral and Consultation; D016036:Seroepidemiologic Studies; D013222:State Medicine