A pilot study of rapid hepatitis C virus testing in the Rhode Island Department of Corrections.
BACKGROUND
The correctional population bears a heavy burden of hepatitis C virus (HCV) infection necessitating expansion of HCV testing and treatment opportunities. Rapid HCV testing provides point-of-care antibody results and may be ideal for correctional facilities, particularly jails, where persons are often incarcerated for short periods of time, yet feasibility has not been established.


METHODS
We conducted a pilot study of a rapid HCV testing algorithm among short-term inmates with unknown HCV status. Participants completed a questionnaire, viewed an informational video and underwent rapid HCV testing and confirmatory testing, when indicated. Persons with chronic infection were referred to community care after release. Baseline characteristics, risk behaviors, test results and linkage were examined by descriptive analyses.


RESULTS
Two hundred and fifty-two inmates were enrolled and 249 completed all study activities. Twenty-five participants (10%) had reactive rapid tests and 23 (92%) completed confirmatory testing. 15/23 (65%) had detectable HCV RNA, but only 4 linked to care after release. Persons with reactive HCV tests were more likely to be White (P = 0.01) and to have ever injected (P < 0.0001) and/or recently injected (P < 0.0001) drugs.


CONCLUSIONS
Rapid HCV testing within jails is feasible, identifies previously unrecognized cases of HCV infection, and implementation should be considered. Low rates of linkage to care after release remain a barrier to care.
The Miriam Hospital/Alpert Medical School of Brown University, Providence, Rhode Island 02906, USA.
Curt G
CG
Beckwith
New York University, New York, NY, USA.
Ann E
AE
Kurth
The Miriam Hospital, Providence, Rhode Island, USA.
Lauri B
LB
Bazerman
The Miriam Hospital, Providence, Rhode Island, USA.
Emily J
EJ
Patry
George Washington University, Washington, DC, USA.
Alice
A
Cates
The Miriam Hospital, Providence, Rhode Island, USA.
Liem
L
Tran
The Miriam Hospital/Alpert Medical School of Brown University, Providence, Rhode Island 02906, USA.
Amanda
A
Noska
George Washington University, Washington, DC, USA.
Irene
I
Kuo
D000328:Adult; D003266:Continuity of Patient Care / Q000458:organization & administration; D005260:Female; D016174:Hepacivirus; D006526:Hepatitis C / Q000175:diagnosis*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D000067716:Point-of-Care Testing / Q000706:statistics & numerical data; D011329:Prisoners / Q000706:statistics & numerical data; D011330:Prisons / Q000706:statistics & numerical data*; D012237:Rhode Island / Q000453:epidemiology; D011795:Surveys and Questionnaires
hepatitis C virus; jail/prison; linkage to care, rapid HCV antibody test