Theme: Models of Care Year: 2021
Background: Kombi clinic has been screening and linking Hepatitis C Virus (HCV) patients to care in marginalised communities across South East Queensland since 2017. In this time, it has become clear that more must be done in the Queensland correctional space to screen and cure HCV if we are to achieve elimination by 2030. HCV care for people incarcerated has a number of barriers including access to phlebotomy, time to results, access to Fibroscan and timely access to treatment. Further complication is offender movement without notice. Description of model of care: Kombi Clinic along with QuIHN, QHealth and Hepatitis Queensland launched facility wide blitz at Palen Creek Correction Centre over 3 days in December 2020 and Brisbane Women’s CC over 4 days in February 2021. Kombi Clinic has continued on to run regular Point of Care testing (PoCT) clinics at probation and parole offices throughout SE QLD. We use Cepheid GeneXpert HCV RNA as well as Fibroscan. Effectiveness: We conducted 366 GeneXpert HCV RNA tests which represents 95% of the prison population. Twenty patients were HCV positive and started on treatment within a week by the Kombi doctor or a corrections nurse practitioner. Fibroscan was performed where deemed appropriate. SVR time point is not yet reached. Qualitative data gathered from offenders to the acceptability of PoCT was overwhelmingly positive. Conclusion and next steps: Correction centre wide blitz of screening and linkage to HCV care is possible and highly effective with PoCT. The ability to screen and link to care an entire prison in a few days is a game changer to ensure timely commencement of treatment, without loss to follow up or delay. People in prison were also very welcoming of this testing modality. This model of care has clear ability to be replicated throughout other correctional centres. Disclosure of Interest Statement: GeneXpert machines and cartridges were provided free of charge by Gilead Sciences Pty. Ltd. via a pilot point-of-care testing program. Acknowledgement: Chris Wallis, Nurse Practitioner, West Moreton Prison Health Services Dr Young and Dr O’Loan have received honorariums from Gilead Sciences, AbbVie, Merck and Indivior
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