Dr Cristina Sotomayor-Castillo1, Mrs. Tracey Jones1, Mrs. Emily Ward1, Ms. Jacqueline Clegg1, Mr. Thomas Wright1, Mrs. Tracey Brown1
1Justice Health NSW, Sydney Olympic Park, Australia
Biography:
Dr Sotomayor-Castillo joined Justice Health NSW early 2022. She holds a DVM bachelor's degree, a Masters in Preventative Medicine and Epidemiology, and a PhD in the utility of genomics science as an efficient surveillance and monitoring tool for early outbreak detection. Her knowledge and experience in the field of infectious diseases, outbreak management and IPC are extremely relevant considering the unique and challenging circumstances surrounding custodial settings and the highly vulnerability of this population.
Abstract:
Introduction
Justice Health and Forensic Mental Health Network (JHNSW) provides comprehensive healthcare services to individuals within the correctional system. There is a close relationship between injecting drugs, imprisonment, and hepatitis C virus (HCV) infection. Since 2016, JHNSW treats HCV infection with direct acting antivirals across prisons to reduce transmission risks in custody and in the wider community upon release. NSW Health has set a goal to eliminate HCV in NSW by 2028, with JHNSW playing a leading role in terms of treatment delivery and virtual elimination of HCV in NSW Prisons if this target is to be achieved.
Methods
Retrospective analysis estimating the number of patients under custody initiating HCV treatment between FY 2015/16 and FY 2022/23.
Results
Since the introduction of HCV curative treatment in 2016, JHNSW has dispensed a total of 6,360 treatments across centres until FY2022/23. Of these, 22.2% (n=1,411) correspond to patients receiving two or more treatment, with 58.4% (n=841) of them identified as of indigenous background. A total of 434 individuals remained in custody between treatment episodes. Of all treatments dispensed, 1,008 patients required treatment due to reinfections.
Conclusions
JHNSW has provided treatment, equivalent to approximate $12M in avoided healthcare costs. It was one of the first jurisdictions to establish a comprehensive retreatment surveillance system. Multiple strategies are in place to support elimination efforts including early infection identification, novel testing, clinical models redesigned, harm reduction and other educational models.