The International journal on drug policy · 2026
Impact of Hepatitis C screening and treatment among incarcerated populations in Alberta, Canada on population-level Hepatitis C elimination efforts.
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Tian Feng, Kronfli Nadine, Eze Nkiruka, Feng Zeny, Clement Fiona, Wong William W L
Аннотация
BACKGROUND: In Canada, 11 % of people in prison have been exposed to hepatitis C virus (HCV). Systematic screening and universal access to direct-acting antivirals (DAAs) for people in prison is needed for HCV elimination. This study aims to project the long-term impact of HCV screening and treatment intervention strategies, tailored to incarcerated populations, on the incidence and prevalence of HCV-related health outcomes of both the incarcerated and entire population of Alberta, Canada, up to 2050.
METHODS: An agent-based model was developed to characterize the HCV epidemic before and after the COVID-19 pandemic and the introduction of DAAs in Alberta, Canada. HCV transmission was simulated through contact networks, specifically designed for provincial prisons and the broader community. Model parameters were estimated from existing literature and calibrated against historical data. Sensitivity analyses were performed to assess uncertainty.
RESULTS: By maintaining 90 % HCV screening and DAA coverage among people in provincial prison starting in 2024, the incidence of chronic hepatitis C (CHC), CHC prevalence, and the incidence of CHC-induced liver-related deaths in incarcerated and non-incarcerated populations would decrease by 21.3 %, 54.0 %, and 89.1 %, and by 17.7 %, 53.5 %, and 62.3 %, respectively, between 2015 and 2050. Results were sensitive to the probability of initiating injection drug use and annual number of individuals initiating HCV treatment.
CONCLUSIONS: Offering HCV screening and treatment to people in Alberta provincial prison would accelerate population-level HCV elimination efforts in the province. Improved linkage to HCV care before and after release is essential to meet the desired goals.
METHODS: An agent-based model was developed to characterize the HCV epidemic before and after the COVID-19 pandemic and the introduction of DAAs in Alberta, Canada. HCV transmission was simulated through contact networks, specifically designed for provincial prisons and the broader community. Model parameters were estimated from existing literature and calibrated against historical data. Sensitivity analyses were performed to assess uncertainty.
RESULTS: By maintaining 90 % HCV screening and DAA coverage among people in provincial prison starting in 2024, the incidence of chronic hepatitis C (CHC), CHC prevalence, and the incidence of CHC-induced liver-related deaths in incarcerated and non-incarcerated populations would decrease by 21.3 %, 54.0 %, and 89.1 %, and by 17.7 %, 53.5 %, and 62.3 %, respectively, between 2015 and 2050. Results were sensitive to the probability of initiating injection drug use and annual number of individuals initiating HCV treatment.
CONCLUSIONS: Offering HCV screening and treatment to people in Alberta provincial prison would accelerate population-level HCV elimination efforts in the province. Improved linkage to HCV care before and after release is essential to meet the desired goals.