Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC, Canada.
Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, QC, Canada.
Front Public Health. 2024 Jul 23;12:1380126. doi: 10.3389/fpubh.2024.1380126. eCollection 2024.
Little is known about the impact of the COVID-19 pandemic on hepatitis C (HCV) screening efforts in carceral settings. We explored the impact of the pandemic on HCV screening in two of Quebec's largest provincial prisons.
Retrospective data of HCV-related laboratory tests between July 2018 and February 2022 at l'Établissement de détention de Montréal (EDM) and l'Établissement de détention de Rivière-des-Prairies (EDRDP) were obtained. To examine the association between the pandemic and the number of HCV-antibody (HCV-Ab) tests, a three-level time period variable was created: pre-outbreak, outbreak, and post-outbreak. Negative binomial regression (with monthly admissions as an offset) was used to assess the change in HCV-Ab tests across time periods and by prisons. Adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) were calculated.
A total of 1,790 HCV-Ab tests were performed; 56 (3%) were positive. Among these, 44 (79%) HCV RNA tests were performed; 23 (52%) were positive. There was a significant decrease in HCV-Ab screening at EDM during the outbreak (aOR 0.29; 95% CI 0.17-0.48) and post-outbreak (aOR 0.49; 95% CI 0.35-0.69) periods, compared to the pre-outbreak period. There was no significant change in HCV-Ab screening at EDRDP during the outbreak (aOR 0.98; 95% CI 0.49-2.11) but a significant increase in HCV-Ab screening post-outbreak (aOR 1.66; 95% CI 1.04-2.72).
The COVID-19 pandemic negatively affected HCV screening at EDM but had minimal impact at EDRDP. To eliminate HCV from carceral settings, minimizing screening interruptions during future outbreaks and combined HCV/SARS-CoV-2 screening should be prioritized.
关于 COVID-19 大流行对监禁环境中丙型肝炎 (HCV) 筛查工作的影响知之甚少。我们探讨了大流行对魁北克省两个最大的省级监狱 HCV 筛查的影响。
获得了 2018 年 7 月至 2022 年 2 月期间在蒙特利尔拘留中心 (EDM) 和里维耶尔-德普雷迪埃拘留中心 (EDRDP) 进行的 HCV 相关实验室检测的回顾性数据。为了研究大流行与 HCV 抗体 (HCV-Ab) 检测数量之间的关联，创建了一个三级时间段变量：爆发前、爆发中和爆发后。使用负二项回归（以每月入院人数为偏移量）评估不同时间段和监狱之间 HCV-Ab 检测的变化。计算了调整后的优势比 (aOR) 和 95%置信区间 (95%CI)。
共进行了 1790 次 HCV-Ab 检测；56 次（3%）呈阳性。其中，44 次（79%）进行了 HCV RNA 检测；23 次（52%）呈阳性。与爆发前相比，EDM 在爆发期间（aOR 0.29；95%CI 0.17-0.48）和爆发后（aOR 0.49；95%CI 0.35-0.69）期间 HCV-Ab 筛查明显减少。EDRDP 期间 HCV-Ab 筛查无显著变化（aOR 0.98；95%CI 0.49-2.11），但爆发后 HCV-Ab 筛查显著增加（aOR 1.66；95%CI 1.04-2.72）。
COVID-19 大流行对 EDM 的 HCV 筛查产生了负面影响，但对 EDRDP 的影响很小。为了消除监禁环境中的 HCV，应优先考虑在未来的爆发中尽量减少筛查中断，并进行 HCV/SARS-CoV-2 联合筛查。
