# Prospective Evaluation of Blood Borne Virus Testing in Custody Suites in North‐East England

## TL;DR

A blood borne virus testing program in custody suites in North-East England found a high rate of active hepatitis C infections, with most starting treatment.

## Contribution

This study demonstrates the feasibility of BBV testing in custody suites and highlights its potential for HCV elimination efforts.

## Key findings

- 12 newly identified HCV infections were found among 582 tested individuals.
- 77% of those with active HCV infection started antiviral treatment.
- No cases of HBV or HIV were identified in the study period.

## Abstract

Drug‐related crime is a common reason for arrest. Therefore, some arrested individuals are at risk of hepatitis C virus infection (HCV). We present the outcomes of a blood borne virus (BBV) testing programme in custody suites in North‐East England. Individuals reviewed in healthcare departments of three custody suites were offered dry blood spot BBV testing for HCV, hepatitis B (HBV) and human immunodeficiency virus (HIV) between July 2021 and June 2024. Data were collected prospectively on numbers tested, virology results and treatment outcomes. In total, 582 had BBV testing (508 [87%] valid HCV antibody and HCV RNA tests). Overall, 13% (64) had a detectable HCV antibody and 6% (31) had detectable HCV RNA indicating active HCV infection. Of these, 12 (39% of HCV RNA positive; 2.3% of all tested) were newly identified infections. Twenty‐four individuals (77%) commenced antiviral treatment. Six individuals did not start antiviral treatment because of non‐engagement, and one is in treatment workup. Of the 33 HCV antibody–positive, but RNA‐negative individuals, 20 (61%) had previous antiviral treatment and achieved SVR, nine (27%) were thought to have spontaneously cleared the infection and four (12%) were on treatment at the time of testing. There were no cases of HBV or HIV identified. Dry blood spot testing for BBVs in custody suites is feasible and identifies a high proportion with active HCV infection, with the majority commencing antiviral treatment. Viral hepatitis services should consider expanding BBV testing to custody suites to help work towards HCV elimination.