Best practice guidelines for viral hepatitis service delivery in prisons - 03/12/25

Doi : 10.1016/S1473-3099(25)00630-9

Yumi Sheehan, PhD ^a,^{^{†
Contributed equally},}⁎ , Akhil Garg, MDCM ^b,^{^{†
Contributed equally}}, Julia Sheehan ^c, Nonso Maduka, BPharm ^d, Frederick L Altice, ProfMD ^e, Filipa Alves da Costa, PhD ^f,^g, Sean Cox ^c, Ahmed M Elsharkawy, PhD ^h, Ehab Salah, MD ⁱ, Mark Stoové, ProfPhD ^j,^k,^l, Lara Tavoschi, PhD ^m, Alexander J Thompson, ProfMBBS ^n,^o, Karla Thornton, ProfMD ^p, Andrew R Lloyd, ProfPhD ^a, Joaquín Cabezas, MD ^q,^r, Matthew J Akiyama, MD ^s,^t, Nadine Kronfli, MD ^b,^u,⁎
^a Viral Immunology Systems Program, Kirby Institute, University of New South Wales, Sydney, NSW, Australia
^b Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, QC, Canada
^c The Hepatitis C Trust, London, UK
^d Bensther Development Foundation, Enugu, Nigeria
^e Yale University, New Haven, CT, USA
^f WHO, Regional Office for Europe, Copenhagen, Denmark
^g Research Institutes for Medicines, Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal
^h Liver Unit and National Institute for Health and Care Research Biomedical Research Centre at University Hospitals Birmingham, Birmingham, UK
ⁱ UN Office on Drugs and Crime, Vienna, Austria
^j Burnet Institute, Melbourne, VIC, Australia
^k School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
^l Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
^m Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
ⁿ Department of Gastroenterology, St Vincent’s Hospital Melbourne, Melbourne, VIC, Australia
^o University of Melbourne, Melbourne, VIC, Australia
^p University of New Mexico School of Medicine, Albuquerque, NM, USA
^q Gastroenterology and Hepatology Department, University Hospital Marques de Valdecilla, Santander, Spain
^r Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute, Santander, Spain
^s Department of Medicine, Albert Einstein College of Medicine, New York City, NY, USA
^t Montefiore Medical Centre, New York City, NY, USA
^u Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, QC, Canada

^*Correspondence to: Dr Yumi Sheehan, Viral Immunology Systems Program, Kirby Institute, University of New South Wales, Sydney 2052, NSW, AustraliaViral Immunology Systems ProgramKirby InstituteUniversity of New South WalesSydneyNSW2052Australia^**Dr Nadine Kronfli Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal H3H 2R9, QC, CanadaCentre for Outcomes Research and EvaluationResearch Institute of the McGill University Health CentreMontréalQCH3H 2R9Canada

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 03 December 2025

Summary

Viral hepatitis constitutes a major health burden among people living in prison globally. There is poor access to prison-based viral hepatitis services, and people living in prison are rarely prioritised for care, undermining global elimination efforts. This Review is a narrative summary of the first Global Guidelines for Viral Hepatitis Service Delivery in Prisons , which included a systematic review and an expert-led GRADE process to develop best practice recommendations for viral hepatitis management in prisons. 703 articles were included, underpinning the development of 30 recommendations across eight domains: policy, testing, treatment, continuity of care, prevention and harm reduction, education, minority populations and special considerations, and monitoring and evaluation. Quality of evidence and strength of recommendations were rated as A1 (n=5), B1 (n=7), C1 (n=10), D1 (n=7), and expert opinion (n=1). The guidelines aim to standardise a global approach to prison-based viral hepatitis elimination efforts with consistent policy, practice, and reporting.

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