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"Seek, Test, Treat and Retain" For Hepatitis C in the United States Criminal Justice System

The potential benefits and challenges of applying “seek, test, treat and retain” (STTR) model of care to hepatitis C virus (HCV) in the US criminal justice system is examined. Sections of this article cover: seek-the potential of criminal justice populations for case findings; test-expanding HCV testing through opt-out screening; treat-implications of emerging HCV therapies for correctional settings; retain-ensuring adherence during and after incarceration; and challenges to HCV STTR in the criminal justice system, directions for future research, and conclusions. "The burden of morbidity and mortality associated with chronic HCV infection in the USA is increasing and without significantly increased treatment uptake, will likely continue to do so for several decades. The authors argue that the US criminal justice system is an ideal focus for HCV case finding and treatment due to a high prevalence of infection and large volume of individuals in contact with this system. STTR would identify large numbers of HCV infections, leading to opportunities for secondary prevention and primary care. Important challenges to the implementation of STTR include treatment costs and training of prison medical providers" (p. 164).