{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T15:55:36Z","timestamp":1771862136452,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T00:00:00Z","timestamp":1542758400000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CIHR FDN\u2010143270"],"award-info":[{"award-number":["CIHR FDN\u2010143270"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern AIDS Soc"],"published-print":{"date-parts":[[2018,11]]},"abstract":"Abstract<\/jats:title>Introduction<\/jats:title>The prevalence of hepatitis C virus (HCV<\/jats:styled-content>) is far higher in prison settings than in the general population; thus, micro\u2010elimination strategies must target people in prison to eliminate HCV<\/jats:styled-content>. We aimed to examine incarceration patterns and determine whether incarceration impacts HCV<\/jats:styled-content> treatment uptake among Canadian HIV<\/jats:styled-content>\u2010HCV<\/jats:styled-content> co\u2010infected individuals in the direct\u2010acting antiviral (DAA<\/jats:styled-content>) era.<\/jats:p><\/jats:sec>Methods<\/jats:title>The Canadian Co\u2010Infection Cohort prospectively follows HIV<\/jats:styled-content>\u2010HCV<\/jats:styled-content> co\u2010infected people from 18 centres. HCV RNA<\/jats:styled-content>\u2010positive participants with available baseline information on incarceration history were included and followed from 21 November 2013 (when second\u2010generation DAA<\/jats:styled-content>s were approved by Health Canada) until 30 June 2017. A Cox proportional hazards model was used to assess the effect of time\u2010updated incarceration status on time to treatment uptake, adjusting for patient\u2010level characteristics known to be associated with treatment uptake in the DAA<\/jats:styled-content> era.<\/jats:p><\/jats:sec>Results<\/jats:title>Overall, 1433 participants (1032\/72% men) were included; 67% had a history of incarceration and 39% were re\u2010incarcerated\u00a0at least once. Compared to those never incarcerated, previously incarcerated participants were more likely to be Indigenous, earn <$1500 CAD<\/jats:styled-content>\/month, report current or past injection drug use and have poorly controlled HIV<\/jats:styled-content>. There were 339 second\u2010generation DAA<\/jats:styled-content> treatment initiations during follow\u2010up (18\/100 person\u2010years). Overall, 48% of participants never incarcerated were treated (27\/100 person\u2010years) compared to only 31% of previously incarcerated participants (15\/100 person\u2010years). Sustained virologic response (SVR<\/jats:styled-content>) rates at 12\u00a0weeks were 95% and 92% respectively. After adjusting for other factors, participants with a history of incarceration (adjusted hazard ratio (aHR<\/jats:styled-content>): 0.7, 95% CI<\/jats:styled-content>: 0.5 to 0.9) were less likely to initiate treatment, as were those with a monthly income <$1500 (aHR<\/jats:styled-content>: 0.7, 95% CI<\/jats:styled-content>: 0.5 to 0.9) or who reported current injection drug use (aHR<\/jats:styled-content>: 0.7, 95% CI<\/jats:styled-content>: 0.4 to 1.0). Participants with undetectable HIV RNA<\/jats:styled-content> (aHR<\/jats:styled-content>: 2.1, 95% CI<\/jats:styled-content>: 1.6 to 2.9) or significant fibrosis (aHR<\/jats:styled-content>: 1.5, 95% CI<\/jats:styled-content>: 1.2 to 1.9) were more likely to initiate treatment.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The majority of HIV<\/jats:styled-content>\u2010HCV<\/jats:styled-content> co\u2010infected persons had a history of incarceration. Those previously incarcerated were 30% less likely to access treatment in the DAA<\/jats:styled-content> era even after accounting for several patient\u2010level characteristics. With SVR<\/jats:styled-content> rates above 90%, HCV<\/jats:styled-content> elimination may be possible if treatment is expanded for this vulnerable and neglected group.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25197","type":"journal-article","created":{"date-parts":[[2018,11,21]],"date-time":"2018-11-21T12:10:23Z","timestamp":1542802223000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Previous incarceration impacts access to hepatitis C virus (HCV) treatment among HIV\u2010HCV co\u2010infected patients in Canada"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2724-0496","authenticated-orcid":false,"given":"Nadine","family":"Kronfli","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases\/Chronic Viral Illness Service Department of Medicine Glen site McGill University Health Centre Montreal QC 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