Chronic hepatitis C in the state prison system: insights into the problems and possible solutions

Abstract

The prevalence of chronic hepatitis C virus (HCV) within the correctional system is estimated to be 10–20-times greater than that which is reported in the general population. High-risk behavioral patterns probably account for the greater estimates in this population. Recent observations of more than 780 patient-inmates infected with HCV within the California Department of Corrections suggest a very high prevalence of advanced fibrosis in this population. Observational studies performed in Texas have shown that the rates of chronic liver disease-related deaths have increased significantly between 1989 and 2003, especially among Hispanic patient-inmates. Viral hepatitis accounts for a significant number of these chronic liver disease-related deaths. Identification of high-risk patient-inmates infected with HCV, as well as appropriation of funds for their treatment, should result in a decreased rate of liver-related complications. This should translate into reduced morbidity and cost to correctional institutions, as well as to improved public health and safety.

Keywords::

• barriers to care
• chronic hepatitis C
• chronic liver disease
• Correctional Medicine Consultation Network
• Department of Corrections
• incarcerated patients
• public health

Acknowledgements

I would like to acknowledge Lori Kohler, MD, Megan Mahoney, MD, Larry Boly, MD, Robert Protell, MD, Pat Nachin, APRN, Marian Kerbleski, RN, Ms Jenna Ferrara and all of our colleagues at CPHCS for their ongoing dedication and commitment to the care of this challenging population.

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.