HCV-related mortality among male prison inmates in Texas, 1994-2003.
OBJECTIVE
The prevalence of hepatitis C virus (HCV) infection is high among adult incarcerated populations, but HCV-related mortality data are lacking. The study purpose was to assess HCV-related mortality over time and across racial/ethnic categories from 1994 through 2003 among male prisoners in the Texas Department of Criminal Justice (TDCJ).


METHODS
TDCJ decedent data were linked with Texas Vital Statistics multiple-cause-of-death data. Crude annual HCV death rates, age- and race-adjusted summary rates, and average annual percent changes were estimated. The proportion of deaths due to chronic liver disease/cirrhosis, liver cancer, hepatitis B, and HIV for which HCV was identified as an intervening or contributing cause of death was calculated.


RESULTS
Among Texas male prisoners, HCV death rates were high and increased over the 10-year study period by an average 21% annually, with the largest increase occurring among Hispanic prisoners. HCV was identified as an intervening or contributing cause of death in 15% of chronic liver disease/cirrhosis deaths, 33% of liver cancer deaths, 81% of hepatitis B deaths, and 7% of HIV deaths.


CONCLUSIONS
Because HCV-related deaths among Texas male prisoners are high and increasing, particularly among Hispanics, targeted prevention, screening, and treatment of HCV infections should be among the priorities of U.S. correctional healthcare systems.
Harzke
Amy J
AJ
Department of Preventive Medicine and Community Health and the Correctional Managed Care Division, University of Texas Medical Branch, Galveston, Texas 77555, USA. ajharzke@utmb.edu
Baillargeon
Jacques G
JG
Kelley
Michael F
MF
Diamond
Pamela M
PM
Goodman
Karen J
KJ
Paar
David P
DP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015658:HIV Infections / Q000150:complications / Q000401:mortality; D006509:Hepatitis B / Q000150:complications / Q000401:mortality; D006526:Hepatitis C / Q000150:complications / Q000401:mortality*; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000401:mortality; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011330:Prisons / Q000706:statistics & numerical data*; D013781:Texas / Q000453:epidemiology