Chronic hepatitis C in the state prison system: insights into the problems and possible solutions.
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.
Imperial
Joanne C
JC
Correctional Medicine Consultation Network, University of California, San Francisco, 1940 Bryant Street, San Francisco, CA 94110, USA. imperialj@fcm.ucsf.edu
D002140:California / Q000453:epidemiology; D005260:Female; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D011330:Prisons / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D013781:Texas / Q000453:epidemiology; D047568:Unsafe Sex