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.
Correctional Medicine Consultation Network, University of California, San Francisco, 1940 Bryant Street, San Francisco, CA 94110, USA. imperialj@fcm.ucsf.edu
Joanne C
JC
Imperial
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