A prison-based hepatitis C screening and treatment program could benefit the broader community, researchers suggest.
Besides reducing the spread of hepatitis C after prisoners are released, “universal [hepatitis C] testing and treatment in prisons would reduce outcomes of advanced [hepatitis C] such as liver cancer, end-stage liver disease and death among prisoners,” said study senior author Jagpreet Chhatwal, of Massachusetts General Hospital’s Institute for Technology Assessment in Boston.
“We now have highly effective treatments for [hepatitis C], so we wanted to know the impact of providing routine testing and treatment to inmates, a group in which the infection is highly prevalent,” Chhatwal said in a hospital news release.
More than 1 percent of the U.S. population has hepatitis C, but the virus affects more than 17 percent of prisoners, the researchers said. Use of injected drugs is the leading cause of hepatitis C among people with a history of imprisonment, the researchers noted.
While most patients respond to anti-viral medication, treatment is expensive and might be discouraged in federal prisons with limited health care budgets, the study said.
The researchers developed a computer model to project the results of four screening strategies: one-time screening of inmates with a history of injected drug use or screening of all inmates for one, five or 10 years, unless they opted out.
The study, published Nov. 23 in Annals of Internal Medicine, found the four screening strategies would significantly increase the number of inmates diagnosed with the virus — perhaps by nearly 123,000 cases over a 30-year period.
Treating these inmates when their hepatitis C infection advances could prevent up to 12,700 new cases. Prison screening could also prevent up to 11,700 liver-related deaths, as many as 8,600 liver cancers, up to 7,300 cases of end-stage liver disease, and up to 900 liver transplants, the researchers concluded.
The four inmate screening strategies could also cut hepatitis C-related costs by at least $260 million and possibly as much as $760 million, the researchers said. Although screening and treatment would increase state and federal prison budgets by 12.4 percent in the first year, the model predicted that over 30 years these measures would become highly cost-effective.
“Prisons have limited budgets and may therefore be reluctant to provide universal [hepatitis C] screening and treatment,” said Chhatwal. “But providing additional resources that would allow prisons to conduct programs like these would benefit society as a whole.”
The U.S. Centers for Disease Control and Prevention provides more information on hepatitis C.