Hepatitis C in state correctional facilities

Background: No previous studies have examined the extent to which correctio nal facilities in the United States screen for and treat hepatitis C (HCV) infection. Methods: Medical directors of state correctional facilities responded to a survey assessing the degree to which prisons screen for and treat hepatitis C, To estimate numbers of inmates eligible for interferon treatment and to examine costs associated with HCV management, we constructed a feasibility model that incorporated screening criteria used in California and Rhode Is land. Results: Thirty-six states and Washington, DC, responded, resulting in a su rvey response rate of 73%, representing 77% of all inmates in state facilit ies nationwide. Colorado alone reported routine screening. Only California reported conducting a systematic seroprevalence study, which found that 39. 4% of male inmates were hepatitis C antibody positive in 1994, Seventy-thre e percent of the respondents sometimes consider treating with interferon, F our states follow a standard protocol. The feasibility model suggests that treating suitably screened inmates is a reasonable expenditure for correcti onal systems. Conclusion: Prison may be an appropriate setting for treatment of hepatitis C, If accompanying substance abuse issues are addressed, instituting HCV t reatment for certain eligible incarcerated individuals may be a worthy targ et for public health dollars. (C) 1999 American Health Foundation and Acade mic Press.