Screening And Treating Prisoners For Hepatitis C Could Reduce Infection Rate In General Population

Nov 26, 2015

Paper from researchers at Pitt and elsewhere finds screening and treating prison inmates for Hepatitis C could reduce infection among the general population.
Credit Michael Coghlan / Flickr

Screening and treating prison inmates for Hepatitis C would help reduce the number of infections in the general population according to projections made by researchers at the University of Pittsburgh Graduate School of Public Health and Massachusetts General Hospital. 

About 2.7 million people in the U.S. are infected with Hep C, according to the U.S. Centers for Disease Control and Prevention.

Of those currently infected, many contracted the disease through blood transfusions – a holdover from when donated blood was not yet screened. But new infections are still popping up.

“The most common reason for picking up Hepatitis C now is through intravenous drug abuse, or sharing of needles from people who are affected to people who are unaffected,” said co-author Mark Roberts, MD, department chair and professor of health policy and management at Pitt.

He said while they may contract it in prison, there are risks to the greater community.

“People who have and get Hepatitis C in prisons, once they get out and they go back to their community, they actually turn out to be a surprisingly large contributor to the new people who get Hepatitis C,” said Roberts.

Roberts and the other investigators developed a model showing the progression of Hepatitis C; another model represented people in the prison population and community at large and looked at a range of risk categories and other factors. They found that screening and treating those in prison could prevent 80 to 90 percent of new infections in the general population.

“One of the big barriers to this is that prisons don’t have a lot of extra money hanging around and this would be hundreds of millions of dollars to screen and treat all of the people who are currently in prison,” said Roberts.  

It would cost about $900 million to screen and treat every prison inmate, according to Roberts.

Hepatitis C, when left untreated, can lead to chronic health problems. It is the leading cause of cirrhosis and liver cancer and the most common reason for the need for a liver transplant in the U.S., according to the CDC. Roberts said this paper, published in the Annals of Internal Medicine, is one of a series examining Hepatitis C.

“What we were trying to do with this paper was show that from society’s point of view, it actually makes sense to direct resources to prison, to treat the epidemic in prison so that you will impact the epidemic outside of prison,” said Roberts.

Jagpreet Chhatwal, PhD, with MGH was senior author of the report; other co-authors included John Grefenstette, PhD (Pitt); Kan Ki, MS, University of Texas Health Science Center at Houston; Anne Spaulding, MD, MPH, Rollins School of Public Health, Emory University; and Turgay Ayer, PhD, Georgia Institute of Technology. The study was funded by the National Institutes of Health and the China Scholarship Council.