HCV in Incarcerated Populations: An Analysis of Gender and Criminality on Risk (Hepatitis C Virus) (Report‪)‬

The increasing size of the correctional population in the United States and the unique problems faced by the individuals under correctional control, whether in confinement or under community supervision, has created an ongoing public health concern. Prisoners have higher rates of many infectious diseases, including HIV, hepatitis, and tuberculosis as well as higher rates of some chronic diseases such as asthma (MacNeil, Lobato & Moore 2005; Baillargeon et al. 2003). Increased rates of risky behaviors and engagement in factors associated with poor health outcomes have been found in offending populations, including alcohol and other drug use, tobacco use, unprotected sex, and irregular health care (BJS 2005). Hepatitis C (HCV) is an infectious disease transmitted through blood that is endemic in drug-using populations (CDC 1998). Chronic hepatitis C infection (longer than six months), occurring in approximately 80% of all HCV cases, is often asymptomatic (Spaulding et al. 2006), can progress to symptomatic liver disease and death, and is the most common reason for liver transplant in the US. Injection drug use (IDU) is the behavior most associated with HCV infection, accounting for 57% of all HCV cases in the nonincarcerated population from 1999 to 2002. While prevalence of HCV was estimated at 1.6% in the US in 2002 (Armstrong et al. 2006), it is most likely that this is an underestimate, since the National Health and Nutrition Examination Survey (NHANES) data excludes homeless and incarcerated persons; these populations are more likely to have higher rates of HCV than the general population. Hepatitis C (HCV) is more common among offenders than the general population. In a study using the data from incarcerated offenders in 1997, Hammett, Harmon & Rhodes (2002) estimated that the prevalence of HCV infection in the correctional population ranged from 17% to 24%. They also estimated that 29% to 43% of all persons with HCV passed through the correctional system in 1997.