Hepatitis C (HCV) infection is an emerging epidemic that is particularly threatening to prisoners, with approximately one-third of U.S. inmates infected. HCV leads to cirrhosis, liver cancer, liver failure, and is the leading cause of liver transplantation in the U.S. Treatment of HCV is estimated at $700 million annually. Of those infected, 85% become chronic carriers, perpetually capable of infecting others. Adoption of certain behaviors can lead to reduction in long-term sequelae in those infected. Risks for HCV infection include injection drug use (IDU), tattooing, body piercing, and contact with contaminated blood and body fluids. Statistics reveal that between 1/3 to 2/3 of inmates have a history of IDU before incarceration and continue this behavior while in prison. There is also the common practice of tattooing and high-risk sexual activity that increases the likelihood of contracting and spreading HCV behind prison walls. The risk behaviors for HCV are similar to those for HIV infection, though HCV is more highly contagious and is more prevalent than HIV infection in correctional facilities. While the threat of HIV transmission has been recognized and policies and programs designed to reduce transmission in correctional facilities have been implemented in United States, little attention has been paid to HCV prevention. This paper describes existing U.S. policies regarding HCV prevention in correctional facilities, compares them with HIV prevention policies, and provides recommendations for development and improvement of HCV prevention policies.
Keywords: Hepatitis C, Prison
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