Screening Inmates for Hepatitis C May Improve Public Health

A Mass General study suggests that in-prison screening could reduce overall prevalence of hepatitis C.

Screening and treating local inmates for hepatitis C could greatly reduce transmission in the general population, according to recent projections by Massachusetts General Hospital and the University of Pittsburgh Graduate School of Public Health.

Hepatitis C, a blood-borne virus primarily transmitted through needles, is the leading cause of liver cancer. The virus, while rare, disproportionately affects inmates: About 17 percent are infected, usually through drug use, versus 1 percent of the general U.S. population. This year, hepatitis C surpassed HIV as one of the most frequent causes of death in prison communities.

Study lead Jagpreet Chhatwal, an assistant professor of radiology at Harvard Medical School, said in a statement that in-prison screening programs could greatly reduce rates of liver cancer, end-stage liver disease, and death, since hepatitis C can be treated better when caught early.

In addition to lowering transmission rates, a screening program could be highly cost effective, since the cost of extended screening and treatment early on is far lower than the cost of treatment at the disease’s advanced stages, according to the Mass General report.

These projections were based on a computer-simulated model that tested the outcomes of several screening techniques. The model predicted that, using the preferred strategy of universal screening among inmates, between 42,000 and 123,000 new cases of hepatitis C would be caught over a 30-year period. According to the research, which was recently published in the health journal Annals of Internal Medicine, that level of detection could save between $260 million and $760 million dollars.

Chhatwal emphasized in the statement that everyone stands to benefit from universal screening, even if it seems like an initial constraint on prisons’ limited budgets:

“Providing additional resources that would allow prisons to conduct programs like these would benefit society as a whole, both by reducing the need to treat infected inmates after they are released and by preventing future hepatitis C transmission and the associated costs.”