New opportunities for the management and therapy of hepatitis C in correctional settings

Abstract

Hepatitis C in prison populations is now a major public health problem, and large numbers of correctional facilities have no comprehensive management program, often because of formidable projected costs and tightening budget constraints. The North Dakota Department of Corrections and Rehabilitation has operated a management and therapy program since 2002 using consensus interferon and ribavirin with 45% cost savings. The program has provided excellent sustained viral responses: 54.2% for genotype 1 hepatitis C, 75% for genotypes 2 and 3, and 63.6% overall.

FIGURE 1

Treatment protocol for hepatitis C therapy using consensus interferon and ribavirin: North Dakota Department of Corrections and Rehabilitation, July 2002–November 2008. Note. BID = twice daily; MCG = micrograms. ^a15 mcg subcutaneously three times a week.

FIGURE 2

Outcomes of hepatitis C therapy using consensus interferon and ribavirin: North Dakota Department of Corrections and Rehabilitation, July 2002–November 2008. Note. SVR = sustained virologic response; EVR = early virologic response. ^aAll genotype 1. ^bFour genotype 1, one genotype 3 and one genotype 4. ^cOne inmate quit voluntarily, one inmate discontinued due to illegal drug use, and one inmate failed EVR.