Epidemiology of Hepatitis C in Corrections

What is hepatitis C, and how does a person get it?

Hepatitis C is a virus that can be transmitted through the use of needles, blood exposure, or through some medical procedures.

Typically, a person becomes exposed via needles when they are an IV drug user who uses unclean needles or when they get a tattoo at an unlicensed facility.

A person can also become exposed to hepatitis C if they come into contact with blood that is infected with the virus. This can happen through trauma or through working in a medical facility where blood is present. Lastly, a person can become infected with hepatitis C if they had a blood transfusion or received an organ transplant prior to 1992.

Is the transmission rate different for prisoners vs. civilians?

Yes! It is estimated that the general civilian population has a hepatitis C rate of 1-2%, whereas the estimated prison population has an estimated hepatitis C rate of 30-35%. Although research is still being done to fully understand why, many believe that the problem is multi-faceted.

First, prisoners are more likely to have used IV drugs than the average civilian, which puts them at a higher risk. Second, people in prison are more likely to have experienced physical trauma either personally or by witnessing such, before or during prison, than the average person. This increases the likelihood that they have been in close proximity to someone else’s blood, either coming from an injured person or through a blood spill, which increases their chances of being exposed to the virus.

In addition, people in prison often come from a financially insecure background, where they may not have had access to medical testing or treatments, and even those who had frequent medical visits before prison are likely to not have access to consistent medical care while they are in prison, including receiving regular blood-work that would identify a hepatitis C infection in its earliest or acute phase, when treatment and cure rates are highest. This increases the likelihood that a person in prison will have a chronic hepatitis C infection.

My loved one is in prison, what should they do to avoid hepatitis C?

If someone you love is currently incarcerated and may have already been exposed to the hepatitis C virus, they may not have access to regular medical treatment, especially during the acute phase of a hepatitis C infection. This is because many early infections do not show symptoms, so they may not be aware they have been exposed, and they won’t know to request a blood test.

Also, some prisons and jails are understaffed in their medical departments, which can lead to long waits between the beginning of symptoms and the time the prisoner is provided with proper testing and diagnosis. However, they should report their exposure to blood and/or needles and request to see the medical staff as soon as possible in order to be tested for hepatitis C. If your loved one does not believe they have been exposed to blood or needles, they can minimize their risk by avoiding both.

If there are fights or other cause for bloodshed, the prisoner should avoid coming into contact with it. Prison guards have protocols in place regarding how to manage blood spills and it is important that they handle these events. Inmates who find dirty needles should not touch them. Prisoners who are currently using IV drugs but wish to quit should speak with their social worker or case worker about this goal, as well as discussing it with medical staff to begin a detoxification regimen.

I am in prison and think I have hepatitis C, what do I do?

If you are concerned that you may have been exposed to hepatitis C prior to or during your time in prison, it is important to alert the prison guard or your social worker as soon as possible. This will allow them to try to keep others safe from exposure, as well as to place you on the schedule to see the medical personnel on staff. As you may not know you have been exposed, and because not all exposure becomes a case of hepatitis C, you may experience a long wait time between requesting medical attention and being provided with a blood test.

If you find yourself experiencing symptoms of the hepatitis C virus, it is important to let your social worker know about them right away. These symptoms include fatigue, fever, nausea, abdominal pain, and/or jaundice (the yellowing of the skin or whites of the eyes). This may lead to an expedited medical appointment, where your blood can be tested for hepatitis C and a treatment plan if you test positive for the virus.1-6

View References
  1. Awofeso, MBChB, PhD, N. (2016). Publichealthreports.org. Retrieved 26 June 2016, from http://www.publichealthreports.org/issueopen.cfm?articleID=2480
  2. Editor, S. (2016). National Hepatitis Corrections Network - An Overview of Hepatitis C in Prisons and Jails. Hcvinprison.org. Retrieved 26 June 2016, from http://www.hcvinprison.org/resources/71-main-content/content/191-hepcprison
  3. Fox, R., Currie, S., Evans, J., Wright, T., Tobler, L., & Phelps, B. et al. (2005). Hepatitis C Virus Infection among Prisoners in the California State Correctional System. Clinical Infectious Diseases, 41(2), 177-186. http://dx.doi.org/10.1086/430913
  4. Larney, S., Kopinski, H., Beckwith, C., Zaller, N., Jarlais, D., & Hagan, H. et al. (2013). Incidence and prevalence of hepatitis C in prisons and other closed settings: Results of a systematic review and meta-analysis. Hepatology, 58(4), 1215-1224. http://dx.doi.org/10.1002/hep.26387
  5. Treloar, C., McCredie, L., & Lloyd, A. (2015). Acquiring hepatitis C in prison: the social organisation of injecting risk. Harm Reduction Journal, 12(1). http://dx.doi.org/10.1186/s12954-015-0045-2
  6. Zampino, R. (2015). Hepatitis C virus infection and prisoners: Epidemiology, outcome and treatment. WJH, 7(21), 2323. http://dx.doi.org/10.4254/wjh.v7.i21.2323