1117 Increasing liver-related mortality in incarcerated populations

Theodore, Dickens; Dougherty, Karen A.; Smith, Phillip H.; Jackson, Rosemary; Zacks, Steven; Galanko, Joseph; Russo, Mark; Stephens, Georgia; Fried, Michael

doi:10.1016/s0270-9139(03)81155-2

Hepatology

2003

DOI: 10.1016/s0270-9139(03)81155-2

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1117 Increasing liver-related mortality in incarcerated populations

Dickens Theodore¹,

Karen A. Dougherty²,

Phillip H. Smith³

et al.

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“…[7][8][9][10][11] An increase in deaths from liver disease among inmates has been observed. 12 The need to identify and treat inmates with HCV has been highlighted by both correctional and public health officials. [13][14][15][16][17] Challenges related to HCV treatment include: resource needs, limited epidemiologic and other data, treatment constraints related to duration of incarceration and indeterminate inmate length of stay, management of treatment side effects, frequent movement of inmates between facilities, co-morbidities, inmate attitudes and behaviors, lack of referral resources and follow-up after release, and difficulties in data collection.…”

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Promoting HCV Treatment Completion for Prison Inmates: New York State's Hepatitis C Continuity Program

et al. 2007

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SYNOPSISThis article describes the development of a statewide program providing continuity of hepatitis C virus (HCV) treatment to prisoners upon release to the community. We discussed length of stay as a barrier to treatment with key collaborators; developed protocols, a referral process, and forms; mobilized staff; recruited heath-care facilities to accept referrals; and provided short-term access to HCV medications for inmates upon release. The Hepatitis C Continuity Program, including 70 prisons and 21 health-care facilities, is a resource for as many as 130 inmates eligible to start treatment annually. Health-care facilities provide fairly convenient access to 87.1% of releasees, and 100% offer integrated HCV-human immunodeficiency virus/acquired immunodeficiency syndrome care. As of March 2006, 24 inmates had been enrolled. The program was replicated in the New York City Rikers Island jail. The program is operational statewide, referrals sometimes require priority attention, and data collection and other details are still being addressed.

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Promoting HCV Treatment Completion for Prison Inmates: New York State's Hepatitis C Continuity Program

et al. 2007

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Evaluation of the Federal Bureau of Prisons Protocol for Selection of Which Hepatitis C?Infected Inmates Are Considered for Treatment

et al. 2005

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The Federal Bureau of Prisons limits hepatitis C therapy to those inmates with certain biochemical abnormalities. To evaluate this protocol, an analysis was done on data collected on hepatitis C infected inmates in the Louisiana Department of Corrections. A quality assurance database of hepatitis C infected inmates evaluated in the Louisiana Department of Corrections was reviewed for liver biopsy and laboratory results. Patients were compared as to whether they would have been biopsied under the Federal Bureau of Prisons protocol and if there were histologic differences between those who would and those who would not have been biopsied. Of 490 inmates biopsied, 26% (129) had an alanine aminotransferase level between one and two times the upper limit of normal without other biochemical abnormalities. If treating stages 2-4, 48% of these would qualify for treatment (15% if treating stages 3-4). There was no statistical difference between this group and either the group with an alanine aminotransferase level between one and two times the upper limit of normal and with other laboratory abnormalities or the group with an alanine aminotransferase level greater than or equal to two times the upper limit of normal and without other abnormalities. In the Louisiana Department of Corrections, the Federal Bureau of Prisons protocol was neither sensitive nor specific enough at identifying those that should be considered for hepatitis C therapy.

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1117 Increasing liver-related mortality in incarcerated populations

Cited by 2 publications

References 0 publications

Promoting HCV Treatment Completion for Prison Inmates: New York State's Hepatitis C Continuity Program

Promoting HCV Treatment Completion for Prison Inmates: New York State's Hepatitis C Continuity Program

Evaluation of the Federal Bureau of Prisons Protocol for Selection of Which Hepatitis C?Infected Inmates Are Considered for Treatment

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