A Comparison of Liver Disease Mortality With HIV and Overdose Mortality Among Georgia Prisoners and Releasees: A 2-Decade Cohort Study of Prisoners Incarcerated in 1991

Spaulding, Anne C.; Sharma, Akshay; Messina, Lauren C.; Zlotorzynska, María; Miller, Lesley; Binswanger, Ingrid A.

doi:10.2105/ajph.2014.302546

Cited by 28 publications

(37 citation statements)

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“…As described in our prior studies, 6 17 the initial cohort consisted of all persons incarcerated in GA prisons on 30 June 1991. Administrative records containing demographic data and incarceration history were obtained from the GA Department of Corrections (GDC) Planning and Strategic Management Section and linked with the NDI through 31 December 2010.…”

Section: Methodsmentioning

confidence: 99%

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Retrospective cohort study of cancer incidence and mortality by HIV status in a Georgia, USA, prisoner cohort during the HAART era

et al. 2016

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ObjectiveNon-AIDS-defining cancers (NADCs) have emerged as significant contributors to cancer mortality and morbidity among persons living with HIV (PLWH). Because NADCs are also associated with many social and behavioural risk factors that underlie HIV, determining the extent to which each of these factors contributes to NADC risk is difficult. We examined cancer incidence and mortality among persons with a history of incarceration, because distributions of other cancer risk factors are likely similar between prisoners living with HIV and non-infected prisoners.DesignRegistry-based retrospective cohort study.ParticipantsCohort of 22 422 persons incarcerated in Georgia, USA, prisons on 30 June 1991, and still alive in 1998.Outcome measuresCancer incidence and mortality were assessed between 1998 and 2009, using cancer and death registry data matched to prison administrative records. Age, race and sex-adjusted standardised mortality and incidence ratios, relative to the general population, were calculated for AIDS-defining cancers, viral-associated NADCs and non-infection-associated NADCs, stratified by HIV status.ResultsThere were no significant differences in cancer mortality relative to the general population in the cohort, regardless of HIV status. In contrast, cancer incidence was elevated among the PLWH. Furthermore, incidence of viral-associated NADCs was significantly higher among PLWH versus those without HIV infection (standardised incidence ratio=6.1, 95% CI 3.0 to 11.7, p<0.001).ConclusionsAmong PLWH with a history of incarceration, cancer incidence was elevated relative to the general population, likely related to increased prevalence of oncogenic viral co-infections. Cancer prevention and screening programmes within prisons may help to reduce the cancer burden in this high-risk population.

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Section: Methodsmentioning

confidence: 99%

“… 17 The study was recently updated to include deaths through 2010 and found 5% of the population were HIV infected and overall cancer was a close second to heart disease as a leading cause of death among all prisoners regardless of HIV status. 6 …”

Section: Introductionmentioning

confidence: 99%

Retrospective cohort study of cancer incidence and mortality by HIV status in a Georgia, USA, prisoner cohort during the HAART era

et al. 2016

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“…4 The period immediately after release is especially risky for receptive syringe sharing, acquisition of HIV and hepatitis C virus (HCV), and mortality. [29][30][31][32] Thus, the transition between the prison and community settings represents a high-risk…”

Section: Introductionmentioning

confidence: 99%

Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees

et al. 2016

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The prison setting presents not only challenges, but also opportunities, for the prevention and treatment of HIV, viral hepatitis, and tuberculosis. We did a comprehensive literature search of data published between 2005 and 2015 to understand the global epidemiology of HIV, hepatitis C virus (HCV), hepatitis B virus (HBV), and tuberculosis in prisoners. We further modelled the contribution of imprisonment and the potential impact of prevention interventions on HIV transmission in this population. Of the estimated 10·2 million people incarcerated worldwide on any given day in 2014, we estimated that 3·8% have HIV (389 000 living with HIV), 15·1% have HCV (1 546 500), 4·8% have chronic HBV (491 500), and 2·8% have active tuberculosis (286 000). The few studies on incidence suggest that intraprison transmission is generally low, except for large-scale outbreaks. Our model indicates that decreasing the incarceration rate in people who inject drugs and providing opioid agonist therapy could reduce the burden of HIV in this population. The prevalence of HIV, HCV, HBV, and tuberculosis is higher in prison populations than in the general population, mainly because of the criminalisation of drug use and the detention of people who use drugs. The most effective way of controlling these infections in prisoners and the broader community is to reduce the incarceration of people who inject drugs.

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“…In contrast, the corresponding prevalence in US prisons is 17.3% (2). Liver disease is a frequent cause of death in inmates, as well as in society, and it has recently surpassed that from HIV (3-5). Hepatitis C virus (HCV) infection is also the leading cause of hepatocellular carcinoma and the most common indication for liver transplant (6).…”

Section: Introductionmentioning

confidence: 99%

Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons

He¹,

Li²,

Roberts³

et al. 2015

Ann Intern Med

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Background The prevalence of hepatitis C virus (HCV) in United States prisoners is high; however, HCV testing and treatment is rare. Infected inmates released back into society contribute to the spread of HCV in the general population. Routine hepatitis screening of inmates followed by treatment with new therapies offers hope to reduce ongoing HCV transmission. Objective To evaluate the health and economic impact of HCV screening and treatment in prisons on the HCV epidemic in the society. Design An agent-based microsimulation model of transmission and progression of HCV. Data Sources Published literature. Target population Population in US prisons and general community. Time horizon 30 years. Perspective Societal. Interventions Risk-based and universal opt-out hepatitis C screening in prisons followed by treatment in a portion of patients. Outcome measures Prevention of HCV transmission and associated-disease in prisons and society, costs, quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER), and total prison budget. Results of Base-Case Analysis Implementing risk-based and opt-out screening could diagnose 41 900–122 700 new HCV cases in the next 30 years in prisons. Compared with no screening, these scenarios could prevent 5500–12 700 new HCV infections caused by releasees, where about 90% of averted infections would have occurred outside of prisons. HCV screening could also prevent 4200–11 700 liver-related deaths. The ICERs of screening scenarios were between $19 600–$29 200/QALY, and the respective 1st year prison budget were between $900 and $1150 million. Prisons would require an additional 12.4% of their current healthcare budget to implement such interventions. Results of Sensitivity Analysis Results were sensitive to the time horizon; and ICERs otherwise remained below $50 000 per QALY. Limitations Data on transmission network, re-infection rate and opt-out HCV screening rate are lacking. Conclusions Universal opt-out HCV screening in prisons is highly cost-effective and would reduce HCV transmission and HCV-associated diseases primarily in the outside community. Investing in US prisons to manage hepatitis C is a strategic approach to address the current epidemic.

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A Comparison of Liver Disease Mortality With HIV and Overdose Mortality Among Georgia Prisoners and Releasees: A 2-Decade Cohort Study of Prisoners Incarcerated in 1991

Abstract: Our study design deemphasized immediate deaths but highlighted long-term sequelae of exposure to viral hepatitis and alcohol. Treating hepatitis C and implementing interventions to manage alcohol use disorders may improve survival among prisoners in the Southeast.

Cited by 28 publications

References 29 publications

Retrospective cohort study of cancer incidence and mortality by HIV status in a Georgia, USA, prisoner cohort during the HAART era

Retrospective cohort study of cancer incidence and mortality by HIV status in a Georgia, USA, prisoner cohort during the HAART era

Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees

Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons

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