Enhanced Screening in Prisons Could Reduce Spread of Hepatitis C

Routine hepatitis C (HCV) screenings of prison inmates could help prevent the spread of the virus upon their release.

A study published in Annals of Internal Medicine sought to evaluate whether conducting HCV screenings and treatments in prisons could halt the spread of infection into the general population.

In order to conduct the study, researchers used a microsimulation model, which is a computerized analytical tool that gives a detailed analysis of disease spreading through the population, to follow the progression of HCV over 30 years.

The results of the study showed that implementing a risk-based and opt-out screening program for HCV in prisons could diagnose 41,900 to 122,700 new cases over the next 30 years.

Compared with not screening for HCV, this strategy could potentially prevent 5500 to 12,700 new cases caused from infected inmates that were released. About 90% of averted infections would have happened outside of the prisons.

They found between 4200 and 11,700 deaths related to the liver could be prevented from these routine screenings.

Incremental cost-effectiveness ratio for screenings cost about $19,600 to $29,200 per quality adjusted life years with a first year prison budget of $900 to $1150 million, according to researchers.

In order to implement this into the prisons, it would require about 12.4% more of their current health care budget.

Some limitations for this study were that the data was lacking for transmission network, reinfection rate, and opt-out screening rates.

Researchers concluded if the universal opt-out screening in prisons were implemented it would be highly-cost effective and reduce the spread of HCV to the outside community.