Prisons plagued with Hepatitis C
Michelle Hillman / News Staff Writer
August 25, 2003
rate of HIV infection among prison inmates has remained steady
since 1999, a surge in inmates with deadly Hepatitis C has
caught the state system off guard.
C, a deadly liver disease which can be contracted through
intravenous drug use, is being called the new HIV/AIDS
epidemic, challenging corrections officials in Massachusetts
and nationally to treat and manage the virus with slim
now, to treat everyone would be unaffordable to most state
prison systems," said Edward Harrison, president of the
National Commission on Correctional Health Care in Chicago.
"The legislatures aren't appropriating the dollars, the
taxpayers aren't interested in pursuing it."
more inmates in the state prison system with Hepatitis C or a
combination of Hepatitis C and HIV/AIDS than there is
treatment available, said health advocates who work in the
an increasing caseload of people to get into a very small
system of care," said Kathy Blumenthal of Great Brook
Valley Health Center in Worcester, who oversees a program for
inmates at MCI-Framingham.
Martin, director of health services for the Massachusetts
Department of Correction, said inmates with HIV are living
longer because of drug "cocktails," but are
succumbing to complications from co-infection with Hepatitis
to data from the Department of Correction, the number of
AIDS-related deaths dropped from a high of 19 in 1994 to two
DeMaria, assistant commissioner of the Bureau of Communicable
Disease Control at the Department of Public Health, said that
of the 10,000 inmates in the state prison system, 300 are HIV
positive. About 3 percent of the male inmate population and 5
percent of the female population have the virus.
to those with HIV, there are 3,000 inmates in state prisons
infected with Hepatitis C, or about 30 percent of the male
population and 40 percent of the female population, said
they're both significant problems we need to deal with,"
percent of the 300 inmates with HIV are co-infected with
Hepatitis C, and 10 percent of the 3,000 inmates with
Hepatitis C are co-infected with HIV, he said.
Walsh-Boldstead, senior assessment coordinator at Span Inc.,
which runs the Transitional Integration Project, or TIP,
serving inmates in Waltham, Framingham and Lowell, said
Hepatitis C is a growing problem.
initiated by the federal government, TIP was designed to stop
the spread of HIV/AIDS in prisons -- an effort complicated by
rising numbers of inmates with both HIV and Hepatitis C.
said a high percentage of inmates are co-infected. In 2002,
she said, at least five died from complications of Hepatitis C
prior to their release from state prisons and county jails.
still little data available to gauge the extent of the
problem, Walsh-Boldstead said. "There's a big concern
about people who are co-infected because it complicates their
HIV," she said.
is the most common blood-borne virus in the United States and
is the leading cause of liver transplants. It can lead to
cirrhosis, liver failure, liver cancer and death.
It is more
contagious than HIV because it requires much less exposure to
contaminated blood. Like HIV, Hepatitis C can be contracted
through intravenous drug use, and symptoms can take years to
for Hepatitis C consists of expensive drugs called Interferon
and Ribavirin and costs up to $25,000 a person for one year,
treatment is so costly, only 50 to 60 of the 3,000 state
inmates with Hepatitis C can be treated at one time, said
DeMaria. Not everyone qualifies for the treatment, which cures
50 percent of patients.
some people the treatment is worse than the disease,"
the state corrections system is voluntary. Once an inmate
tests positive, they are referred to a specialist. Inmates
wait up to a year for treatment, said DeMaria.
tight budgets, providers must weigh criteria such as the
likelihood the person will comply with the painful treatment
and whether treatment will be successful.
Wilson, director of policy and advocacy at the Massachusetts
Public Health Association, a private, nonprofit group, said
Hepatitis C is an epidemic that has not fully emerged in the
those infected are moving through the corrections system
unaware they are living with the deadly virus, she said.
Hepatitis C can take up to 20 years to reveal symptoms, and it
is most effectively treated before it rapidly progresses.
of Correction health director Martin said the department has
developed a treatment program in conjunction with the
Department of Public Health and the Lemuel Shattuck Hospital
in Jamaica Plain.
and treating people in prison is the best opportunity to
prevent Hepatitis C transmission and re-infection once inmates
are released, Wilson said.
Hillman can be reached at 508-626-4447 or email@example.com)
· From August 1999 to May
2003 the number of inmates with HIV who also tested positive
for Hepatitis C from ranged from 50 to 69 percent of
· The lowest rate
of co-infection in the state prison system was recorded in
November 2000 with 20.2 percent of inmates with HIV also
testing positive for Hepatitis C.
MCI-Framingham, an all-women's prison, from August 1999 to May
2003, the number of inmates with HIV who also tested positive
for Hepatitis C ranged from 50 to 85 percent.
· In May 2003,
the most current statistics available, 66.6 percent of those
with HIV at MCI-Framingham tested positive for Hepatitis C.
The Massachusetts Department of Corrections