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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”


Hepatitis C Virus and HIV in the Correctional Setting


Proposed Inclusion Criteria for Hepatitis Treatment in Prisons Adapted from RI DOC Criteria and California DOC

•  Rule out other causes of liver disease (hemochromatosis, Wilson's disease, autoimmune hepatitis, and alpha-1 antitripsin deficiency) 
•  Hepatitis virus detectable by PCR
•  No alcohol or parenteral drug use in preceding 6 months
•  Enroll in a substance abuse program if history of drug/alcohol use
•  Control of major illnesses, including HIV (CD4 usually > 400 cells/ml) 
•  Good control of any psychiatric illness, especially depression
•  Length of stay in prison > 15 months from initiation of treatment
• No signs of decompensated liver disease
• Transaminases greater than upper limits of normal
• Platelet count > 75,000
• Hematocrit > 30%, Albumin > 3.5 mg/dl, Creatinine < 1.5 mg/dl, 
INR< 1.2
• Thyroid function tests nl., no elevated autoantibody titers (ANA, AMA)
• Before treatment with ribavirin: No evidence of coronary heart disease. Birth control, if conception possible (men and women).  Willingness to submit to monthly pregnancy tests (women).