Treatment of Chronic Hepatitis C in a State Correctional Facility

  1. Scott A. Allen, MD;
  2. Anne C. Spaulding, MD;
  3. Albert M. Osei, MD;
  4. Lynn E. Taylor, MD;
  5. Asya M. Cabral, MPH; and
  6. Josiah D. Rich, MD, MPH
  1. From Rhode Island Department of Corrections, Cranston, Rhode Island; and The Miriam Hospital and Brown Medical School, Providence, Rhode Island.

    Abstract

    Background: Approximately 1 in 4 of the nearly 2 million individuals in state and federal correctional facilities are infected with hepatitis C virus (HCV). Currently, there are few reports of treatment outcomes of this common infection in this setting.

    Objective: To describe HCV therapy in the incarcerated setting.

    Design: Retrospective, descriptive observational study.

    Setting: Rhode Island Department of Corrections, Cranston, Rhode Island.

    Patients: 93 inmates with chronic HCV infection.

    Intervention: Interferon-α with ribavirin.

    Measurements: HCV RNA levels 6 months after treatment.

    Results: Response rates are similar to previously published rates achieved in the community; 63% (50 of 79) of patients achieved viral clearance after 6 months of therapy, and 46% (26 of 57) achieved sustained response 6 months after treatment.

    Conclusion: The incarcerated population (which is disproportionately affected by addiction and psychiatric illness) can be effectively treated for HCV infection with interferon and ribavirin. The correctional setting may provide an opportunity to safely treat patients with these two challenging comorbid conditions.

    Article and Author Information

    • Grant Support: Dr. Josiah D. Rich is partially supported by grant P30-AI-42853 from the National Institutes of Health Center for AIDS Research (NIH CFAR).

    • Requests for Single Reprints: Josiah D. Rich, MD, MPH, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906; e-mail, jrich{at}lifespan.org.

    • Current Author Addresses: Drs. Allen, Spaulding, Osei, and Cabral: Rhode Island Department of Corrections, 39 Howard Avenue, Cranston, RI 02920.

    • Drs. Taylor and Rich: The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906.

    • Author Contributions: Conception and design: S.A. Allen, A.C. Spaulding, A.M. Osei, J.D. Rich.

    • Analysis and interpretation of the data: S.A. Allen, A.C. Spaulding, A.M. Osei, L.E. Taylor, J.D. Rich.

    • Drafting of the article: S.A. Allen, A.C. Spaulding, L.E. Taylor, J.D. Rich.

    • Critical revision of the article for important intellectual content: A.C. Spaulding, A.M. Osei, L.E. Taylor, J.D. Rich.

    • Final approval of the article: S.A. Allen, J.D. Rich.

    • Provision of study materials or patients: S.A. Allen.

    • Administrative, technical, or logistic support: A.C. Spaulding, A.M. Cabral.

    • Collection and assembly of data: S.A. Allen, A.C. Spaulding, A.M. Cabral.

    Summaries for Patients

    • Summaries for Patients:Treatment for Hepatitis C Virus Infection among Inmates Ann Intern Med February 4, 2003 138:I-50
    • Letter:Correction: Treatment of Chronic Hepatitis C in a State Correctional Facility Ann Intern Med October 7, 2003 139:605
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    1. Ann Intern Med February 4, 2003 vol. 138 no. 3 187-190
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