With support from the California legislature, researchers from the University of California at San Francisco have studied sample groups of inmates in the state prison system to determine how many are infected with hepatitis C.

With the research close to completion, the organization charged with the study - the Hepatitis C in the California Prisons Project  [HEPCAP] - has already begun to formulate recommendations for the state and the state prison system.

According to Sue Currie, director of the program, a final report to the legislature is being prepared and analysis of the data collected is in full swing. The data focuses on three groups within the prison system, offenders at intake, offenders who are being paroled and staff members.

One important piece of data that researchers found was a higher prevalence rate of HCV among parolees, Currie said.

"What we found was, and it makes perfect sense, the prevalence among parolees is higher than other prisoners in the system. [But] who are the folks who are paroled? They have a higher prevalence of injection drug use," Currie said.

Someone whose crime would not allow them to be considered for parole, such as murder, may have risk factors, but not those related to injection drug use, which is one of the highest forms of transmission for hepatitis C, she added.

"What we found amongst the parolees is there was a 42 percent prevalence rate for Hep C. For the folks at entry, we found was there was a higher prevalence rate among women -- 38 percent at entry. Among men it was 33 percent," she said. "I think it is a bias of [which women are] being incarcerated within the system."

For staff members, Currie said the good news was that the prevalence of hepatitis C was no greater than in the general population, but the bad news is that the risk factors for staff - including blood and bodily fluid exposure - was much higher than for those in the general population.

Based on the research, HEPCAP is poised to make a series of recommendations to the state for all three groups studied.

Among those recommendations are:
*that the correctional facilities try to collaborate prior to re-entry into the community with local public health departments to coordinate possible treatment and services for offenders who have tested positive for HCV.
*that public health entities test for HCV when they test for HIV. According to Currie, the study showed that 64 percent of the offenders had been previously tested for HIV but only 30 percent had ever been tested for HCV. "Why aren't we testing for both at the same time? - Especially if there is a much higher prevalence for Hep C," Currie said.
*that those at high risk for hepatitis C (bot offenders and staff) be vaccinated for hepatitis A and B.
*that peer enhancing and modeling of some of the current inmate peer education programs be done in the facilities for both offenders and staff.

For more information contact Currie at sue.currie@med.va.gov