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Hepatitis C Fight Hinges on Prisons, Inmate Care

Lawsuits across the country are seeking better but more expensive care for inmates with the infectious disease, who can spread it upon their release.

INMATES AND THEIR advocates are pushing for legal and political fixes to fight hepatitis C, a public health problem experts say can’t be solved in the U.S. overall without first tackling it within prison walls.

The hepatitis C virus attacks the liver and can turn deadly: Research shows it was associated with more fatalities in 2013 than 60 other infectious conditions combined – HIV and tuberculosis included. And though the disease affects 1 percent of the general population, according to the Centers for Disease Control and Prevention, the prison prevalence is thought to be around 17 percent.

When infected and formerly incarcerated people re-enter society, they can spread the blood-borne virus through intravenous drug use with dirty needles and, less often, sexual contact. Linked to the opioid crisis, hepatitis C spiked by more than 200 percent in 30 states since the period 2010-2014, Yale University researchers note in a 2018 follow-up article to a landmark study they published two years earlier.

“Since the prison system has the highest concentration of people living with the virus, failure to scale up treatment in prisons dooms any effort to eliminate hepatitis C in America,” the 2018 article states.

A sign of hope came in 2013, when drugs with around a 90 percent cure rate for hepatitis C began reaching the market. At first, these direct-acting antivirals, known as DAAs, cost up to a staggering $94,500 for complete treatment. Negotiations between state officials and drug companies, plus the release of generics, have lowered prices, though it can still cost $20,000 or more for an eight- to 12-week course. And if the disease progresses to threatening the patient’s life, an exorbitantly expensive liver transplant may become necessary.

Still, once the medical community accepted these medications as the norm, prisoners who knew they had hepatitis C asked for them. And when corrections officials said no, citing the treatment cost, prisoners’ lawyers started demanding the highly effective drugs.

The U.S. Supreme Court armed them with precedent establishing that officials cannot act with deliberate indifference to inmates’ serious health needs, and that denying them treatment can subject them to needless suffering and violate the Eighth Amendment ban on cruel and unusual punishment.

Read on: Hepatitis C Fight Hinges on Prisons, Inmate Care

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