Screening and Treating Hepatitis C In Prisons Cost Effective For Wider Community

Dr. Tianhua He MD Beijing China, 100005

Dr. Tianhua He

MedicalResearch.com Interview with:
Dr. Tianhua He MD
Beijing China, 100005

Medical Research: What is the background for this study? What are the main findings?

Response: The prevalence of Hepatitis C (HCV) infection is high (17%) in US prisons. And about 30% of all HCV-infected persons in US spend part of the year in correctional facilities.

However, most state prisons offer no routine screening for Hepatitis C. Undiagnosed and untreated inmates, after releasing, will contribute to the spread of the disease in society. HCV infection is now the leading cause of liver cancer, and the most common indication for liver transplant. With the recently launched highlyy effective antiviral drugs, previous studies have shown that treating infected prisoners was cost-effective. However, no studies yet have evaluated the effect of interventions including screening and treatment among prisoners on prevention of Hepatitis C transmission and reduction of disease burden, neither the cost effectiveness of such interventions.

Medical Research: What is the background for this study? What are the main findings?

Response: Our study projected that universal Hepatitis C screening inside prisons followed by treatment with new drugs is highly cost-effective, and could reduce HCV transmissions and disease burden due to advanced HCV-related disease outcomes, such as end-stage liver disease, liver cancer, and liver-related deaths. Most of the benefits gained from such strategies were primarily realized in the outside community.

Medical Research: What should clinicians and patients take away from your report?

Response Among all benefits gained from strategies applied in prisons, 80 to 90 percent were realized among the general population outside prisons.

Such benefits were gained from 2 aspects,

1) by reducing advanced disease outcomes, and

2) by preventing future need of treatment from further transmissions outside prisons.

Therefore, prison-based screening and treatment turned out to be an promising Hepatitis C controlling strategy, besides birth-cohort screening (the current standard of care). Prison-based Hepatitis C screening and treatment is highly cost-effective, thus providing more resources to prisons healthcare will be a good investment for society.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Further researches may focus on evaluating the cost-effectiveness of hepatitis C screening and treatment in jails, and among other high-risk populations. In addition, such agent-based microsimulation approaches may also be applied to future studies of other infectious disease to capture the indirect benefit of treatment (i.e. treatment as prevention) or other interventions.

Citation:

He T, Li K, Roberts MS, Spaulding AC, Ayer T, Grefenstette JJ, et al. Prevention of Hepatitis C by Screening and Treatment in U.S. Prisons. Ann Intern Med. [Epub ahead of print 24 November 2015] doi:10.7326/M15-0617

[wysija_form id=”5″]

Dr. Tianhua He MD (2015). Screening and Treating Hepatitis C In Prisons Cost Effective For Wider Community 

Tags: