Presentation on theme: "Hepatitis C In Alaska’s Department of Corrections"— Presentation transcript:
1 Hepatitis C In Alaska’s Department of Corrections Ginger Provo RNViral Hepatitis Prevention CoordinatorState of Alaska, Division of Public Health
2 HCV Prevalence in the U.S. HCV infection is the most commonblood-borne infection.In the U. S. approximately 3.2 million persons are chronically infected per CDC.this estimate does not include the incarcerated
3 HCV Prevalence in Alaska Average annual rate of new HCV cases in Alaska is new cases per 100,000 population or1.3 % prevalence rate.Section of Epidemiology receives an average of932 new reports of hepatitis C infection each year.In new infections were reported
4 Natural History of HCV, 513 HCV-infected deaths were reported in Alaska
5 Average Annual Rate of Newly Reported HCV Infections, by Age and Sex — Alaska, 2003–2012
6 HCV in CorrectionsApproximately 1%-1.5% of Americans have chronic hepatitis C (HCV) compared to 12-35% of U.S. prison inmates.CDC Correctional Facilities and Viral Hepatitis Jan. 23, 2014HCV cases in correctional populations represent about 1/3 of total US HCV cases.Varan et. al. Hepatitis C Seroprevalence Among Prison Inmates Since 2001: Still High but Declining. Public Health Reports, 2014; 129:
7 Correctional Facilities in Alaska Alaska has 13 jails and prisons•Anchorage Correctional Complex•Anvil Mountain Correctional Center•Fairbanks Correctional Center•Goose Creek Correctional Center•Hiland Mountain Correctional Center•Ketchikan Correctional Center•Lemon Creek Correctional Center•Mat-Su Pretrial•Palmer Correctional Center•Point Mackenzie Correctional Farm•Spring Creek Correctional Center•Wildwood Correctional Center•Yukon Kuskokwim Correctional Center
8 Alaska’s Inmate Population 2004 - 2021 Total offender population is projected to grow at an average of 1.93% annuallyfor the next 5 years.*Figures based on the average annual population8Alaska DOC
9 What Percent of Inmates Have HCV Disease? 12-35%CDC Correctional Facilities and Viral Hepatitis. Jan. 23, 201417.4%Hepatitis C Seroprevalence Among Prison Inmates Since 2001; Still High but Declining.Public Health Reports. March-April 201420-40%New Hepatitis C Treatments: Considerations and Potential Strategies for States.National Governors Association Feb. 25, 2015
10 How Much HCV is in Alaska DOC? Alaska is one of 38 states that do not routinely test inmates on intake.We do not have an accurate number of HCV infections in AK DOC however DOC estimates that 30% of inmates are infected.Alaska State Virology Laboratory (ASVL) in Fairbanks conducts hepatitis testing for DOC.
11 Who Gets Tested For HCV in DOC? Any inmate can request testingTesting by risk factors:History of injection drug use (IDU)TattoosIncluded in STD testingClinical findings of liver disease
12 Risk Factors for HCV in DOC 52 inmates in prison or halfway houses were included in the Rapid HCV Testing ProjectPrison inmates could be tested if they were within 30 days of release or in a halfway house22 Tattoo / piercing20 IDU4 High risk sexual practices2 Baby Boomer cohort4 unknownwere
13 HCV Testing in DOCOf the 6359 inmates tested for HCV between , 1507 or 19% tested positive for hepatitis C antibody meaning they had been infected with the virus at some time.
16 Is HCV in DOC on the Decline? “The highest rate of HCV disease is in the Baby Boomer cohort (born between ) - this population is aging out of DOC – thus the rate of HCV in DOC is declining.”Varan et. al. Hepatitis C Seroprevalence Among Prison Inmates Since 2001: Still High but Declining. Public Health Reports, 2014; 129:
19 Approximately 30% of Alaska’s 5000 inmates are infected with hepatitis C on any given day. Approximately 95% of Alaska’s inmates will eventually be returned to the community.
20 What Would it Cost to Treat These Inmates Today? ~ 5000 inmates in AK DOC~ 30% are infected5000 x 30% = 1500 – 25% (375) = 1125Cost of treatment meds = $95,000 per inmate1125 X $95,000 = $106,875,000.00
21 Who Gets Treated? Prioritized Critical High Guarded Advanced liver diseaseContinued care from outsideHighCo-infected HIV / HBV /advanced liver diseaseGuardedPost transplantDecompensated liver diseaseRoutine SurveillanceStable diseaseRecent infection <5-10 years
22 In Summary Hepatitis C is the #1 blood-borne disease ~ 1.3% of Alaskans are infected~ 30% of Alaska’s inmates are infectedMain transmissions routes: IDU and tattooingInmates can be tested and treated for HCVNew treatments cure hepatitis C – at a CO$T!Treatment is allocated by severity of disease