Maryland: Hepatitis Epidemic Looms in Prisons

Maryland prison and health officials say a looming hepatitis C epidemic will be a bigger and potentially more expensive health crisis than HIV/AIDS, but they still do not have a comprehensive policy in place to address it.

Officials do not have an accurate account of the number of inmates infected with hepatitis C, but its close association with HIV and the experiences of states with similar prison populations lead them to believe the disease could be more expensive than HIV.

Maryland had the second highest rate of HIV infection among prison inmates in the nation in 2000, according to a recent Justice Department report. By law, the state cannot require that prisoners be tested for either virus, so exact numbers are not available. The results of a double-blind study that anonymously tested more than 3,000 inmates for both HIV and hepatitis C will be available soon. Until then, the state is forced to work with estimates based on other states' infection rates.

Dr. Tony Swetz, director of inmate health for Maryland's prisons, estimates that costs for hepatitis C treatment range from $12,000 to $20,000 per patient or more. Maryland already spends $1,500 to $15,000 per inmate on HIV treatment. About 1,000 inmates, or 4.3 percent of the state's prisoners, were HIV-positive in 2000, according to the Department of Justice. That number was twice the national average.

Dr. Sharon Baucom, medical director for the Department of Public Safety and Correctional Services, is leading a task force to create the state's new policy for testing and treating inmates for hepatitis C. She is looking at how other federal and state prison systems handle the problem. The challenge, she said, is finding a treatment policy that is both "clinically effective and cost effective."

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