U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics Special Report Hepatitis Testing and Treatment in State Prisons April 2004, NCJ 199173 -------------------------------------------------------------- This file is text only without graphics and many of the tables. A Zip archive of the tables in this report in spreadsheet format (.wk1) and the full report including tables and graphics in .pdf format are available from: http://www.ojp.usdoj.gov/bjs/abstract/httsp.htm -------------------------------------------------------------- Allen J. Beck, Ph.D. and Laura M. Maruschak BJS Statisticians -------------------------------------------- Highlights Nearly all State inmates held in facilities that test for hepatitis C * At midyear 2000, 1,113,035 inmates (94% of all inmates) were held in facilities that reported having a testing policy for hepatitis C. * Forty-nine States and the District of Columbia reported having at least one facility that tested inmates for hepatitis C. Ten States reported that all of their facilities tested inmates. Nearly a third of hepatitis C tests confirmed positive * 33% of tests in facilities that tested only targeted groups were positive compared to 27% of those in facilities that conducted broad tests (random basis or all inmates). * Of the 1,033 facilities that provide hepatitis B vaccinations, 680 (66%) had a policy to vaccinate inmates in high-risk groups. Thirty-six States and the District of Columbia completed at least one 3-dose series hepatitis B vaccination. -------------------------------------------- ------------------------------------------ Overview of hepatitis B and hepatitis C Hepatitis B and hepatitis C are viral diseases that attack the liver. The hepatitis B virus (HBV) and the hepatitis C virus (HCV) can cause lifelong infection, cirrhosis (scarring) of the liver, cancer, liver failure, and death. Both viruses are spread through infected blood, most commonly in shared needles to inject illegal drugs, and through sexual contact. Hepatitis B typically causes a limited infection that the body can fight off within a few months. Persons who resist the infection develop an immunity to the virus; those who do not become carriers of the virus. About 5-10% of those infected with HBV develop chronic hepatitis B. Hepatitis B can be treated with immunization if diagnosed within 2 weeks of exposure. About 80% of persons infected with HCV develop a chronic infection. However, the majority of those with chronic infection will not have severe liver damage. Chronic HCV can be treated with antiviral medications, with success rates of 30-40%. These medications may cause harsh side effects. Sources: The Merck Manual of Medical Information, Merck Research Laboratories, NJ, 2003, and Centers for Disease Control, MMWR, January 24, 2003. --------------------------------------------- In the 2000 Census of State and Federal Adult Correctional Facilities, 1,209 of the 1,584 State public and private adult correctional facilities reported that they tested inmates for hepatitis C between July 1,1999, and June 30, 2000. These facilities housed about 94% of all State inmates for whom prison census data were reported on June 30, 2000. Of the 57,018 hepatitis C tests made in the 12 months before the census, 17,911 (31%) were positive. Nearly 70% of all State adult correctional facilities (1,104) reported that they had a policy to treat inmates for hepatitis C. A total of 6,046 inmates were treated between July 1, 1999, and June 30, 2000. At midyear 2000, 1,033 facilities also reported that, as a matter of policy, they provide hepatitis B vaccinations. During the 12-month period, 401 facilities actually administered the vaccination. In those facilities 13,655 inmates completed the 3-dose series vaccination for hepatitis B. The census was an enumeration of all 84 Federal, 1,320 State, and 264 private facilities in operation on June 30, 2000. The census, for the first time, included information on testing and treatment for hepatitis C, as well as vaccination policies and administration for hepatitis B. ------------------------------------------------- Nearly 8 in 10 State prison facilities reported testing inmates for hepatitis C State prison facilities reported circumstances under which inmates were tested for hepatitis C, including testing all at some time, at admission, a random sample, high-risk inmates, upon inmate request, and upon clinical indication. Of the 1,584 State prison facilities reporting in the 2000 Census of Adult State and Federal Correctional Facilities, 1,209 reported testing inmates for hepatitis C; 322 facilities reported no testing of inmates. As of June 30, 2000, 94% of State inmates were held in facilities that tested inmates for hepatitis C: 88% in facilities that tested a targeted group (high risk, inmate request, or clinical indication) and 6% in facilities that tested a broad group (all at some time, at admission, or at random). About 70% of facilities tested a targeted group, while 9% tested more broadly. The largest number of facilities tested inmates based on clinical indication of need (1,000), followed by inmate request (604), and high-risk indicators (492). The fewest facilities reported testing inmates at random (27) or at admission (61). Only South Carolina reported having no facility that tested for hepatitis C. Excluding South Carolina, at least one reception, diagnostic, or medical facility in each State reported testing inmates. Nearly a third of hepatitis C tests confirmed positive Between July 1, 1999, and June 30, 2000, 57,018 hepatitis C tests were completed in State prisons. About 31% (17,911) of these tests were confirmed positive. Among facilities that tested a targeted group only, a third of all hepatitis C tests were confirmed positive. Among facilities that tested more broadly, slightly more than a quarter of all tests were confirmed positive. Hepatitis C tests concentrated in 23 States Twenty-three States each reported testing more than 500 inmates between July 1, 1999, and June 30, 2000. Of the 57,018 hepatitis C tests performed in State prisons, 52, 813 (93%) were completed in those 23 States. California alone accounted for more than a quarter (27%) of all tests. Nearly all of the confirmed positive test results (93%) were in these 23 States. In the 12-month period ending June 30, 2000, more than 2% of all inmates in State prisons tested positive for hepatitis C. Among States administering 500 or more hepatitis C tests, 5 reported that more than 5% of their inmates were confirmed positive: New Mexico (16.0%), Montana (9.6%), Massachusetts (9.6%), Connecticut (6.1%), and California (5.4%). ------------------------------------------------------ ----------------------------------------------------- More than 6,000 inmates in State prisons treated for hepatitis C in the 12-month period before the census Of the 1,584 State operated adult correctional facilities, 1,104 (70%) reported that they had a policy to treat inmates for hepatitis C. Facilities most commonly reported a policy to treat HCV-positive inmates for whom treatment was recommended. Between July 1, 1999, and June 30, 2000, 19 facilities treated nearly three-quarters of all inmates receiving treatment for hepatitis C. These facilities in 9 States and the District of Columbia each reported treating at least 50 inmates for hepatitis C. Together these facilities treated 4,382 inmates. Macon Correctional Institution in Georgia treated 1,300 inmates for hepatitis C, 22% of all inmates treated nationwide. Eight facilities in California treated 2,344 inmates; more than a third of all inmates treated. Two-thirds of facilities had a policy to vaccinate inmates for hepatitis B On June 30, 2000, 1,033 State prison facilities reported having a policy to vaccinate inmates for hepatitis B. These facilities held 84% of all inmates in State prisons. About 1 in 8 facilities reported having a policy to vaccinate all inmates. State prison facilities were most likely to report a policy to vaccinate high- risk inmates (680) and were least likely to report a policy to vaccinate inmates with sexually transmitted diseases (17). About a third of all facilities reported having no hepatitis B vaccination. In the 12 months before the census, 13,655 inmates completed a 3-dose series vaccination for hepatitis B More than a third of State facilities (401) that reported having a hepatitis B vaccination policy, completed at least one hepatitis B 3-dose series vaccination. A total of 13,655 inmates were reported to have completed a 3-dose series vaccination for hepatitis B in the 12-month period ending June 30, 2000. Of the facilities that reported actually completing at least one 3- dose series vaccination, 328 had a policy to vaccinate high-risk groups, 76 had a policy to vaccinate upon inmate request, and 37 had a policy to vaccinate all inmates. ---------------------------------------------- Methodology The 2000 Census of State and Federal Adult Correctional Facilities was the sixth enumeration of State institutions conducted by the Bureau of Justice Statistics. Earlier censuses were completed in 1974, 1979, 1984, 1990, and 1995. The facility universe was developed from the 1995 census. Each department of corrections was contacted to identify new facilities and facilities that had been closed since June 30, 1995. Data were collected from all facilities, resulting in a final response rate of 100%. Facilities were included in the census if they had separate staffs; housed primarily State or Federal prisoners; were physically, functionally, and administratively separate; and operational on June 30, 2000. Overall, the census identified 84 Federal facilities, 1,295 State facilities, 22 facilities under State and local authority, 3 facilities operated by the District of Columbia, and 264 privately operated facilities. All Federal facilities and 26 privately operated facilities that held at least 50% of their inmates for Federal authorities were excluded from this report. Data on testing and treatment for hepatitis C and vaccination policies and administration for hepatitis B were not reported for these facilities. ------------------------------------------- The Bureau of Justice Statistics is the statistical agency of the U.S. Department of Justice. Lawrence A. Greenfeld is the director. Allen J. Beck and Laura M. Maruschak wrote this report. Jennifer C. Karberg provided statistical assistance and verification. Tom Hester edited the report. Jayne Robinson administered final production. Data collection and processing for the 2000 Census of State and Federal Adult Correctional Facilities were carried out by Pam Butler and Linda Huang, with assistance from Patricia Torreyson and Bill Bryner, under the supervision of Charlene Sebold, Governments Division, U.S. Census Bureau. April 2004, NCJ 199173 ------------------------------------------ End of file 02/25/04 ih