Hepatitis C seroprevalence among prison inmates since 2001: still high but declining

Public Health Rep. Mar-Apr 2014;129(2):187-95. doi: 10.1177/003335491412900213.


Objectives: Although the hepatitis C epidemic in the United States disproportionately affects correctional populations, the last national estimates of seroprevalence and disease burden among these populations are more than a decade old. We investigated routine hepatitis C surveillance conducted in state prison systems and updated previous estimates.

Methods: We surveyed all U.S. state correctional departments to determine which state prison systems had performed routine hepatitis C screening since 2001. Using seroprevalence data for these prison systems, we estimated the national hepatitis C seroprevalence among prisoners in 2006 and the share of the epidemic borne by correctional populations.

Results: Of at least 12 states performing routine testing from 2001 to 2012, seroprevalences of hepatitis C ranged from 9.6% to 41.1%. All but one state with multiple measurements demonstrated declining seroprevalence. We estimated the national state prisoner seroprevalence at 17.4% in 2006. Based on the estimated total U.S. correctional population size, we projected that 1,857,629 people with hepatitis C antibody were incarcerated that year. We estimated that correctional populations represented 28.5%-32.8% of the total U.S. hepatitis C cases in 2006, down from 39% in 2003.

Conclusions: Our results provide an important updated estimate of hepatitis C seroprevalence and suggest that correctional populations bear a declining but still sizable share of the epidemic. Correctional facilities remain important sites for hepatitis C case finding and therapy implementation. These results may also assist future studies in projecting the societal costs and benefits of providing new treatment options in prison systems.

MeSH terms

  • Adult
  • Female
  • Hepatitis C / epidemiology*
  • Hepatitis C / etiology
  • Humans
  • Male
  • Prisoners / statistics & numerical data
  • Risk Factors
  • Seroepidemiologic Studies
  • Sex Distribution
  • Substance Abuse, Intravenous / complications*
  • United States / epidemiology