HEPATITIS C RAMPANT AMONG STATE INMATES

SALEM - Education aimed at changing behavior is a better bet than medical
treatment for reducing the chance of released prisoners spreading hepatitis
C, lawmakers were told Wednesday.

State officials gave a report to the Joint Health & Human Services Interim
Committee on the steps being taken to deal with a mounting hepatitis problem
in state penal institutions.

Tests given last fall showed 30 percent of inmates entering the prison
system had the potentially serious liver disease, meaning an estimated 3,000
prisoners are infected with the virus.

The ailment afflicts about 2 percent of the general public.

Intravenous use of illegal drugs accounts for most of the prison cases of
the blood-borne disease, according to the state Corrections Department
report to the committee.

Use of contaminated razors, body-piercing needles and unprotected sex also
can transmit hepatitis C, authorities say.

Dr. Steve Shelton, state corrections medical director, said women admitted
to the prison system have a higher hepatitis rate - more than 40 percent -
than men. That's apparently because proportionately more crimes committed by
females are drug-related, he said.

Shelton said while two medicines are used against the virus, precautions are
better insurance against its spread.

``Behavior can be changed,'' he told legislators. ``Medical treatment is not
highly effective. Treating people does not stop the spread of the disease.''

The disease can progress to cause cirrhosis and liver failure requiring
liver transplants. About 4 percent of cases are fatal.

While 80 percent of chronic hepatitis patients don't develop liver damage
requiring treatment, they still can transmit the ailment.

Inmates can request hepatitis C blood testing at any time, and education and
counseling programs are aimed at ways to avoid risky behaviors.

Two drugs used to combat the disease can help as many as 40 percent of
patients. The cost is about $10,000 for six months' treatment, with some
patients needing a year's worth.

The drugs can cause severe side effects, including depression and suicidal
behavior, that cause some patients to stop treatment.

Sen. Cliff Trow, D-Corvallis, said he hoped the cost wasn't preventing
inmates from being treated. Corrections officials said money wasn't curbing
treatment and that the department can fund the hepatitis management program
from its current budget without added money.

Dr. Kent Benner of Oregon Health Sciences University said the number of new
hepatitis C cases is dropping but that the disease develops very slowly, so
some victims can be infected for as long as 30 years without knowing it.

``There's a bit of an iceberg effect,'' he said