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."