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An Overview of Hepatitis C in Prisons and Jails

Updated 02/22/2016

Prevalence of HCV in Prisons and Jails

About 1% of Americans have chronic hepatitis C (HCV)[i], though it is likely that the prevalence is actually greater.

The rates in correctional institutions are much higher. A recently updated estimate of rates in US prisons is 17.4%[ii] and chronic infection has been estimated to be between 12 and 35%[iii]. Correctional populations represent about 1/3 of total US HCV cases[iv].

One reason for the high prevalence is that many populations who are most affected by incarceration such as the poor, injection drug users, and the mentally ill, are also more likely to have HCV.

Correctional Health is Public Health

Since over 90% of people in correctional custody will be released[v], providing HCV testing, treatment, and linkage to care services to people while they are incarcerated can improve the health of our everyday communities by saving lives, reducing disease transmission, and reducing costs related to rising HCV mortality.

Despite new, more effective therapies for HCV, prisons provide HCV treatment for only some patients. Cost of the medications is one factor, but there are others. Many jails typically do not treat, as the average length of stay is too short.  

Many institutions provide HCV testing, but HCV testing is only routine in a small number of state prisons and jails[vi].

Some efforts being undertaken include providing HCV education to correctional health care providers and to incarcerated HCV patients, providing linkage to care and health insurance signup services for HCV patients being released from prisons or jails, and by advocating for better access to testing and care for HCV behind bars.

Expanding these services in corrections could have a broad public health impact on the HCV epidemic, by both affecting individual health outcomes and by broadening our understanding of HCV epidemiology.

Where can I find more information?

Reliable information about HCV treatment and testing practices in prisons and jails is hard to find. Practices vary widely and change regularly, especially given the many recent changes in HCV treatment.

We recommend visiting the Centers for Disease Control and Prevention for accurate information about viral hepatitis. 

If you are seeking more information about your state or local community, or if you are interested in providing better services to incarcerated HCV patients in your area, the NHCN can connect you to many resources.

You may contact us by emailing This email address is being protected from spambots. You need JavaScript enabled to view it. or calling the Hepatitis Education Project at (206) 732-0311.


[i] National Center for Health Statistics, Centers for Disease Control. National Health and Nutrition Examination Survey. Available at:  http://www.cdc.gov/nchs/about/major/nhanes/currentnhanes.htm. Retrieved 4.2.2014.

[ii] Varan et al.Hepatitis C Seroprevalence Among Prison Inmates Since 2001: Still High but Declining. Public Health Reports, 2014; 129: 187-195.

[iii]  http://www.cdc.gov/hepatitis/Settings/Corrections.htm

[iv] Varan et al.Hepatitis C Seroprevalence Among Prison Inmates Since 2001: Still High but Declining. Public Health Reports, 2014; 129: 187-195.

[v] Spaulding AC, Kim AY, Harzke AJ, et al. Review: Impact of New Therapeutics for Hepatitis C Virus Infection in Incarcerated Populations. Top Antivir Med. 2013;21(1): 27-35

[vi] Varan et al.Hepatitis C Seroprevalence Among Prison Inmates Since 2001: Still High but Declining. Public Health Reports, 2014; 129: 187-195.


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