New Position Statement Addresses Diagnosis and Management of Hepatitis C

By Newton Kendig, MD

The care of patients with chronic hepatitis C infection has been a major challenge for correctional health care professionals for decades. For many years, our treatments for HCV infection were quite limited in their efficacy and included complicating side effects. Treatment options improved dramatically with the historic development of curative medications for HCV.  Never before in the field of infectious diseases have we been able to cure a chronic viral infection.

That scientific advancement has spurred the development of a national plan for eliminating HCV that highlights the strategic importance of diagnosing and treating underserved patient populations, including persons in the carceral setting. The vital role of correctional health care in eliminating hepatitis C is more important than ever as, sadly, new cases of HCV infection in the United States continue to rise, largely due to the unprecedented scope of the national opioid crisis. 

For these reasons, my colleagues and I on the Research and Policy Committee felt it was timely and important for NCCHC to articulate its position on the Diagnosing and Management of Hepatitis C. The organization’s recently adopted position statement recommends that U.S. jails and prisons provide opt-out patient education and HCV testing for all people newly admitted to correctional facilities. Curative treatment with direct-acting antivirals should be provided to patients with HCV infection in accordance with the most current evidence-based guidelines. Highly effective hepatitis C treatment programs have been successfully  implemented in U.S. jails and prisons using a variety of models, including training of on-site primary care providers, referral to on-site or off-site specialists, and through telehealth modalities.

The provision of hepatitis C medications can create fiscal challenges for correctional health administrators due to high drug costs and the number of potential patients. Our Position Statement recommends that correctional systems plan budgetarily for investing in hepatitis C programs and explore available federal and state funding opportunities. Lastly, we emphasize the importance of effective discharge planning for our patients with hepatitis C, including the provision of medications to bridge care; links to treatment for opioid use disorder, when indicated; providing education on harm reduction strategies; assisting with benefit applications; and coordinating with community partners to support psychosocial needs.  

We are hopeful that this position statement will encourage more correctional systems to adopt comprehensive hepatitis C programs. Such investments will advance the well-being of our patients, help address health care disparities, and promote the public health of our communities. 

Read the Diagnosis and Management of Hepatitis C position statement.

Read all NCCHC’s position statements.

Newton Kendig, MD, is a member of the NCCHC Governance Board representing the American College of Physicians, vice-chair of the NCCHC Policy and Research Committee, and a professor of medicine at The George Washington University.