The Effect of Hepatitis C Virus Infection on Health-Related Quality of Life in Prisoners

Abstract

Hepatitis C virus (HCV) infection in prisoners represents an important public health problem. However, there is very little information about HCV-related health-related quality of life (HRQOL). We examined the effect of HCV antibody positivity, HCV viremia, and being a prisoner on prisoners'' HRQOL. Population-based health surveys incorporating HCV screening were conducted among prisoners at New South Wales (NSW), Australia, correctional centers in 1996 and 2001. HCV antibody and HCV RNA status were determined from venous blood sampling. HRQOL and mood status were assessed using the Short Form-36 (SF-36) Health Survey and Beck Depression Inventory (BDI). Comparison of HRQOL scores between HCV antibody negative, HCV antibody positive/non-viremic, and HCV antibody positive/viremic and assessment of temporal change in HRQOL between 1996 and 2001 within groups were made using ANCOVA adjusting for confounders. Factors associated with HRQOL were determined in linear regression models. Analyses between HCV antibody negative (n = 423), HCV positive/non-viremic (n = 89), and HCV positive/viremic (n = 178) prisoners found no measurable effect of HCV on HRQOL, including that attributable to HCV viremia. Compared to uninfected Australian population norms, prisoners had lower HRQOL irrespective of HCV status. The prevalence of 'moderate' to 'severe' depressive symptoms was greater in the HCV antibody positive/viremic group than the HCV antibody positive/non-viremic group or the HCV antibody negative group. Selected demographic factors (age), co-morbidity, severity of depressive symptoms and medical care utilization influenced HRQOL. There was evidence to support the effect of knowledge of HCV status on HRQOL. In conclusion, our findings contrast with previous studies in non-prisoner groups in which HCV infection appears to decrease overall HRQOL. Non-HCV factors may override HCV-specific HRQOL impairment in this population. Targeted management strategies are required to improve HRQOL of prisoners.

Self-Reports of Health before and during Imprisonment in Female Inmates

“…Following the findings by Barros et al [31], the prevalence of reported hepatitis C and HIV is prominent. Furthermore, though these diseases have increasingly become the subject of attention of both prison health policies and researchers [21], the high number of inmates with hepatitis C and HIV remains a matter of concern for public health [21, 32, 33], being the female prison population the most affected [34, 35]. …”

Treating hepatitis C in the prison population is cost-saving

“…56 Although quality of life in prisoners is lower than that of the general population, hepatitis C infection has not been shown to make a significant impact. 57 This is likely because non-HCV factors override HCV-specific quality of life impairment. Furthermore, nonviral HCV-specific quality of life impairments are likely to be equally distributed between prisoners who are and who are not treated for hepatitis C infection.…”

What can circle sentencing courts tell us about drug and alcohol problems affecting Aboriginal communities?

“…Recent international and national research acknowledges that tattooing and body piercing practices exist in prisons and could be a risk for the transmission of blood borne virus infections; however due to overlapping risk behaviours such as injecting drug use it is difficult to establish the extent of the risk (Post et al, 2001;Abiona et al, 2010;Thein et al, 2006;Butler et al, 2004 Of the 102 young people who reported having at least one tattoo, 66% reported to have one or two tattoos, 26% had three or four tattoos and 9% reported to have five or more tattoos. There were no significant differences detected in the number of tattoos by gender or Aboriginality.…”