Hepatitis C seroprevalence among prison inmates since 2001: still high but declining.

OBJECTIVES: Although the hepatitis C epidemic in the United States disproportionately affects correctional populations, the last national estimates of seroprevalence and disease burden among these populations are more than a decade old. We investigated routine hepatitis C surveillance conducted in state prison systems and updated previous estimates. METHODS: We surveyed all U.S. state correctional departments to determine which state prison systems had performed routine hepatitis C screening since 2001. Using seroprevalence data for these prison systems, we estimated the national hepatitis C seroprevalence among prisoners in 2006 and the share of the epidemic borne by correctional populations. RESULTS: Of at least 12 states performing routine testing from 2001 to 2012, seroprevalences of hepatitis C ranged from 9.6% to 41.1%. All but one state with multiple measurements demonstrated declining seroprevalence. We estimated the national state prisoner seroprevalence at 17.4% in 2006. Based on the estimated total U.S. correctional population size, we projected that 1,857,629 people with hepatitis C antibody were incarcerated that year. We estimated that correctional populations represented 28.5%-32.8% of the total U.S. hepatitis C cases in 2006, down from 39% in 2003. CONCLUSIONS: Our results provide an important updated estimate of hepatitis C seroprevalence and suggest that correctional populations bear a declining but still sizable share of the epidemic. Correctional facilities remain important sites for hepatitis C case finding and therapy implementation. These results may also assist future studies in projecting the societal costs and benefits of providing new treatment options in prison systems.

The relationship of cigarette smoking to postoperative complications from dental extractions among female inmates.

OBJECTIVES: The purpose of this study is to assess the contribution of smoking to postoperative complications, including alveolar osteitis (dry socket), after dental extractions. In addition, it attempts to determine the effect of the ban imposed on tobacco use in the prison on postoperative complications. STUDY DESIGN: All inmates having dental extractions at the Federal Correctional Institution in Danbury, CT, during the period January 2004 to April 2005, were included in this study (N = 219; mean age = 37.7 years). Data on postextraction complications were analyzed for association with smoking by using the chi-square test. Significance was set at P < .05. RESULTS: The incidences of overall complications and alveolar osteitis were 19.6% and 5.0%, respectively. It was found that (1) there was a significant difference in overall complications between smokers and nonsmokers (P = .02), (2) there was a significant difference in the incidence of alveolar osteitis between mandibular third molar and other extractions, regardless of smoking status (P = .02), (3) surgical trauma contributed significantly to both an increase in total complications (P = .05) and alveolar osteitis (P = .01), and (4) smoking appeared to be a contributing factor to increased complications among multiple extractions (P = .03). CONCLUSION: In this study, smoking, mandibular third molars, and surgical trauma were significantly associated with the increased incidence of overall complications including alveolar osteitis.