Correctional Facilities and Viral Hepatitis

Adults in correctional facilities are at risk for Hepatitis B virus (HBV) infection through sex with HBV-infected persons, injection drug use, and sharing close living quarters with other inmates infected with HBV. In addition, a high percentage of prison inmates have Hepatitis C virus (HCV) infection.

Hepatitis B Vaccination

The Advisory Committee on Immunization Practices recommends Hepatitis B vaccination for adults in correctional settings because of their increased risk for infection, both inside and outside of prisons and jails. Although the majority of HBV infections among incarcerated persons are acquired in the community, infection may also be transmitted within correctional settings. Furthermore, upon release, susceptible inmates are often at increased risk for infection if they resume high-risk behaviors.

Correctional settings also provide an opportunity to vaccinate at-risk adults who do not routinely access prevention services in the community. Vaccinating inmates in prisons has been demonstrated to be feasible and cost-saving. Many state prison systems and the Federal Bureau of Prisons have implemented Hepatitis B vaccination programs of varying scope, and acceptance of vaccination by inmates is high.

Hepatitis C Testing

The prevalence of HCV infection in prison inmates is substantially higher than that of the general U.S. population. Among prison inmates, 16%–41% have ever been infected with HCV, and 12%–35% are chronically infected, compared to 1%–1.5% in the uninstitutionalized US population. HCV infection is primarily associated with a history of injection drug use. CDC recommends that correctional facilities ask inmates questions about their risk factors for HCV infection during their entry medical evaluations. Inmates reporting risk factors should be tested for HCV infection and those who test positive for HCV should receive further medical evaluation to determine if they have chronic infection and/or liver disease.