Hep-C Treatment Needed in Los Angeles County Jails to Save Lives and Money
Over a five-year stint working in Los Angeles County’s jail system, Dr. Mark Bunin Benor saw hundreds of detainees with Hepatitis-C who were not being treated. In an article published by the Los Angeles Times on April 2, 2024, Benor said that jail officials were still not doing enough to prevent the spread of the potentially fatal disease.
Benor has worked for almost two decades as a physician to marginalized and disadvantaged patients. While working for the Los Angeles County Department of Health Services (DHS)—the nation’s second largest municipal health system, which provides healthcare to County jail detainees—Benor discovered that Hep-C is alarmingly prevalent. Over a third of detainees tested positive.
Despite its identification in the 1980s and the development of effective medication treatments, Hep-C still claims about 14,000 American lives annually, surpassing the toll of HIV. A major hurdle that the County Sheriff’s Department (LASD) faces in its jails is a lack of routine screening for Hep-C, which is recommended by the federal Centers for Disease Control and Prevention (CDC). County jails have programs to monitor and manage other contagious diseases, including tuberculosis and COVID-19, for which all detainees are screened at intake.
But not Hep-C.
As recently as 2018, when Benor began working in the jail system, Hep-C screening was rare, and most known cases were never treated unless advanced liver fibrosis developed. Even then, a special police escort was necessary to transport infected detainees to and from hospital appointments. Delivery of antiviral medication often took weeks, further discouraging treatment.
In 2019, Dr. Lauren Wolchok traced the poor delivery of Hep-C treatment in jails to the short length of the average detainee’s stay. That high turnover rate and unpredictable release dates magnified difficulties in identifying and tracking infected detainees—difficulties exacerbated by a lack of treatment funding, especially accessing reduced-price treatments through the federal Health Resources and Services Administration’s 340b Program.
Meanwhile, intravenous drug use and unsterile tattooing among detainees contributed to the virus’ spread, perpetuating the epidemic within County jails. A concerted effort to test and treat Hep-C in the jail system could significantly reduce infection rates in the surrounding county, as well, yet such efforts are not being made, Benor said. He concluded that treating Hep-C is “cost-effective given the resulting reduction in cirrhosis, liver cancer, heart disease, kidney disease, arthritis, and diabetes.”
“In the long run,” the doctor added, “decreasing the spread of infection will save both dollars and lives.”
Source: Los Angeles Times
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