Prison Deaths and Hepatitis C: A Health Crisis Behind Bars

This week's longform feature looks at the public-health challenges of fighting hepatitis C, a virus that attacks the liver and has infected 17 percent of the American prison population. In Colorado, more than 2,200 state prisoners have the virus; statistically, about one in four will develop cirrhosis or liver cancer if untreated.

A new generation of wonder drugs can actually cure the disease, but the drugs are so expensive — an average of around $57,000 per patient now — that only fifty inmates to date have been approved to receive the medication.

This "triage" approach ignores the treatment guidelines developed by the American Association for the Study of Liver Diseases, which recommend use of the drugs in all cases of chronic hep C except for those patients with short life expectancies.

Failure to treat the disease has, in fact, shortened quite a few prisoners' lives. Through an open-records request, Westword obtained records for fifteen years (2001-2016) on causes of death that the Colorado Department of Corrections submits to the U.S. Bureau of Justice Statistics. Close to 20 percent of the deaths during that period were attributed to "end stage liver disease" or related illnesses. Here's how the numbers shake out for 823 deaths in the DOC:
A couple of caveats about these numbers: Not all liver-related deaths are the result of complications of hepatitis C. However, there are several deaths in the DOC data that fall under "other natural causes" that might actually be related to the virus, including the simple entry "organ failure" (which could be a result of cirrhosis or other liver damage).

Nationally, chronic liver disease is the twelfth-leading cause of mortality. But in Colorado's prisons, it's number one — with a bullet.