Hepatitis C

People behind bars are needlessly dying from a curable disease because carceral facilities refuse to act.

Hepatitis C is an easily transmitted liver disease resulting from HCV infection, which that has devastating effects on those who contract it. In addition to liver damage (and ultimate failure), HCV puts patients at risk for depression, arthritis, various cancers, nerve damage, jaundice, heart attacks, and diabetes. In the past few years, hepatitis C has killed more Americans than all other reportable infectious diseases combined.

Incarcerated people are infected at roughly 20 times the rate of the general population, making prisons the epicenter of this deadly disease. This is a policy choice. There has been a cure for hepatitis C since 2011, but many facilities have refused to adopt these new standards of treatment solely due to cost constraints. Prison systems instead ration out lifesaving treatments, treating only the patients with severe liver damage as approximated by liver scar tissue. As a result, incarcerated individuals must suffer in silence until their livers are irreversibly damaged in order to qualify for treatment.

We act as amicus counsel for medical experts in the fields of public health and infectious disease to challenge this widespread policy of drug rationing.

The standard of care for HCV, as published in widely accepted treatment guidelines, is that virtually all patients with chronic HCV infection should be treated with direct-acting antiretrovirals which functionally eradicate the virus. When incarcerated individuals sue after having been denied adequate medical treatment for their hepatitis C infection, our amici advocate on their behalf to articulate the correct medical standard and challenge outmoded carceral policies.

We also use our amicus briefs as an opportunity to educate the courts about important policy considerations from an epidemiological perspective. Although cost is the primary justification cited by prisons that deprive their HCV-infected inmates of direct-acting antiretrovirals, the benefits far outweigh the expense for society at large. Because of the high concentration of HCV-infected Americans living in prisons, we emphasize the substantial public health opportunity these institutions present for eradicating the disease. Treating incarcerated individuals is not only medically necessary, but ultimately benefits public health because they can no longer transmit the virus to others.

Our Hepatitis C Cases