The Health Affairs article titled “The National Hepatitis C Plan Needs A Correctional-Care Standard” argues that the United States cannot eliminate hepatitis C without establishing a consistent national standard for testing and treating people in jails and prisons. Correctional facilities represent a critical intervention point because chronic HCV is estimated to affect about 8.7% of state-prison residents—nearly nine times the prevalence in the general population.
Yet correctional care remains fragmented. Testing and treatment policies vary among jurisdictions, and many facilities do not routinely identify or cure infected patients. The article’s essential recommendation is a nationwide correctional-care standard built around universal opt-out screening at intake, reflex RNA confirmation after a positive antibody test, and prompt access to curative direct-acting antivirals. Treatment already underway should never be interrupted because someone enters custody.
The standard must also extend beyond the walls. Release planning should include enough medication to bridge the transition, Medicaid enrollment or reactivation, patient navigation, connection to a community HCV provider, and access to opioid-use-disorder treatment and harm-reduction services. Without this coordinated handoff, patients can disappear from care during one of the most vulnerable transition periods.
The broader message is that correctional medicine is inseparable from community health. Most incarcerated people eventually return home; diagnosing and curing HCV during incarceration prevents cirrhosis and liver cancer, reduces health inequities and limits further community transmission. A national elimination program that merely mentions correctional populations—but does not require and fund a measurable care standard—will leave a major reservoir of infection untouched.
This model is consistent with current correctional-health recommendations, which endorse opt-out testing, timely antiviral treatment, telehealth-supported specialty care and coordinated discharge planning.
