Correlation between Hepatitis C Viremia Prevalence in the Federal Bureau of Prisons and in State Prison Systems for Predictive Modeling of Missing State Data Restricted; Files & ToC
Kauffman, Alexandra (Spring 2024)
Abstract
Background: The incarcerated population has nearly 9 times the prevalence of the hepatitis C virus (HCV) than the general population. Data on the prevalence of HCV viremia is necessary for determining the current burden of chronic HCV infection in all 50 state prison systems and clarifying needs to achieve national elimination goals.
Methods: Data on HCV viremia prevalence among entrants to the Federal Bureau of Prisons (BOP) from July 2022 to June 2023 was tested with negative binomial (NB) regression as a predictor of state HCV viremia prevalence using data from 27 state correctional systems who provided data. We analyzed other predictors: Medicaid expansion, PA requirements, and heroin use by state, with likelihood ratio tests to determine if they were associated with the outcome. We then used BOP data for all 50 states in the final NB model to predict viremia prevalence for the remaining 23 states.
Results: We found that there was a significant association between HCV viremia prevalence in the BOP and in states. None of the additional predictive variables were found to be significant. Of these 23 states with missing data, the model predicted Oregon with the lowest prevalence of HCV viremia per 1,000 persons in prison (82) and New Hampshire with the highest prevalence per 1,000 persons in prison (175).
Conclusion: This was the first study that sought to extrapolate federal prison data on HCV to state prisons. NB regression modeling demonstrated a significant association between state and federal prison systems’ HCV viremia prevalence. This study has demonstrated that there is potential in extrapolating from the uniform and systematic screening processes in the BOP to to state agencies with less public health resources. This study fills an important gap by providing estimates of HCV viremia burden in state prison facilities with missing data.
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