Sharp rise in Hepatitis C cases at Tihar,screening on for inmates

According to Dr N K Girdhar,Resident Medical Officer of Tihar Jail,“After we started our Integrated Counselling and Testing Centre (ICTC) for HIV,we got to know that Hepatitis C is also transmitted in a similar manner as HIV. It was also established that HCV is particularly common among IDUs due to sharing of needles. So,we made testing compulsory at DAC.”

Patients suffering from Hepatitis C are referred to the GB Pant Hospital for treatment,he said.

Stating that the prison is also engaged in a collaborative study with the hospital to identify what makes IDUs more susceptible to the disease,Dr Giridhar said,“We do a complete molecular profile of patients before and after treatment to identify precisely what makes them more likely to get the disease,besides checking for molecular changes,post-treatment.”

The testing has resulted in early diagnosis of Hepatitis C,a factor that is critical for treatment of the ailment. “If diagnosed late,Hepatitis C could cause liver cirrhosis or scarring of the liver. This leads to liver cancer and liver failure. More than 50 per cent patients infected with HCV develop such complications,and prognosis is poor simply due to lack of timely diagnosis,” said an official of the Gastroenterology department in a Delhi hospital.

As IDUs have been identified as a high risk group at Tihar,the prison has become the first in South Asia to introduce a Opioid Substitution Therapy programme. “A regulated dose of opioid is given to patients to help with their de-addiction. We have treated about 120 patients so far. Preference is given to IDUs because they are the highest risk group for severe co-infections,” said Guna Shekhar,programme in-charge from the United Nations Office on Drugs and Crime (UNODC). The programme is jointly run by UNODC and AIIMS.

According to prison authorities,following up on patients released during treatment has turned out to be one of the major problem areas. “We provide Interferon injections,the most widely accepted treatment modality,completely free. But once the inmates are released,we have no way of tracking their progress,” said Dr Girdhar.

The 120-bed DAC bears the load of all the nine prisons housed in the Tihar complex. In a situation where authorities say that at least 8 to 10 per cent of the inmates are drug addicts,the centre is desperately in need of more hands.

“We have four psychiatrists and a single nurse for the wards and patients. Considering that we get extremely complex cases of multiple substance abuse,and co-infections like Hepatitis C and HIV,we could really do with more staff members,” said a psychiatrist from the DAC.

According to the doctor,staff members make a conscious decision to not admit more than 50 patients at a time.