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DOCR reports steep reductions in hepatitis C cases after treatment regimen change; requests $1.3 million for next biennium
Summary
DOCR medical staff told the appropriations committee the department will have treated the in‑custody hepatitis C caseload by mid‑biennium using an 8‑week regimen supported by new protocols and state lab partnerships; the department requested $1.3 million to treat incoming cases next biennium and described expanded STD screening initiatives.
Agency medical officials told the Appropriations — Human Resources Section on Thursday that DOCR’s hepatitis C treatment program has produced large reductions in prevalence among people entering custody and described continued funding needs.
Jessica Wilkins, DOCR chief nursing officer, said the department expects to have treated about 241 hepatitis C patients by February 2025 and projected the number treated to reach about 297 by the end of the biennium. Wilkins said DOCR adopted an 8‑week antiviral regimen after identifying an evidence base (identified by DOCR clinical staff and Dr. Gravning) showing equivalent cure rates for certain genotypes compared with the more‑common 12‑week course. Wilkins said the change allowed DOCR to stretch medication dollars: “Every three patients we treated, we were able to treat another patient,” enabling higher throughput without reducing effectiveness.
Wilkins said treatment has reduced DOCR’s test‑positive rate on arrival by roughly six percentage points, and the department expects to be “caught up” on treating currently incarcerated individuals by July of the next biennium; the $1.3 million request in the DOCR packet is intended to treat incoming people who test positive during the upcoming biennium (not to “catch up” on the existing incarcerated population).
DOCR medical staff also described broader infectious‑disease screening: upon admission patients are screened for HIV and hepatitis C; DOCR runs testing for gonorrhea and chlamydia in partnership with the North Dakota State Lab and, given rising statewide syphilis counts, has added syphilis screening. The department said it received a $10,000 DHHS grant to support syphilis testing and reported 50 new syphilis positives on admissions since April 2024; those cases prompted outreach to public‑health partners.
Lawmakers praised the department’s treatment results but asked for clarifications about ongoing costs and retesting schedules. Wilkins said viral loads are measured on treatment completion and again at three and six months; a negative viral load at six months constitutes cure. The department said it expects the hepatitis C caseload to decline over time as fewer new positive cases arrive.
Ending: The committee accepted the update and asked DOCR to return with any further refinements to hepatitis C cost estimates and projections of incoming positive cases.
