Four Bismarck physicians are in the process of collecting data on the treatment of hepatitis C in North Dakota prisons.

Jeff Hostetter, Kent Martin, John Hagan and Olimpia Rauta presented initial findings at the Centers for Disease Control's National Viral Hepatitis Conference on Dec. 8 in Washington, D.C.

Hostetter, the medical director for North Dakota prisons, said initial data was sent to the CDC, which asked the four physicians to present their research. After presenting, Hostetter said they received approval to continue collecting data for further reports.

Hepatitis C is a blood-born pathogen transmitted mostly through needles during drug use or if a medical professional gets stuck by a needle.

Hostetter said the pathogen can be transmitted through sexual contact if bleeding occurs.

Martin and Hagan have been treating inmates for hepatitis C using a drug called Consensus Interferon instead of Peginterferon, the drug typically used to treat the disease.

Hostetter said their findings have been positive. He said the reason most patients with hepatitis C are not treated with Consensus Interferon, which is less expensive and has fewer side effects, is that Peginterferon only needs to be administered once a week.

Consensus Interferon must be administered three times a week, which Hostetter said is possible for inmates. The state decided to use the drug because it is less expensive.

"For other people, it is difficult to do the three injections per week," he said. "They forget or just don't come in for the shot. It's not effective if they don't get them."

He said the data he, Martin, Hagan and Rauta have presented and will continue to collect may show that Consensus Interferon should be used instead of Peginterferon.

"If you ask people, they'd rather have the inconvenience of three shots a week than the side effects of the Peginterferon," Hostetter said. "The problem is it doesn't work because people don't get the shots as often as they need to."

The side effects include a variety of ailments because Peginterferon stays in the body and acts as a toxin.

Hostetter said the data is simply medical charts that would be collected even if a study was not being conducted.

"We're not doing anything that wouldn't be done anyway," he said. "It's important to realize we're not experimenting on prisoners."

An increase in methamphetamine use is blamed for the rise in hepatitis C cases. Hostetter said in 2000, 10 percent of inmates in the North Dakota State Penitentiary were meth users. This year, 62 percent of inmates in the penitentiary are meth users.

"People who use meth have high-risk behavior," Hostetter said. "When they're tweaked out on meth, they don't care about having clean needles."

He said due to the increase in hepatitis C, employees and inmates at North Dakota prisons are educated on keeping themselves safe. When inmates begin their sentences, they go through an hourlong course informing them of how to avoid coming into contact with the disease.

Medical professionals at the prison and all other facilities are advised by the CDC to practice "universal precaution," meaning they handle every patient as if he or she could have hepatitis C or HIV.

Hostetter said 20 percent to 30 percent of hepatitis C patients get extremely sick right away and pass the disease through their system. The rest have it for life.

"You can live a relatively normal life with hepatitis C if you take care of yourself,"he said. "If you drink alcohol, you have almost a 100 percent chance of eventually developing liver cancer."

Hostetter said there may be a way for Consensus Interferon to be used more effectively than Peginterferon.

He said using a pump put in the body to deliver the injection on time is an option. So is having public health officials go out and give the injections to patients to be sure they get them on time.

"It's an ethical dilemma," he said. "Should we be letting patients deal with more side effects because it's more convenient?"

(Reach reporter Katie Brown at 250-8225 or katie.brown@;bismarcktribune.com.)