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  • North Carolina Prisoner Legal Services, Inc.

Landmark Settlement in Hepatitis C Lawsuit

Updated: Mar 4, 2021

Raleigh, Mar. 1, 2021– A federal judge approved a landmark settlement agreement between North Carolina Prisoner Legal Services (“NCPLS”), the American Civil Liberties Union of North Carolina (the “ACLU”), and the North Carolina Department of Public Safety (“NCDPS”) that will require NCDPS to take targeted actions to drastically reduce the incidence of hepatitis C virus (“HCV”) in all state prisons.

HCV is a life-threatening virus spread through exposure to infected blood. Transmission may happen through unsafe health care, transfusion of unscreened blood or blood products, injection drug use, tattooing, piercing, or sex. HCV is especially common in prisons, with some experts estimating that 40% of all prisoners in the U.S. are HCV-positive. For a minority of people, HCV is a short-term illness that their immune system clears, but for most people who become infected with HCV, it becomes a long-term, chronic infection. Left uncured, chronic HCV often progresses to liver cancer, liver failure, death, and other chronic, deadly conditions. Antiviral medicines known as direct-acting antivirals (“DAAs”) can cure more than 95% of cases of HCV in as few as eight to twelve weeks, with minimal or no side effects.

As part of the settlement, NCDPS will begin testing prisoners for HCV upon request and verbally offering testing to every prisoner upon admission to NCDPS custody and at every facility transfer and physical examination. Over the next five years, NCDPS will also begin DAA treatment of at least 2,100 prisoners with chronic HCV—approximately one third of the estimated total number of prisoners in North Carolina who have chronic HCV but have not received DAA treatment. Nearly all prisoners with chronic HCV will now be eligible for DAA treatment, which NCDPS will administer to the sickest prisoners first and prisoners with less advanced disease afterwards. Prisoners with chronic HCV awaiting DAA treatment will now receive a physical examination with a physician at least once every six months to address HCV complications and monitor disease progression. NCDPS will also refer HCV-positive prisoners who are released before receiving DAA treatment to a North Carolina Department of Health and Human Services bridge counselor, who will help the prisoner find low or no-cost HCV treatment.

When NCPLS and the ACLU filed this lawsuit, Buffkin v. Hooks, 18-cv-502 (M.D.N.C. 2018), NCDPS only offered HCV testing to prisoners who presented one or more of several specific HCV risk factors, and NCDPS only administered DAA treatment to a limited number of severely ill HCV-positive prisoners. Prisoners awaiting treatment received sporadic monitoring that typically only entailed a blood test, and prisoners released before receiving treatment did not receive formalized state-support for obtaining treatment. As a result, thousands of HCV-positive prisoners went untested and untreated every year, and, upon release, many of them unknowingly spread HCV to their loved ones in the outside community.

“This is a tremendous victory for all North Carolinians. Prisoners suffering with chronic hepatitis C will finally have a realistic path to diagnosis and treatment, and we can expect to see a meaningful reduction in the spread of HCV in prisons and outside communities across the state,” said Cory Tischbein, Supervising Attorney with NCPLS.

Moving forward, as always, NCPLS will continue to advocate for safe and humane conditions in North Carolina prisons. Inquiries can be directed to

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