On May 15, 2017, after serving 37 years, David Maldonado was released from prison. He had been sentenced to life for a murder he committed when he was 16. But for Maldonado, getting out was about more than freedom; his release might have also saved his life. In 1997, Maldonado was diagnosed with chronic hepatitis C—a disease, now curable, that the state of Pennsylvania had refused to treat. “Society really didn’t care whether I lived or died,” he told me recently.
Hepatitis C is caused by a virus that infects and inflames the liver; it’s spread through blood, most often via intravenous drug use. Between 75 and 85 percent of those infected with hepatitis C develop chronic hepatitis C, which can lead to liver scarring, liver cancer, cirrhosis, and death. It’s the most deadly infectious disease in the United States, killing around 20,000 people a year—more than the next 60 infectious diseases combined.
Prisons are at the epicenter of this epidemic; an estimated 20 percent of incarcerated individuals carry the virus, compared to about 1 percent of the general population, according to American Association for the Study of Liver Diseases and the Infectious Diseases Society of America (AASLD/IDSA).