North Carolina prison authorities must stop denying expensive medicines to most of the inmates believed to be carriers of the potentially deadly blood-borne infection hepatitis C, a federal judge ruled this week.

U.S. District Judge William Osteen wrote in an order issued Wednesday that the three inmates suing prison officials immediately receive drugs for a hepatitis C treatment regimen that should prevent liver cancer, cirrhosis or other ailments. The state Department of Public Safety buys several types of drugs that average out to a cost of about $33,000 per inmate treated, an agency spokesman said in January.

Osteen also ordered that the lawsuit be expanded to cover all current and future prisoners in state custody who could have the hepatitis C virus.

Lawyers for the American Civil Liberties Union claim prison authorities are violating the U.S. constitution's prohibition against cruel and unusual punishment.

But the inmates' lawyers will have to show later in the proceedings that prison officials knowingly disregarded the serious medical need of inmates and substantial risks they faced, Osteen said. "Medical care in the prison setting must be adequate, not necessarily ideal, and (hepatitis C virus) treatment in the prison system is dependent upon the availability of resources," the judge wrote.

The judge said it was too early in the litigation to require that all inmates be tested for the virus as the ACLU is seeking. Federal health agencies estimate that between 17 percent and one-third of the country's inmates may have the infection and could need treatment. That means around 6,000 to 12,000 of North Carolina's 36,000 inmates could be infected.

"This ruling is an important step toward combating a major public health crisis that leads to the suffering and death of thousands of people both inside and outside prison walls," ACLU of North Carolina staff attorney Emily Seawell said in a statement. "The vast majority of people who are incarcerated will one day re-enter the community, and medical experts have made it clear that to combat the hepatitis C epidemic, we must provide treatment as quickly as possible."

The state prison system will comply with Osteen's order, spokesman John Bull wrote in an email. Agency lawyers had said previously that officials prioritize patients for treatment based on their medical needs and history before they face serious health risks.

Lawyers for the state said in court documents that as of June, prison authorities had treated 38 percent of the 1,543 inmates they'd identified as having a chronic form of the hepatitis C infection, which is a common reason for liver transplants.

The ACLU and other lawyers have filed similar lawsuits in about 10 states including Colorado and Connecticut, arguing that inmates can't be denied drugs that can cure the infection. Florida and Massachusetts prisons have already agreed to test and treat inmates.

About 2.4 million Americans are living with hepatitis C, according to the Centers for Disease Control and Prevention.

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