Clinical care of incarcerated people with HIV, viral hepatitis, or tuberculosis

Rich, Josiah D.; Beckwith, Curt G.; Macmadu, Alexandria; Marshall, Brandon D. L.; Brinkley‐Rubinstein, Lauren; Amon, Joseph J; Milloy, M‐J; King, Maximilian R F; Sánchez, Jorge; Atwoli, Lukoye; Altice, Frederick L.

doi:10.1016/s0140-6736(16)30379-8

Cited by 97 publications

(87 citation statements)

References 83 publications

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“…As reported elsewhere, opt-out HIV screening seemed an efficient strategy to diagnose HIV among inmates [7,27,28]. It allowed diagnosing a high number of early stage infections, with no physical signs of immune depression (nearly 80% were CDC-stage A).…”

Section: Discussionmentioning

confidence: 83%

High mortality among male HIV-infected patients after prison release: ART is not enough after incarceration with HIV

et al. 2017

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ContextFrench Guiana is a South American French territory, where HIV prevalence consistently exceeds 1% in the adult population. In the only correctional facility, HIV prevalence fluctuates at around 4%.AimsAfter describing the population of HIV-positive inmates, we aimed to evaluate mortality after release from the correctional facility, and to identify its predictive factors.RationaleOutside North American settings, data on treatment outcome and vital status of HIV-positive former inmates are scarce. There were no data in French Guiana. Filling this gap represents a basis for potential improvements.MethodsAll HIV-infected adults released from an incarceration of 30 days or more, between 2007 and 2013, were enrolled in a retrospective cohort study. Mortality was described over time, one to seven years following release, using Kaplan-Meier estimates. Factors associated with mortality were identified through a non-parametric survival regression model.Results147 former inmates were included. The male to female ratio was 4.4. The median age was 37.3 years. The majority were migrants, 25.8% were homeless, 70.1% suffered from substance abuse, with 34.0% of crack-cocaine users. On admission, 78.1% had an early HIV-stage infection (CDC-stage A), with a median CD4 count of 397.5/mm3, 34.0% had one comorbidity, mainly hypertension. Upon release, 50.3% were on ART. Reasons for not being treated were not fulfilling the criteria for 74.6%, and refusing for 15.1%. Before release, 84.5% of the patients on ART had a viral load≤200cp/ml. After release, 8.2% of the cohort had died, with a crude incidence of 33.8/1000 person-years. All recorded deaths were males, with an incidence of 42.2/1000 person-years. Comparing with the age-specific mortality rates for males in French Guiana, the standardized mortality ratio was 14.8. In multivariate analysis, factors associated with death were age and CD4 count before release.ConclusionDespite access to ART while incarcerated, with good virological outcome, the post-release mortality was very high for males, almost 15 times what is observed in the general male population living in French Guiana, after age standardization. Access to ART in correctional facilities may be a necessary, but not sufficient condition to protect male inmates from death after release.

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Section: Discussionmentioning

confidence: 83%

High mortality among male HIV-infected patients after prison release: ART is not enough after incarceration with HIV

et al. 2017

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“…International surveys have shown that a small portion of the world imprisoned population has consistent access to measures for prevention of STIs, highlighting the low frequency of condom use in the prison environment, which, among other factors, has the existence of imposed sexual relations as determinant. (26,27) Condom use is an important measure for the prevention of new cases of hepatitis B, because its efficacy is proven as a physical barrier in the transmission of particles with size similar to that of small STI-causing viruses. In addition, if used correctly, it reduces the risks of slides or ruptures.…”

Section: Discussionmentioning

confidence: 99%

Prevalência de hepatite B e fatores associados em internos de sistema prisional

et al. 2017

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Objective: To estimate the prevalence of HBsAg marker in prisoners of the Brazilian prison system, correlating it to associated factors. Methods: An epidemiological, cross-sectional study was conducted in prison units with closed or semi-open regime (n=12), totaling 2,131 participant prisoners. Data were collected in an interview, followed by rapid testing for Hepatitis B (HBsAg). Simple, bivariate and multivariate descriptive analyses were carried out, with the use of logistic regression with the p value settled at 0.05. Results: The prevalence of positive HBsAg was 0.5%, with a statistically significant association with the variables "does not like to wear condoms" (ORa=3.63) and "does not know how to prevent sexually transmissible diseases" (ORa=5.02). Conclusion: The estimated prevalence was equal to or lower than that found in the general population of the country and the results proved that there are factors statistically associated with the prevalence of HBsAg positivity in the studied population. ResumoObjetivo: Estimar a prevalência do marcador HBsAg em internos de sistema prisional brasileiro, correlacionando-a a fatores associados. Métodos: Pesquisa epidemiológica, transversal, realizada nas unidades prisionais com regime fechado ou semiaberto (n=12), totalizando 2.131 internos participantes. A coleta de dados ocorreu por meio da realização de entrevista, seguida de testagem rápida para Hepatite B (HBsAg). Foram realizadas análises descritivas simples, bivariadas e multivariadas, utilizando-se a Regressão Logística com o valor de p fixado em 0,05. Resultados: A prevalência de HBsAg positivo foi de 0,5%, com associação estatisticamente significativa com as variáveis "não gostar de utilizar preservativo" (ORa=3,63) e "não saber como prevenir infecções sexualmente transmissíveis" (ORa=5,02). Conclusão: A prevalência estimada esteve igual ou menor que a encontrada na população geral do país e comprovou-se que existem fatores estatisticamente associados à prevalência de positividade do HBsAg na população estudada.

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“…Time during incarceration and immediately after release back to the general community has also been implicated in transmission of HBV infection. Prisons are a potential location for treatment of chronic illness, including chronic HBV infection [4, 5]. However, during our review of the literature, we found no descriptions of treatment of active hepatitis B infection in prisoners.…”

Section: Introductionmentioning

confidence: 93%

Epidemiology and Treatment of Hepatitis B in Prisoners

Smith

Uvin

Macmadu

et al. 2017

Curr Hepatology Rep

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Purpose of Review The review details recent literature reports regarding Hepatitis B Virus (HBV) and, in particular, Hepatitis B prevalence/incidence in incarcerated populations around the world. Furthermore, the review will summarize the national/international guidelines regarding HBV and look at diagnosis, vaccination, treatment, and linkage to care after release. Recent Findings HBV affects prisoners at a much higher rate than the general populations. Many who are at increased risk for HBV infection are also at increased risk for incarceration. Incarcerated settings also have higher rates of HBV transmission. Summary Incarcerated individuals should be immunized if they are not already immune to HBV. Increased access to safe injecting and tattoo paraphernalia, condoms, and personal hygiene equipment could reduce the spread of HBV and other blood-borne and sexually transmitted infections. Future research should focus on ways to prevent the spread of HBV and similar viruses in incarcerated settings in order to protect incarcerated individuals and the general public. Research on effective linkage to community HBV care following release is needed.

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Clinical care of incarcerated people with HIV, viral hepatitis, or tuberculosis

Cited by 97 publications

References 83 publications

High mortality among male HIV-infected patients after prison release: ART is not enough after incarceration with HIV

High mortality among male HIV-infected patients after prison release: ART is not enough after incarceration with HIV

Prevalência de hepatite B e fatores associados em internos de sistema prisional

Epidemiology and Treatment of Hepatitis B in Prisoners

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