Hospital admissions for HIV-infected prisoners in Italy

Abstract

Purpose The purpose of this paper is to give a description of the clinical conditions and patient demographics of inpatient admissions of human immunodeficiency virus (HIV)-infected inmates in three hospital wards that provide hospital care for inmates in Italy. Design/methodology/approach This is a retrospective review of hospital medical admissions of patients living with HIV from January 1 to December 31, 2014, in three Italian referral centers for hospitalization of inmates. Findings A total of 85 admissions for 85 different HIV-infected inmates occurred in 2014 in the three centers participating to the study. Most patients (54.1 percent) were co-infected with hepatitis C. Discharge diagnosis largely varied ranging from common HIV-related co-morbidities to completely independent diagnosis. The most commonly observed discharge diagnoses were chronic hepatitis C, liver cirrhosis, opiate dependence and thrombocytopenia. Originality/value Discharge diagnosis between HIV-infected inmates and HIV-infected patients in freedom are strikingly and significantly different. A large number of hospitalized HIV-infected inmates were affected by chronic viral hepatitis and liver cirrhosis; this is probably a direct consequence of the high prevalence of HCV and/or HBV co-infections in the inmate population in Italy. In addition, a significantly lower proportion of cancer diagnosis was observed among inmates; this is possibly justified by the fact that in our Italian settings when HIV infection is at advanced stages or if cancer treatment is started those affected are released from prison and can continue their diagnostic and treatment follow-up in freedom.

The global and regional prevalence of hepatitis C and B co-infections among prisoners living with HIV: a systematic review and meta-analysis

“…Of the 52 included studies, 48 were cross-sectional [ 6 , 7 , 9 , 19 – 31 , 33 , 35 – 59 , 61 – 66 ] and 4 were prospective cohort studies [ 10 , 32 , 34 , 60 ]. Of all, 50 studies reported HCV infection [ 6 , 7 , 9 , 10 , 19 – 63 , 65 ] and 23 studies reported either solely HBV infection or both HBV and HCV infections [ 19 , 21 , 25 , 28 , 32 , 34 – 37 , 41 , 43 – 46 , 52 , 54 – 56 , 58 , 60 , 64 – 66 ]. Regarding the study location, 21 studies were conducted in Europe [ 9 , 10 , 21 , 24 , 25 , 27 , 33 , 34 , 39 , 42 , 45 – 47 , 49 , 52 , 55 , 56 , 58 , 60 , 63 , 65 ], 18 were conducted in America [ 6 , 7 , 20 , 22 , 23 , 26 , 29 – 32 ,…”

“…Of all, 50 studies reported HCV infection [ 6 , 7 , 9 , 10 , 19 – 63 , 65 ] and 23 studies reported either solely HBV infection or both HBV and HCV infections [ 19 , 21 , 25 , 28 , 32 , 34 – 37 , 41 , 43 – 46 , 52 , 54 – 56 , 58 , 60 , 64 – 66 ]. Regarding the study location, 21 studies were conducted in Europe [ 9 , 10 , 21 , 24 , 25 , 27 , 33 , 34 , 39 , 42 , 45 – 47 , 49 , 52 , 55 , 56 , 58 , 60 , 63 , 65 ], 18 were conducted in America [ 6 , 7 , 20 , 22 , 23 , 26 , 29 – 32 , 37 , 38 , 50 , 57 , 59 , 61 , 62 , 66 ], 2 in South-East Asia [ 41 , 48 ], 7 in East Mediterranean [ 28 , 36 , 40 , 43 , 44 , <...>…”

“…Out of the 52 included studies [ 6 , 7 , 9 , 10 , 19 – 66 ], we found 17 studies [ 9 , 10 , 19 , 22 , 28 , 33 , 37 , 39 , 43 , 44 , 46 , 47 , 53 , 54 , 56 , 58 , 66 ] with high quality, 25 studies with medium quality [ 6 , 7 , 20 , 21 , 23 , 24 , 29 – 31 , 35 , 38 , 40 , 41 , 45 , 49 , 50 , 56 , 57 , 59 – 65 ], and 10 studies with low quality [ 25 – 27 , 32 , 34 , 36 , 42 , 48 , 51 , 52 ]…”

“…The overall pooled prevalence of HBV among HIV positive prisoners was 12% (95% CI 9.0–16.0, I 2 = 93.8% ( P < 0.001). Also, twenty three studies [ 19 , 21 , 25 , 28 , 32 , 34 – 37 , 41 , 43 – 46 , 52 , 54 – 56 , 58 , 60 , 64 – 66 ] reported a 15% prevalence of HBV among HIV-positive prisoners with a history of drug injection (pooled prevalence = 12%, 95% CI 5.0–23.0), with significant heterogeneity in the results I 2 = 84.8% ( P < 0.001). Subgroup analysis by WHO regions is provided in Fig.…”

Chronic Viral Hepatitis in the Italian Prison Setting: Prevalence, Outcomes, Literature Needs and Perspectives

“…A study conducted by Pontali et al on incarcerated PLWH hospital admissions in Italy ( n = 85), documented a HCV and HBV infection in 54.1% and 2.4% of cases, respectively [ 29 ]. Studies on viral hepatitis among PLWH have been summarized in Table 2 .…”