| Title | Effectiveness of antiretroviral therapy among HIV-infected prisoners: reincarceration and the lack of sustained benefit after release to the community. |
| Publication Type | Journal Article |
| Year of Publication | 2004 |
| Authors | Springer, Sandra A., Edward Pesanti, John Hodges, Thomas Macura, Gheorghe Doros, and Frederick L. Altice |
| Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America |
| Volume | 38 |
| Issue | 12 |
| Pagination | 1754-60 |
| Date Published | 2004 Jun 15 |
| ISSN | 1537-6591 |
| Keywords | Antiretroviral Therapy, Highly Active, CD4 Lymphocyte Count, Cohort Studies, HIV Infections, HIV-1, Humans, Prisoners, Prisons, Retrospective Studies, Viral Load |
| Abstract | Responses to highly active antiretroviral therapy (HAART) in correctional settings and their sustained benefit in prisoners after release are currently not known. To examine the human immunodeficiency virus type 1 (HIV-1) RNA level (VL) and CD4 lymphocyte response to HAART during incarceration and upon reentry to the correctional system, we conducted a retrospective cohort study of longitudinally linked demographic, pharmacy, and laboratory data from the Connecticut prison system. During incarceration, the mean CD4 lymphocyte count increased by 74 lymphocytes/ mu L, and the mean VL decreased by 0.93 log10 copies/mL (P<.0001). Fifty-nine percent of the subjects achieved a VL of <400 copies/mL at the end of each incarceration period. For the 27% of subjects who were reincarcerated, the mean CD4 lymphocyte count decreased by 80 lymphocytes/ mu L, and the mean VL increased by 1.14 log10 (P<.0001). Although HAART use resulted in impressive VL and CD4 lymphocyte outcomes during the period of incarceration, recidivism to prison was high and was associated with a poor outcome. More effective community-release programs are needed for incarcerated patients with HIV disease. |
| DOI | 10.1007/s11904-011-0095-3 |
| Alternate Journal | Clin. Infect. Dis. |
