Antiretroviral Outcomes in South African Prisoners A Retrospective Cohort Analysis 英文参考文献.docVIP
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Antiretroviral Outcomes in South African Prisoners A Retrospective Cohort Analysis 英文参考文献
AntiretroviralOutcomesinSouthAfricanPrisoners:A
RetrospectiveCohortAnalysis
NatashaE.C.G.Davies1*,AlanS.Karstaedt2
1Division of Infectious Disease, Department of Medicine, Chris Hani Baragwanath Hospital and Wits Reproductive Health and HIV Institute, University of the
Witwatersrand, Johannesburg, South Africa, 2Division of Infectious Diseases, Department of Medicine, Chris Hani Baragwanath Hospital and the University of the
Witwatersrand,Johannesburg,SouthAfrica
Abstract
BackgroundandMethods:Littleisknownaboutantiretroviraltherapy(ART)outcomesinprisonersinAfrica.Weconducted
aretrospectivereviewofoutcomesofalargecohortofprisonersreferredtoapublicsector,urbanHIVclinic.Thereview
included baseline characteristics, sequential CD4 cell counts and viral load results, complications and co-morbidities,
mortalityandlosstofollow-upupto96weeksonART.
Findings: 148 inmates (133 male) initiated on ART were included in the study. By week 96 on ART, 73% of all inmates
enrolledinthestudyand92%ofthosestillaccessingcarehadanundetectableviralload(,400copies/ml).ThemedianCD4
cellcountincreasedfrom122cells/mm3atbaselineto356cells/mm3by96weeks.Bystudyend,96(65%)inmateshadever
receivedtuberculosis(TB)therapywith63(43%)receivingtherapyduringthestudy:28%hadahistoryofTBpriortoART
initiation,33%wereonTBtherapyatARTinitiationand22%developedTBwhilstonART.Nine(6%)inmatesdied,7inthe
secondyearonART.Losstofollow-up(LTF)wascommon:14(9%)patientswereLTFwhilststillincarcerated,11(7%)were
LTFpost-releaseand9(6%)whosemovementscouldnotbetraced.16(11%)inmateshadinter-correctionalfacilitytransfers
and34(23%)werereleasedofwhomonly23(68%)returnedtotheARTclinicforongoingfollow-up.
Conclusions:InmatesrespondedwelltoART,despiteahighfrequencyofTB/HIVco-infection.Attentionshouldbedirected
towardsensuringeligibleprisonersaccessARTprogramspromptlyandthatinter-facilitytransfersandreleaseprocedures
facilitatecontinuityofcare.InstitutionalTBcontrolmeasuresshouldremainapriority.
Citation: Davies NECG, Karstaedt AS (20
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