Antiretroviral Outcomes in South African Prisoners: A Retrospective Cohort AnalysisReportar como inadecuado

Antiretroviral Outcomes in South African Prisoners: A Retrospective Cohort Analysis - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Background and Methods

Little is known about antiretroviral therapy ART outcomes in prisoners in Africa. We conducted a retrospective review of outcomes of a large cohort of prisoners referred to a public sector, urban HIV clinic. The review included baseline characteristics, sequential CD4 cell counts and viral load results, complications and co-morbidities, mortality and loss to follow-up up to 96 weeks on ART.


148 inmates 133 male initiated on ART were included in the study. By week 96 on ART, 73% of all inmates enrolled in the study and 92% of those still accessing care had an undetectable viral load <400copies-ml. The median CD4 cell count increased from 122 cells-mm3 at baseline to 356 cells-mm3 by 96 weeks. By study end, 96 65% inmates had ever received tuberculosis TB therapy with 63 43% receiving therapy during the study: 28% had a history of TB prior to ART initiation, 33% were on TB therapy at ART initiation and 22% developed TB whilst on ART. Nine 6% inmates died, 7 in the second year on ART. Loss to follow-up LTF was common: 14 9% patients were LTF whilst still incarcerated, 11 7% were LTF post-release and 9 6% whose movements could not be traced. 16 11% inmates had inter-correctional facility transfers and 34 23% were released of whom only 23 68% returned to the ART clinic for ongoing follow-up.


Inmates responded well to ART, despite a high frequency of TB-HIV co-infection. Attention should be directed towards ensuring eligible prisoners access ART programs promptly and that inter-facility transfers and release procedures facilitate continuity of care. Institutional TB control measures should remain a priority.

Autor: Natasha E. C. G. Davies , Alan S. Karstaedt



Documentos relacionados