Treatment Outcomes of Brazilian Inmates with Treponema pallidum and Human Immunodeficiency Virus Infection: A Prospective Cohort Study.

Autor: Bet GMDS; Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil., Souza GHA; Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil., Croda J; Faculdade de Medicina (FAMED), Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.; Instituto Penal de Campo Grande, Agência Estadual de Administração do Sistema Penitenciário (Agepen), Mato Grosso do Sul, Campo Grande, Brazil., Correa ME; Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil., de Sales RO; Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil., Santos RADS; Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil., Viebrantz Enne Sgarbi R; Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil., Yassuda RTS; Instituto Penal de Campo Grande, Agência Estadual de Administração do Sistema Penitenciário (Agepen), Mato Grosso do Sul, Campo Grande, Brazil., Coimbra Motta-Castro AR; Laboratório de Imunologia Clínica, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.; Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil., Pompílio MA; Faculdade de Medicina (FAMED), Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil., Simionatto S; Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil.
Jazyk: angličtina
Zdroj: The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2018 Jun; Vol. 98 (6), pp. 1603-1608. Date of Electronic Publication: 2018 May 03.
DOI: 10.4269/ajtmh.17-0592
Abstrakt: A prospective cohort study was conducted to evaluate the incidence and treatment outcomes of syphilis and human immunodeficiency virus (HIV) in inmates from Central Brazil. In 2013, 3,363 inmates from 12 prisons in the state of Mato Grosso do Sul were recruited, and 1,614 remained incarcerated after 1 year. The inmates were interviewed, and blood samples were collected for serological testing for Treponema pallidum and HIV infections. Inmates infected with T. pallidum or HIV within the first year were assessed for treatment using prison medical record data, based on Venereal Disease Research Laboratory test results, HIV-1 viral load, and CD4 counts. Acquired syphilis was identified in 5.8% ( N = 95) of the inmates and 74% ( N = 70) of them demonstrated poor treatment outcomes after 1 year. Multivariate analysis revealed that not reporting a stable partner was a risk factor for failure of syphilis treatment. Twenty-five patients had HIV (1.5%) and among those, 13 (52%) had an HIV-1 viral load > 200 copies/mL after 1 year. The incidence of T. pallidum and HIV infections was 0.5% ( N = 9). The poor treatment outcomes of syphilis and HIV within Brazilian prisons demonstrate the inadequacy of public health programs. Although the incidence of these infections within the prison population is low, new cases still occur. Our results reinforce the significance of screening programs during prison admission for early detection and treatment of sexually transmitted infections.
Databáze: MEDLINE