NCJ Number
99955
Journal
Annals of Internal Medicine Volume: 98 Issue: 3 Dated: (March 1983) Pages: 297-303
Date Published
1983
Length
7 pages
Annotation
This report describes the clinical features, treatment, and outcome of seven New York State prisoners with acquired immunodeficiency syndrome (AIDS) and the impact of AIDS on the prison health care system.
Abstract
These previously healthy, young male inmates had been incarcerated for 5 to 38 months. The first two patients were discovered during hospital diagnosis for P. carinii pneumonia; prison physicians, alerted to symptoms, discovered the other cases. Immunological testing was performed on peripheral blood lymphocytes; monoclonal analysis of T-lymphocyte subpopulations was also performed. All inmates were anergetic and developed oral candidiasis; six were lymphopenic. In vitro immunologic evaluation showed profound defects in cellular immune function, with inversion of the normal ratio of helper to T-cell populations in four of the five patients tested. No underlying immunosuppressive disorder was found in any patient, including three patients who had postmortem examinations. Based on these cases, the incidence of AIDs among New York State inmates is estimated to be at least 20 out of 100,000 per year. None of the inmates was homosexual, but all had used intravenous drugs extensively before incarceration. If drug use was the cause of the syndrome, findings suggest a prolonged incubation period (mean, 14.6 months). Many features of both the prisoners and the crowded prison environment provide a favorable setting for the development and spread of AIDS. The recognition of the high risk of AIDS among certain prisoners has important implications for the correctional health care system. Included are 30 references. (Author abstract modified)