Hospital admissions for HIV-infected prisoners in Italy

• Published date: 12 June 2017
• Pages: 105-112
• Date: 12 June 2017
• DOI: https://doi.org/10.1108/IJPH-02-2016-0004
• Author: Emanuele Pontali,Roberto Ranieri,Elena Rastrelli,Maria Donata Iannece,Anna Maria Ialungo,Serena Dell’Isola,Alfonso Liberti,Pietro Rosario,Rodolfo Casati,Giulio Starnini,Sergio Babudieri
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Hospital admissions for HIV-infected

prisoners in Italy

Emanuele Pontali, Roberto Ranieri, Elena Rastrelli, Maria Donata Iannece,

Anna Maria Ialungo, Serena Dell’Isola, Alfonso Liberti, Pietro Rosario, Rodolfo Casati,

Giulio Starnini and Sergio Babudieri

Abstract

Purpose –The purpose of this paper is to give a description of the clinical conditions and patient

demographics of inpatient admissions of human immunodeficiency virus (HIV)-infected inmates in three

hospital wards that provide hospital care for inmates in Italy.

Design/methodology/approach –This is a retrospective review of hospital medical admissions of

patients living with HIV from January 1 to December 31, 2014, in three Italian referral centers for

hospitalization of inmates.

Findings –A total of 85 admissions for 85 different HIV-infected inmates occurred in 2014 in the three

centers participating to the study. Most patients (54.1 percent) were co-infected with hepatitis C. Discharge

diagnosis largely varied ranging from common HIV-related co-morbidities to completely independent

diagnosis. The most commonly observed discharge diagnoses were chronic hepatitis C, liver cirrhosis,

opiate dependence and thrombocytopenia.

Originality/value –Discharge diagnosis between HIV-infected inmates and HIV-infected patients in freedom

are strikingly and significantly different. A large number of hospitalized HIV-infected inmates were affected by

chronic viral hepatitis and liver cirrhosis; this is probably a direct consequence of the high prevalence of HCV

and/or HBV co-infections in the inmate population in Italy. In addition, a significantly lower proportion of

cancer diagnosis was observed among inmates; this is possibly justified by the fact that in our Italian settings

when HIV infection is at advanced stages or if cancer treatment is started those affected are released from

prison and can continue their diagnostic and treatment follow-up in freedom.

Keywords HIV, HIV/AIDS, Prisoners, Mental illness, Drug dependence, HCV

Paper type Research paper

Introduction

Since its introduction, combination antiretroviral treatment has resultedin a decline in opportunistic

infections rates and has significantly reduced human immunodeficiency virus (HIV)-associated

morbidity andmortality (Floridia et al., 2002; Mocroftet al., 2004; Palella et al., 1998).Yet, mortality

rates among HIV-infected subjects remain 3 to 15 timeshigher than those observed in thegeneral

population (Antiretroviral Therapy Cohort Collaboration et al., 2009; Cockerham et al.,2010).

In fact, non-infectious and non-HIV-related co-morbidities appear to be more frequent as the

HIV-infected population starts to age (Aguiar et al., 2015; Justice, 2006; Magoni et al.,2011;

Phillips etal., 2008; Sackoff et al., 2006; Weberet al., 2006). In addition, this aging populationmay

also have earlier presentation of such co-morbidities as reported by several authors (Althoff et al.,

2014; Guaraldi et al., 2011; Schouten et al., 2014).

There are studies reporting premature age-related co-morbidities and higher hospitalization

rates amongst patients living with HIV compared to the general population (Falster et al., 2010;

Guaraldi et al., 2011; Magoni et al., 2011). The future impact of such clinical manifestations on

patient care and service provision is still unfolding and information on current trends may be

helpful in planning future services.

Received 23 February 2016

Revised 5 June 2016

30 September 2016

Accepted 3 October 2016

The authors affiliations can be

found at the end of this article.

DOI 10.1108/IJPH-02-2016-0004 VOL. 13 NO. 2 2017, pp. 105-112, © Emerald Publishing Limited, ISSN 1744-9200

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