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

Graciela Mendonça dos Santos Bet Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil;

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Gleyce Hellen de Almeida de Souza Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil;

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Júlio Croda Instituto Penal de Campo Grande, Agência Estadual de Administração do Sistema Penitenciário (Agepen), Mato Grosso do Sul, Campo Grande, Brazil;
Faculdade de Medicina (FAMED), Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil;

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Maísa Estopa Correa Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil;

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Romário Oliveira de Sales Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil;

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Ruthe Aline da Silva Santos Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil;

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Renata Viebrantz Enne Sgarbi Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil;

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Renata Terumi Shiguematsu Yassuda Instituto Penal de Campo Grande, Agência Estadual de Administração do Sistema Penitenciário (Agepen), Mato Grosso do Sul, Campo Grande, Brazil;

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Ana Rita Coimbra Motta-Castro Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil;
Laboratório de Imunologia Clínica, Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil

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Maurício Antônio Pompílio Faculdade de Medicina (FAMED), Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil;

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Simone Simionatto Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Dourados, Mato Grosso do Sul, Brazil;

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DOI:
https://doi.org/10.4269/ajtmh.17-0592
Volume/Issue:
Volume 98: Issue 6
Page(s):
1603–1608
Restricted access
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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.

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Author Notes

Address correspondence to Simone Simionatto, Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados, Rodovia Dourados, Itahum km 12, Cidade Universitária, CEP 79804970, Dourados, Mato Grosso do Sul, Brazil. E-mail: simonesimionatto@ufgd.edu.br

Financial support: This work was partially supported by the Brazilian National Research Council (CNPq grants 480949/2013-1), the Support Foundation for the Development of Education, Science and Technology in the state of Mato Grosso do Sul (FUNDECT grants0068/13, 44/2014 and 092/2015), Universidade Federal da Grande Dourados (UFGD), Ministry of Education (MEC/PROEXT 2013 and 2014) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES–88887.103413/2015-01). M. E. C. and G. H. A. S. received a scholarship from FUNDECT and CAPES, respectively.

Authors’ addresses: Graciela Mendonça dos Santos Bet, Gleyce Hellen de Almeida de Souza, Maísa Estopa Correa, Romário Oliveira de Sales, Ruthe Aline da Silva Santos, Renata Viebrantz Enne Sgarbi, and Simone Simionatto, Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados (UFGD), Dourados, Mato Grosso do Sul, Brazil, E-mails: s_simionatto@yahoo.com.br, gleycehas@gmail.com, ysacorrea@hotmail.com, romariosalles_pav@hotmail.com, ruth_ninne@hotmail.com, renata_enne@hotmail.com, and simonesimionatto@ufgd.edu.br. Júlio Croda, Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil and Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Mato Grosso do Sul, Brazil, E-mail: juliocroda@gmail.com. Renata Terumi Shiguematsu Yassuda, Instituto Penal de Campo Grande, Agência Estadual de Administração do Sistema Penitenciário (Agepen), Mato Grosso do Sul, Campo Grande, Brazil, E-mail: renatayassuda@outlook.com. Ana Rita Coimbra Motta-Castro, Fundação Oswaldo Cruz (FIOCRUZ) and Laboratório de Imunologia Clínica, Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil, E-mail: arcm.castro@hotmail.com. Maurício Antônio Pompílio, Faculdade de Medicina (FAMED), Universidade Federal do Mato Grosso do Sul (UFMS), Campo Grande, Mato Grosso do Sul, Brazil, E-mail: mapompilio@yahoo.com.br.

These authors contributed equally to this work.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2018
Received:
24 Jul 2017
|
Accepted:
20 Feb 2018
|
Published Online:
07 May 2018
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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