News

Table of Contents

• Prison News
  • Report: U.S. Prison Population Tops 2 Million
  • Class-Action Lawsuit by Oregon Inmates Demands HCV Treatment
  • Pennsylvania DOC to Close Two Prisons; Cites HCV Treatment Costs
  • Experts Warn of TB "Time Bomb"; Particular Concern in Russian Prisons
• Inside News
  • Study: Ending Segregation of HIV-Positive Inmates Could Save Money
  • New Formulation of Viracept Approved by the FDA
  • CDC Urges Expanded HIV Screening, Recommends Testing All Pregnant Women
  • FDA Approves Valacyclovir for HIV-Infected Patients
  • Roche Gets FDA OK for Improved HIV Test
  • Am J Prev Med: Treatment for Latent TB in Correctional Facilities

Prison News

The number of inmates in U.S. prisons and jails rose to 2,019,234 last year, the first time the number has exceeded 2 million, according to a report released by the Justice Department. California, Texas, Florida and New York remain the four largest state prison systems, though the number of inmates in federal prisons for the first time surpassed that of any state, with nearly 162,000 federal inmates. The report also noted a 5.4% increase in the number of people confined to local and county jails, the largest growth in the jail population in five years. Other findings: about 12% of all black men in the U.S. between 20-39 years old were in prison or jail, compared to 4% of Hispanic males and 1.6% of white males. (New York Times and Associated Press, 4/7/03)

Class-Action Lawsuit by Oregon Inmates Demands HCV Treatment

In a pending class-action lawsuit, Oregon inmates allege that the state prison system's treatment for the hepatitis C virus (HCV) violates the constitutional ban on cruel and unusual punishment. The federal lawsuit seeks $17.5 million for inmate medical expenses. Initially filed on behalf of 11 current and former inmates, the suit now considers all Oregon HCV-positive inmates plaintiffs. State correctional officials defend their management of the disease, stating it is "medically reasonable, consistent, albeit conservative." (Associated Press, 5/11/03)

Pennsylvania DOC to Close Two Prisons; Cites HCV Treatment Costs

Despite an increase in the state's DOC budget, Pennsylvania is still planning on closing prisons in Waynesburg and Pittsburg, according to state DOC Secretary Jeffrey Beard. Beard said the increase in the budget isn't enough to offset cost increases including the required hepatitis C treatment program. Pennsylvania is one of the only states with mandatory HCV intake testing, and is aggressively treating inmates who have hepatitis C. The state prison system is now at 116 percent capacity; the closing of the two prisons is expected to push the system to 120 percent capacity, though that will ease with the opening of two new prisons next year. (Observer-Reporter, 4/26/03)

Experts Warn of TB "Time Bomb"; Particular Concern in Russian Prisons

A tuberculosis epidemic in Russia, fanned by an increased number of HIV infections, has the potential to spread multi-drug resistant TB (MDR-TB) worldwide, according to Dr. Lee Reichman, executive director of the New Jersey Medical School National Tuberculosis Center. In Russia, overcrowded prisons are experiencing high numbers of both diseases, and many inmates with TB are developing resistance to the typical therapies. Of 300,000 prisoners released each year, 30,000 have active TB and 10,000 have MDR-TB, according to Reichman. (Edmonton Journal, 3/8/03)

Inside News

Study: Ending Segregation of HIV-Positive Inmates Could Save Money

Alabama's prison system could save between $306,000 and $392,000 per year if it didn't segregate HIV-positive inmates from the rest of the prison population, according to a report by the Alabama Prison Project and the ACLU National Prison Project. If the segregation ceased, 56 inmates would be eligible to join community-run corrections programs. Community corrections programs cost the state $11 per day per inmate -- $15 less per day than it costs for an inmate to remain in prison. Alabama is the only state prison system that still segregates HIV-positive prisoners. (Associated Press, 4/30/03)

New Formulation of Viracept Approved by the FDA

The FDA approved a new formulation of Viracept (nelfinavir) that reduces the number of pills patients must take each day. Previously available in 50 mg oral powder and 250 mg tablets, Viracept is now available in a 625 mg pill, reducing the number of tablets taken each day from 10 per day to four per day. The 625 mg tablets will be available in the 3rd quarter of 2003 and will be parity priced with the 250 mg tablets. Viracept 250 mg will be continued to be manufactured. (FDA Release, 4/30/03)

CDC Urges Expanded HIV Screening, Recommends Testing All Pregnant Women

The Centers for Disease Control and Prevention (CDC), in partnership with other federal agencies, is launching a new initiative to advance HIV prevention activities. While previous CDC efforts have focused mainly on preventing people from acquiring HIV/AIDS, new strategies will focus on prevention efforts for individuals already infected with HIV. This includes increased efforts to diagnose people who are not aware they are infected, and to educate each HIV-infected person on ways to prevent spreading the disease. As part of the new initiative, the CDC is recommending that HIV testing become a routine part of medical care, and in particular, offered to all pregnant women. It also aims to streamline the testing procedures so that prevention counseling is not a prerequisite for testing. The agency will be conducting demonstration projects in high-prevalence settings (including correctional facilities) using the OraQuick HIV rapid test, which provides results in 20 minutes. The full report is available at www.cdc.gov/mmwr/preview/mmwrhtml/mm5215a1.htm. (CDC, 4/18/03)

FDA Approves Valacyclovir for HIV-Infected Patients

GlaxoSmithKline announced that it has received supplemental approval from the U.S. Food and Drug Administration (FDA) to market its antiviral valacyclovir HCl (Valtrex) as the first FDA-approved antiviral therapy for the suppression of recurrent genital herpes in HIV-infected individuals. Valtrex was already approved for the treatment of herpes zoster and cold sores. (Reuters, 4/3/03)

Roche Gets FDA OK for Improved HIV Test

Roche announced that it has received FDA approval for an automated version of a test used to detect and measure viral levels in the blood of HIV-positive patients. The Cobas Amplicor HIV-1 Monitor Test (version 1.5) can measure viral load levels as low as 50 copies of HIV RNA per millimeter of blood plasma. The test can also detect a broader range of HIV-1 subtypes than previous tests, according to Roche. (Reuters, 4/11/03)

Study: Physician Experience a Major Contributor to AIDS Survival

Results from a study in Vancouver show that physician experience has an independent effect on the survival of patients with AIDS. Investigators from the British Columbia Centre for Excellence in HIV/AIDS evaluated the impact of "non-immune-based factors" in survival in 1,400 HIV-infected patients starting HAART for the first time, following the cohort for 42 months. When HAART was initiated at CD4 levels about 200, patients treated by either experienced or inexperienced physicians had similar survival rates. However, in patients with CD4 counts <50, the hazard of death was greater for patients treated by inexperienced physicians. The study is presented in the March 28 issue of AIDS. (Reuters, 4/14/03)

Am J Prev Med: Treatment for Latent TB in Correctional Facilities

A field study conducted by the CDC in nearly 50 correctional facilities evaluated high-risk populations at risk for co-infection with tuberculosis (TB) and HIV to find out if treating latent TB infection (LTBI) in inmates was feasible. In 49 correctional facilities in 12 states, 198,102 inmates had a tuberculin skin test (TST) read; 17% were positive. Of those who were PPD-positive and who were also tested for HIV, 14.5% were HIV-positive. Inmates with a positive TST were 4.2 times more likely than those with a negative TST to be infected with HIV. HIV-positive patients who began the 12-month TB treatment regimen were less likely than HIV-negative patients (40% vs 68%, respectively) to complete treatment. The results from the 8-year HIV-Related TB Prevention (HRTP) were published in the April 2003 American Journal of Preventative Medicine. (Am J Prev Med 2003;24(3))