MOLECULAR INVESTIGATION INTO OUTBREAK OF HIV IN A SCOTTISH PRISON

Objectives: To support already established epidemiological links betwe en inmates of Glenochil prison positive for HIV infection by using mol ecular techniques and thus provide evidence of the extent of acquisiti on during a recent outbreak of the disease resulting from needle shari ng. To identify possible sources of the outbreak, and to demonstrate t he ability of the methodology to make further links beyond the origina l outbreak. Design: Viral sequences obtained from the blood of HIV pos itive prisoners previously identified by standard epidemiological meth ods were compared with each other and with sequences from other Scotti sh patients. Setting: Glenochil prison for men, central Scotland. Subj ects: Adults inmates and their possible contacts. Results: Phylogeneti c analysis of viral sequences in two different genomic regions showed that 13 of the 14 HIV positive prisoners had been infected from a comm on source. Previous research had shown that six of these had acquired their infection in Glenochil; molecular evidence suggests taht more th an double this number were infected while incarcerated. Virus from two long term HIV positive patients who were in the prison at the time of the outbreak but who were not identified in the original or subsequen t surveys was sufficiently different to make it unlikely that they wer e the source, A viral sequence from heterosexual transmission from one inmate showed the ability of these techniques to follow the infection through different routes of infection. Conclusion: The number of pris oners infected with HIV during the 1993 outbreak within Glenochil pris on was more than twice that previously shown. This shows the potential for tile spread of bloodborne diseases within prisons bg injecting dr ugs.