Immunologic predictors of HIV-related survival among Texas prison inmates

Research indicates that being incarcerated adversely affects overall health status. Because HIV-infection is a growing problem among the U.S. prison p opulation, understanding how incarceration affects HIV-related survival hol ds particular clinical and public health relevance. Moreover, while the pro gnostic roles of CD4 and CD8 lymphocyte count have been well documented in noninstitutionalized populations, little is known about how these factors o perate to predict survival among prison populations. The present study exam ined immunologic determinants of HIV-related survival in a cohort of 752 Te xas Department of Criminal Justice (TDCJ) inmates who were treated for HIV/ AIDS between 1993 and 1996 at a large southwestern medical center. Survival analysis using proportional hazards modeling showed that: (1) the prognost ic role of CD4 count among inmates was similar to previous findings among n onincarcerated populations; (2) the prognostic role of CD8 count was slight ly weaker than that previously reported for nonincarcerated populations; an d (3) inmates who exhibited high levels of both CD4 and CD8 count had a sur vival advantage over those who had a high score on only one of the two fact ors.