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HIV Resistance in Immigration Detainees
- Dr Edward Costar, Dr Jillian Pritchard, Consultant in Genitourinary Medicine, St Peter's Hospital, Chertsey (5 November 2007)
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Dr Edward Costar, F1 Doctor Kent & Canterbury Hospital, Canterbury, CT1 3NG, Dr Jillian Pritchard, Consultant in Genitourinary Medicine, St Peter's Hospital, Chertsey
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The problem of discontinuous anti-retroviral therapy in the prison healthcare system leading to increased levels of viral resistance (Laurent, C., "Prisoners are developing resistance to HIV drugs because their care is fractured" BMJ 2007;335:583 (22 September)) applies also to detainees held by the immigration authorities. Many such detainess are held for long periods of time after an initial decision to deport pending the resolution of legal challenges. Detainees are often moved between detention centres and immigration removal centres (IRCs) as their cases are considered and their anti-retrovirals often do not follow them. It may be weeks before the local genito-urinary clinic is made aware that a transfer has taken place, a delay which causes a significant gap in treatment. The result of this is that when deportation is eventually effected these patients have developed a resistance pattern which requires second- or third-line anti-retrovirals which are not available in the countries to which they are deported, even if those countries have some provision of anti-retrovirals. It is a significant failure of the healthcare systems provided by the Border & Immigration Agency that the treatment of HIV positive detainees in its custody is undermined by repeated transfers without adequate notice being given to ensure continuity of care. Competing interests: None declared |
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