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| Concerns raised about treatment of Michigan’s HIV-positive prisoners |
| By michiganmessenger.com - Todd A. Heywood |
| Published: 09/13/2011 |
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MDOC investigating failure to follow protocols The Michigan Department of Corrections says it is reviewing its records to determine how an HIV-positive inmate was placed on a treatment regimen that does not meet state, federal or international treatment protocols. The inmate, a 28-year-old who served time for technical parole violations, was diagnosed when he went into prison to serve his time. Shortly after being told of his HIV positive status he was transferred to another facility, where he was treated by a physician who placed him on the HIV drug Combovir. Messenger is not identifying the prisoner or the facility in which the inmate was placed to protect the person’s identity. It is routine to offer HIV testing to incoming prisoner at MDOC, and testing is required for parole or release. Officials for the Michigan Department of Corrections say their records show there was not a prescription for Combovir, or the two drugs that make up the drug, in the last two years. All prescriptions are supposed to be logged into a pharmacy computer system operated by contractor PharmaCorr. PharmaCorr, in turn, fills those prescriptions or rejects them based on current policy. PharmaCorr is a part of Correctional Medical Services (CMS), which in turn is the MDOC medical care provider by contract. “I’m concerned,” said Dr. Craig Hutchinson, MDOC’s infectious disease consultant. He called the situation out of the ordinary, noting that he is the only doctor who is supposed to see the 254 HIV-positive prisoners. “I’m the only one writing or changing meds.” “Those two drugs are not an appropriate regime. They will not suppress the virus,” Hutchinson said. He said it was possible that a physician without expertise in HIV was “freelancing” HIV care in this situation. “We are confident it’s not a typical event. We have all kinds of questions.” Regardless of how atypical the scenario is, the reality is the prescription treatment used in this case could pose a threat not only to the inmate, but to others. Combovir is a combination of two medications from the same class of drugs and treatment with drugs from only one class of medications is considered monotherapy. Montherapy is not recommended for treatment of HIV as the virus quickly mutates a resistance to the specific drugs being used, which can then lead to resistance to an entire class of medications. The resistant virus can be transmitted, making it more difficult to treat both the original infected person and any subsequent new infections. During the late 80s and early 90s, when doctors only had access to the drug AZT as a weapon against the virus, researchers discovered that the drug had a limited effectiveness life because the virus mutated resistance to the drug — particularly if a patient failed to follow the complex treatment regimens required. With the advent of protease inhibitors in 1995, researchers found that using a combination of AZT and other classes of drugs as well as the protease inhibitors reduced viral resistance development. Researchers found that adherence to the complicated pill-taking was a key in preventing resistance. Read More. |
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