Wormser G P, Krupp L B, Hanrahan J P, Gavis G, Spira T J, Cunningham-Rundles S
Ann Intern Med. 1983 Mar;98(3):297-303. doi: 10.7326/0003-4819-98-3-297.
Between September 1981 and June 1982, the acquired immunodeficiency syndrome and Pneumocystis carinii pneumonia were diagnosed in seven previously healthy young men incarcerated for 5 to 38 months in New York State correctional facilities. All seven patients were anergic, six were lymphopenic, and all developed oral candidiasis. Immunologic evaluation in vitro showed profound defects in cellular immune function in patients tested, with inversion of the normal ratio of helper to suppressor T-cell populations in four of five patients studied. No underlying immunosuppressive disorder was found in any patient, including three patients who had postmortem examinations. Based on these cases, the incidence of this syndrome among inmates of New York State correctional facilities is estimated to be at least 20 out of 100 000 per year. None of the inmates was homosexual but all had used intravenous drugs extensively before incarceration. If intravenous drug use is a cause of the syndrome, then the epidemiologic findings of this study suggest a prolonged incubation period (mean, 14.6 months) before development of serious opportunistic infection. Recognition that certain prisoners are at high risk for the acquired immunodeficiency syndrome has important implications for the prison health-care system.
1981年9月至1982年6月期间，纽约州惩教机构中7名曾健康的年轻男性被诊断患有获得性免疫缺陷综合征和卡氏肺孢子虫肺炎，他们此前被监禁了5至38个月。所有7名患者均无变应性，6名淋巴细胞减少，且均出现口腔念珠菌病。体外免疫评估显示，接受检测的患者细胞免疫功能存在严重缺陷，在接受研究的5名患者中，有4名患者辅助性T细胞与抑制性T细胞群体的正常比例发生倒置。在任何患者中均未发现潜在的免疫抑制性疾病，包括3名接受尸检的患者。基于这些病例，估计纽约州惩教机构囚犯中该综合征的发病率至少为每年10万分之20。这些囚犯均非同性恋者，但所有人在入狱前都曾广泛使用过静脉注射毒品。如果静脉注射毒品是该综合征的病因，那么本研究的流行病学结果表明，在严重机会性感染发生之前有较长的潜伏期（平均14.6个月）。认识到某些囚犯感染获得性免疫缺陷综合征的风险很高，这对监狱医疗保健系统具有重要意义。
