European Court of Human Rights

Information Note on the Court’s case-law No. 169

December 2013

Fedosejevs v. Latvia (dec.) - 37546/06

Decision 19.11.2013 [Section IV]

Article 3

Degrading treatment

Inhuman treatment

Lack of antiretroviral therapy for prisoner whose HIV infection had not reached the threshold for such treatment under WHO guidelines: inadmissible

 

Facts - The applicant, who is suffering from HIV and Hepatitis C infections, has been in pre-trial detention and prison since 2005. On his admission into prison he underwent immunological testing, which established that his CD4 cell count was above 500 cells per mm³. It was therefore decided that he did not require antiretroviral treatment in line with the 2006 Guidelines of the World Health Organisation. The tests were repeated every two to six months thereafter and the applicant’s CD4 cell count never went below 200 cells per mm³, which was the relevant threshold for starting therapy under the WHO Guidelines. Meanwhile, he received hepatoprotectives for his Hepatitis C infection on six occasions and vitamin courses on seven occasions.

Law - Article 3: The applicant complained that he did not receive adequate treatment in prison, in particular for his HIV infection. Instead of ruling on matters lying exclusively within the field of expertise of medical specialists, the Court was called upon to determine whether the domestic authorities had provided the applicant with medical supervision capable of effectively assessing his condition and setting up an adequate course of treatment for his diseases. Given the nature and seriousness of the applicant’s ailments, his condition required regular and specialised medical supervision for the monitoring of the progression rate of his diseases, timely prescription of the requisite HIV and hepatitis C therapies, and timely diagnosis and treatment of possible opportunistic infections. The applicant was subjected to a specific blood test - the CD4 cell count - which according to the 2006 WHO recommendations was the test required to identify whether patients with HIV clinical stage 1 or 2 disease needed to start antiretroviral treatment. This test was carried out every two to six months by doctors at a specialised centre for infectious diseases. On every occasion the doctors recorded that the applicant’s HIV infection was at either clinical stage 1 or 2 and that the CD4 cell count had not yet dropped below the relevant threshold for commencement of antiretroviral treatment. In such circumstances, and in the absence of any medical evidence to the contrary, the Court could not but conclude that the national authorities had ensured proper medical supervision of the applicant’s HIV infection. Lastly, the Court was satisfied that the applicant had also received adequate medical care for his Hepatitis C infection and other health problems.

Conclusion: inadmissible (manifestly ill-founded).

 

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