11th Annual Conference of the British HIV Association

20–23 April 2005, Burlington Hotel·Dublin·Ireland


Cite as BHIVA Conf 2005 Apr 20-23;11:xxx
where "xxx" is the abstract number.

Oral Abstracts

O1 A DECADE OF CHLAMYDIA IN LEEDS: COMPARATIVE ANALYSIS OF DEMOGRAPHIC AND GEOSPATIAL RISK FACTORS AT THE ONSET OF CHLAMYDIA SCREENING
BHIVA Conf 2005 Apr 20-23;11:O1
AL Evans1, D Merrick2, EF Monteiro1, MH Wilcox1, CJN Lacey3
Chlamydia continues to show a wide geospatial distribution with increased risk in under-25s and black ethnic groups. Women are now diagnosed mostly in community settings and efforts will need to be concentrated on partner notification to reduce transmission.
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O2 FREE AVAILABILITY OF POSTAL TESTING KITS FOR CHLAMYDIA IN COLLEGES OF FURTHER EDUCATION AS AN ALTERNATIVE TO NURSE-LED CLINICS: A PROSPECTIVE CROSSOVER INTERVENTION TRIAL
BHIVA Conf 2005 Apr 20-23;11:O2
DJ Clutterbuck, K Carrick-Anderson, K Allison, GR Scott, L McKay
Free distribution of postal testing kits generated a lower percentage return rate than supervised distribution (15% (157/891) vs 25% (38/152), χ2=9.07; P=0.026) but results in a greater number of students being tested. Although all methods were successful in accessing men for testing, postal testing kits carried no additional advantage over clinics. Free distribution of postal testing kits detects a greater number of infections than alternative models with comparable outcomes but reduced manpower requirements.
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O3 THE MANAGEMENT OF CHLAMYDIA TRACHOMATIS IN GENITOURINARY MEDICINE CLINICS: A NATIONAL AUDIT IN 2004
BHIVA Conf 2005 Apr 20-23;11:O3
R Challenor1, S Pinsent1, S Chandramani2, N Theobald3, D Daniels4
GUM clinics are delivering high quality care and evidence based national outcome standards are being met.
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O4 COMPLIANCE WITH NOVEL ‘PARTNER INTERVENTIONS’ AMONGST MALE SEXUAL PARTNERS OF WOMEN WITH CHLAMYDIA TRACHOMATIS
BHIVA Conf 2005 Apr 20-23;11:O4
A Johnstone, S Cameron, A Glasier, H Young, GR Scott
These preliminary results suggest that postal testing and PDPM may be similar to standard contact tracing in terms of proportion of sexual partners known to be tested/treated.
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O5 COMPARISON OF VIRUS CULTURE AND TaqMAN REAL-TIME POLYMERASE CHAIN REACTION (PCR) FOR DETECTION OF GENITAL HERPES SIMPLEX VIRUS (HSV) INFECTION
BHIVA Conf 2005 Apr 20-23;11:O5
MK Malu1, R Cunningham2, J Northwood2, S Shaw3, JR Willcox2
The PCR is significantly more sensitive in detecting HSV (more sensitive for type 2 than type 1 virus) compared to culture.
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O6 DO PEOPLE WITH GENITAL HERPES TELL THEIR SEXUAL PARTNERS? THE INFLUENCE OF STIGMA
BHIVA Conf 2005 Apr 20-23;11:O6
J Bickford, SE Barton, S Mandalia
The reaction to a diagnosis of genital herpes and the decision to disclose or not is influenced by cultural understanding of the infection as well the value of the relationship in which the disclosure may occur. Our study demonstrated that stigma is a barrier to disclosure of genital herpes diagnosis. Management strategies aimed at encouraging disclosure to sexual partners must address stigma.
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O7 HAS YOUNG PEOPLE'S KNOWLEDGE AND USE OF CONTRACEPTIVE SERVICES INCREASED SINCE THE INTRODUCTION OF THE TEENAGE PREGNANCY STRATEGY? FINDINGS FROM THE TEENAGE PREGNANCY STRATEGY EVALUATION
BHIVA Conf 2005 Apr 20-23;11:O7
RS French1, CH Mercer1, R Kane2, P Kingori1, JM Stephenson1, K Lachowycz2, P Wilkinson2, K Wellings2
There has been some success in increasing knowledge and use of services, but it may be too early to observe any positive changes in outcomes.
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O8 CORRELATION OF ERECTILE DYSFUNCTION (ED) SEVERITY AS PERCEIVED BY UK HEALTHCARE PROFESSIONAL COMPARED TO THE INTERNATIONAL INDEX OF ERECTILE FUNCTION SCORE (IIEF): RESULTS FROM THE ERECTILE DYSFUNCTION OBSERVATIONAL STUDY (EDOS)
BHIVA Conf 2005 Apr 20-23;11:O8
P Kell1, J Arellano2, M Noone2, A Riley3, S Kontodimas2
Actual numbers of men with severe ED may be under-reported without the use of tools such as the IIEF questionnaire. *IIEF-EF domain score categories: Normal (26–30), Mild (17–25), Moderate (11–16), Severe (1–10).
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O9 ANTIRETROVIRAL THERAPY IN A NEW PUBLIC SECTOR ANTIRETROVIRAL TREATMENT CENTRE IN GHANA: PATIENTS' PRESENTATION AND RESPONSE
BHIVA Conf 2005 Apr 20-23;11:O9
P Collini1, M Adjei1, K Torpey2, R Amenyah2, D Chadwick3, G Bedu-Addo1
Effective and safe ART is achievable when scaling up.
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O10 TARGETING POINTS FOR FURTHER INTERVENTION: A REVIEW HIV INFECTED INFANTS BORN IN IRELAND IN THE 5 YEARS FOLLOWING INTRODUCTION OF ANTENATAL SCREENING
BHIVA Conf 2005 Apr 20-23;11:O10
W Ferguson2, K Butler1,2,3, A Menon3 , M Goode1, L Barrett1, A Walsh1, M Cafferkey2,3
There remain identifiable targets for intervention (pre-conceptual screening, early booking, repeat tests for at-risk women, adherence support). The problem of early in-utero transmission remains.
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O11 EVALUATION OF NELFINAVIR-BASED MOTHER-TO-CHILD TRANSMISSION REGIMENS
BHIVA Conf 2005 Apr 20-23;11:O11
S O’Dea1, F Mulcahy1, F Lyons1, H McDermott1, C Bergin1, S Coughlan2
At standard nelfinavir dosing almost half the cohort failed to achieve virological suppression <50cpm, suggesting that routine TDM should be considered. Despite this, the absence of PI mutations after treatment cessation suggests that short-term nelfinavir use may not be detrimental to future maternal ART options.
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O12 INCREASED PSYCHOSIS IN HIV-1-INFECTED SUB-SAHARAN AFRICAN IMMIGRANTS
BHIVA Conf 2005 Apr 20-23;11:O12
A Holmes, S O’Dea, A O’Dwyer, F Mulcahy
This study confirms the hypothesis that SSA immigrants are at increased risk of psychological morbidity. The incidence of psychotic illness was notably high. We believe that cultural beliefs and the influence of immigration are important factors in both the rate and type of psychological morbidity.
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O12A SEXUAL BEHAVIOUR AND RISK OF ONGOING TRANSMISSION IN SYMPTOMATIC PATIENTS ATTENDING GENITOURINARY MEDICINE CLINICS
BHIVA Conf 2005 Apr 20-23;11:O12A
JA Cassell, CH Mercer, L Sutcliffe, MG Brook, E Jungmann, J Ross, G Kinghorn, J Stephenson, A M Johnson on behalf of the PATSI collaboration
Our data reinforce the need for rapid access to diagnostic and treatment services, for all patients and not just ‘high risk’ groups. Health promotion should emphasize the need for individuals to seek rapid care and cease sexual activity when an STI is suspected.
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O13 OVERSEAS TRAVEL, HIGH-RISK SEXUAL BEHAVIOUR AND STI TRANSMISSION RISK AMONG BRITISH ADULTS: RESULTS OF A NATIONAL PROBABILITY SURVEY OF SEXUAL ATTITUDES AND LIFESTYLES
BHIVA Conf 2005 Apr 20-23;11:O13
KA Fenton, CH Mercer, AM Johnson, AJ Copas, B Erens, K Wellings
Although travellers who have sex abroad select partners from their own geographic regions, their higher prevalence of sexual risk behaviours at home and abroad place them at greater risk and in need of targeted sexual health promotion.
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O14 HIGH-RISK SEXUAL BEHAVIOUR AMONG LONDON GAY MEN: NO LONGER INCREASING?
BHIVA Conf 2005 Apr 20-23;11:O14
J Elford, G Bolding, M Davis, L Sherr1, G Hart2
The percentage of London gay men reporting high risk sexual behaviour with a casual partner has remained stable since 2001, although it increased significantly between 1998–2001. Addressing this elevated level of risk will present a challenge for sexual health promotion.
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O15 RISK FACTORS FOR THE ACQUISITION OF HIV IN INDIVIDUALS KNOWN TO HAVE RECENTLY SEROCONVERTED
BHIVA Conf 2005 Apr 20-23;11:O15
J Fox, M McClure, J Weber, H Ward, S Fidler
High-risk sexual activity is highly linked to those diagnosed with incident HIV. Without immediate behaviour change onward transmission in such individuals is likely.
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O16 A PROSPECTIVE STUDY OF POST-EXPOSURE PROPHYLAXIS (PEP) FOLLOWING NON-OCCUPATIONAL EXPOSURE TO HIV IN THE UK
BHIVA Conf 2005 Apr 20-23;11:O16
JE Blackham1, V Delpech1, P Benn2, BG Evans1 on behalf of the NONOPEP project collaborative group.
The demand for NONOPEP is increasing, particularly in London and among MSM. The reasons for low follow-up rates are unclear and need to be addressed.
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O17 TRENDS IN TRANSMITTED GENOTYPIC ANTIRETROVIRAL RESISTANCE IN PRIMARY VERSUS LONGSTANDING HIV INFECTION
BHIVA Conf 2005 Apr 20-23;11:O17
D Pao1, K Aderogba1, G Dean1, P Cane2, E Smit3, D Pillay4 and M Fisher1
TAR remains of significant clinical importance despite high levels of effective viral suppression. We demonstrate that rates remain stable and furthermore are comparable in individuals diagnosed at non-PHI as well as PHI. All new HIV diagnoses should have baseline resistance testing performed irrespective of time since infection.
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O18 THE LONGEVITY OF HIV-SPECIFIC CD4 T-HELPER RESPONSES AND CLINICAL OUTCOME FOLLOWING SHORT COURSE ANTIRETROVIRAL THERAPY IN PRIMARY HIV INFECTION
BHIVA Conf 2005 Apr 20-23;11:O18
J Fox, T Scriba, A Oxenius, R Phillips, M McClure, K Porter, J Weber, S Fidler
Despite the preservation of HIV-specific CD4 T-helper responses in 50% of treated seroconverters no correlation with CD4 count or clinical progression was observed.
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O19 LATE DIAGNOSIS AND CONSEQUENT SHORT-TERM MORTALITY OF INDIVIDUALS SEXUALLY INFECTED WITH HIV: ENGLAND AND WALES, 2002
BHIVA Conf 2005 Apr 20-23;11:O19
TR Chadborn, VC Delpech, K Sinka, BD Rice, BG Evans
Continued late diagnosis, particularly of older and heterosexual individuals, means missed opportunities to start therapy early and to prevent further transmission, and an approximate 10 times higher risk of death within a year of diagnosis.
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O20 THERAPEUTIC VACCINATION WITH HIV-1 WHOLE KILLED VACCINE IS ASSOCIATED WITH IMMUNE MODULATION IN HAART-NAÏVE, ASYMPTOMATIC HIV-INFECTED INDIVIDUALS
BHIVA Conf 2005 Apr 20-23;11:O20
A Gori1, D Trabattoni1, G Rizzardini2, R Maserati3, F Mazzotta4, G Theofan5, DH Bray6, M Clerici1, G Marchetti
Immunotherapy with REMUNE® may be associated with changes in circulating lymphocytes phenotype and reduction of type 2 cytokines. Data from larger cohorts of patients is required to assess clinical significance.
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O21 DISCORDANT RESPONSES TO HAART IN ARV-NAÏVE HIV INFECTED INDIVIDUALS
BHIVA Conf 2005 Apr 20-23;11:O21
MY Tung, AK Sullivan, S Mandalia, MR Nelson, BG Gazzard
24.9% experience DR at 12 months, affected by age, CD4 count, VL and rate of CD4 decline. DIR and DVR have a good treatment outcome at 24 months. <50 CD4 rise is more predictive of DP than a positive VL.
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O22 DISCORDANT CD4 AND VIRAL LOAD RESPONSES IN PATIENTS STARTING HAART IN THE UK COLLABORATIVE HIV COHORT (CHIC) STUDY
BHIVA Conf 2005 Apr 20-23;11:O22
A Rider1, RJC Gilson1, A Copas1 and CA Sabin2, on behalf of the UK CHIC Steering Committee
Many patients have sub-optimal increases in CD4 count after starting HAART. Discordant responses at 12 and possibly 8 months may be associated with poorer outcome, although few deaths were reported in this cohort study.
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O23 THE EFFECT OF YEAR OF TREATMENT AND NA BACKBONE ON DURABILITY OF NNRTI-BASED REGIMENS
BHIVA Conf 2005 Apr 20-23;11:O23
NT Annan, S Mandalia, M Bower, M Nelson, B Gazzard
We have shown in a large NNRTI-experienced cohort, that although in univariate analysis efavirenz appears to have a higher success rate, this is explained by differences in backbone and year. This may explain differences between reported cohort studies and the 2NN study.
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O24 THERAPEUTIC DRUG MONITORING (TDM) OF EFAVIRENZ (EFV): A TOOL TO PREDICT VIROLOGIC OUTCOME IN HIV-PATIENTS ON FIRST LINE ONCE DAILY (OD) ANTIRETROVIRAL (ARV) THERAPY?
BHIVA Conf 2005 Apr 20-23;11:O24
D Maitland1, M Boffito1, S Mandalia1, S Gibbons2, D Back2, M Nelson1, B Gazzard1, G Moyle1
Our prospective analysis confirms the association between EFV-[C] and virologic response but with wide variability in EFV-[C], suggesting a role for EFV TDM in naïve patients.
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O24A PREDICTORS OF CURRENT CD4+ T-CELL RESPONSE AMONG PATIENTS RECEIVING SUBCUTANEOUS RECOMBINANT INTERLEUKIN-2 (RIL-2) IN ESPRIT (EVALUATION OF SUBCUTANEOUS PROLEUKIN® IN A RANDOMIZED INTERNATIONAL TRIAL)
BHIVA Conf 2005 Apr 20-23;11:O24A
H Nuwagaba-Biribonwoha1, BJ Angus1,2, J Bebchuk3, A Babiker1, B Cordwell1, F van Hooff1, L Hack1, Y Moraes1, B Gazzard4, J Darbyshire1 on behalf of the ESPRIT Research Group
More rIL-2 cycles and undetectable viral load at baseline were associated with a better CD4+ response.
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O25 EVIDENCE FOR SEXUAL TRANSMISSION OF HCV IN RECENT EPIDEMIC IN HIV-INFECTED MEN IN SOUTH-EAST ENGLAND
BHIVA Conf 2005 Apr 20-23;11:O25
M Danta1, D Brown1, O Pybus6, M Nelson4, M Fisher5, C Sabin3, S Bhagani2 for the HIV and Acute HCV (HAAC) group.
Mucosally traumatic sexual factors are significantly associated with the recent transmission of HCV.
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O26 IS THE TREATMENT OF ACUTE HEPATITIS C IN HIV-POSITIVE INDIVIDUALS EFFECTIVE?
BHIVA Conf 2005 Apr 20-23;11:O26
RE Browne, YC Gilleece, D Asboe, M Atkins, S Mandalia, M Bower, BG Gazzard and MR Nelson
SVR rates in HIV positive patients treated acutely for hepatitis C are lower than in HIV negative subjects. A high percentage of individuals seroconvert spontaneously.
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O27 DOES NADIR CD4 COUNT IN HIV-HCV CO-INFECTED PATIENTS PREDICT HCV TREATMENT RESPONSE TO PEGYLATED INTERFERON (P-IFN) AND RIBAVIRIN (RBV)?
BHIVA Conf 2005 Apr 20-23;11:O27
J Turner1, S Hopkins2, T Mahungu2, R Johnstone1, RM Lascar1,3, S Bhagani2, G Dusheiko, MA Johnson2, I Williams1,3, RJC Gilson1,3
This analysis demonstrates SVRs comparable to controlled studies in HIV-HCV co-infected patients. In addition to genotype, nadir CD4 predicted response to HCV therapy. This merits investigation in larger datasets.
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O28 HEPATITIS C INFECTION IS NOT ASSOCIATED WITH SYSTEMIC HIV-ASSOCIATED NON-HODGKIN'S LYMPHOMA: A COHORT STUDY
BHIVA Conf 2005 Apr 20-23;11:O28
L Waters, J Stebbing, S Mandalia, AM Young, M Nelson, BG Gazzard, M Bower
In this immunocompromised patient population, there was no association between HCV infection and an increased risk of lymphoma.
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O29 INHIBITION OF HEPATITIS B VIRUS REPLICATION BY SMALL INTERFERING RNA EXPRESSED FROM VIRAL VECTORS
BHIVA Conf 2005 Apr 20-23;11:O29
M McClure1, MD Moore1, MJ McGarvey2, RA Russell1, BR Cullen3
This work is the first to demonstrate that delivery of RNAi by viral vectors has therapeutic potential for chronic HBV infection and establishes the ground work for the use of such vectors in vivo.
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O30 IS THERE A RELATIONSHIP BETWEEN FAMILIAL MEDITERRANEAN FEVER (FMF) HOST POLYMORPHISMS AND PARADOXICAL REACTIONS (PR) IN TUBERCULOSIS (TB)?
BHIVA Conf 2005 Apr 20-23;11:O30
A Dunleavy1, RAM Breen1, A Bybee2, S Hopkins1, PN Hawkins2, M Lipman1
In our cohort PR appeared to be more strongly associated with Q148 polymorphisms than HIV status. This requires confirmation in a larger study.
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O31 IDENTIFYING THE KEY BELIEFS INFLUENCING UPTAKE AND ADHERENCE TO HAART: FINAL RESULTS OF A 12-MONTH PROSPECTIVE, FOLLOW-UP STUDY
BHIVA Conf 2005 Apr 20-23;11:O31
R Horne, V Cooper, G Gellaitry, M Fisher
Switching from a thymidine analogue to tenofovir achieves similar resolution of lipoatrophy, better reduction in lipids, and fewer treatment discontinuations than switching to abacavir.
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O32 STOPPING COMBINATION THERAPY WHILST TRAVELLING: IS THERE A REASON FOR GREAT CONCERN?
BHIVA Conf 2005 Apr 20-23;11:O32
MA Schuhwerk1, J Richens2, M Prestage1, K Jones1, N De Esteban1, RH Behrens3
A significant proportion stop HAART at low CD4 counts and are at greatly increased risk of developing medical problems. Development of drug resistance is a real concern.
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O33 SWITCHING FROM A THYMIDINE ANALOGUE TO TENOFOVIR (TDF) ACHIEVES SIMILAR RESOLUTION OF LIPOATROPHY AND BETTER REDUCTION IN LIPIDS THAN SWITCHING TO ABACAVIR (ABC). RESULTS OF THE RAVE STUDY, A UK MULTI-CENTRE OPEN-LABEL RANDOMISED CONTROLLED TRIAL
BHIVA Conf 2005 Apr 20-23;11:O33
JD Cartledge, G Moyle, C Sabin, M Johnson, E Wilkins, D Churchill, P Hay, A Fakoya, M Murphy, G Scullard, C Leen, G Reilly (RAVE study group)
Switching from a thymidine analogue to tenofovir achieves similar resolution of lipoatrophy, better reduction in lipids, and fewer treatment discontinuations than switching to abacavir.
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O34 3-DIMENSIONAL SURFACE LASER SCANNING AND PSYCHOLOGICAL ASSESSMENT: OBJECTIVE EVIDENCE FOR THE USE OF POLYLACTIC ACID IMPLANTS IN HIV-ASSOCIATED FACIAL LIPOATROPHY
BHIVA Conf 2005 Apr 20-23;11:O34
J Ong, A Clarke, M Johnson, S Withey, P Butler
PLA implants improve the physical changes of HIV-associated facial lipodystrophy. Physical and psychological measures show objective improvements with treatment which persist for a year following treatment.
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O35 WHAT IS THE COST OF SWITCHING AN ANTI-RETROVIRAL THERAPY (ART) FROM AN HIV-CENTRE PERSPECTIVE?
BHIVA Conf 2005 Apr 20-23;11:O35
T Toward1,M Fisher2,G Scullard3,C De Souza3, P Hay4, A Adebiyi4, F Pang1
This is the first study to estimate the cost of switching ART in the UK, a frequently overlooked element in costing HAART strategies. This resource utilisation model provides a methodological framework for HIV units to determine the cost impact of switching patients.
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O36 EXTENT OF UNDERDOSAGE OF ANTIRETROVIRAL THERAPY IN HIV-INFECTED CHILDREN
BHIVA Conf 2005 Apr 20-23;11:O36
EN Menson, AS Walker, T Duong, K Doerholt, C Wells, M Sharland, DM Gibb
Largely unwittingly, we have greatly underdosed HIV-infected children on ART over the past 7 years.
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O37 ENHANCED SURVEILLANCE FOR LYMPHOGRANULOMA VENEREUM (LGV) IN ENGLAND
BHIVA Conf 2005 Apr 20-23;11:O37
CA Ison, N Macdonald, IMC Martin, S Alexander, KA Fenton, C Lowndes, H Ward on behalf of the LGV Incident Team
The HPA alert, Terence Higgins Trust publicity campaign, and improved diagnostic tests, have increased community and professional awareness about LGV, case ascertainment, and confirmed in-country transmission of this rare disease.
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O38 AN OUTBREAK OF LYMPHOGRANULOMA VENEREUM IN LONDON IN 2004
BHIVA Conf 2005 Apr 20-23;11:O38
M Hamill1, C Ison2, C Carder3, P Benn1, E Jungmann1, N MacDonald2, P French1
Up to 18th January 2005 there were 23 confirmed cases of LGV in the UK including 10 from our centre. Retrospective testing has shown its presence in the UK since April 2004. Clinicians should be aware of LGV in the UK population particularly its presentation as proctitis among HIV positive MSM.
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O39 SYPHILIS OUTBREAK IN COMMERCIAL STREET SEX WORKERS IN EAST LONDON
BHIVA Conf 2005 Apr 20-23;11:O39
N Lomax, H Anderson, H Wheeler, B Goh
Outbreak management in this population is challenging: an MDT approach is crucial in identifying/treating syphilis to prevent onward transmission. High prevalence of syphilis was detected. Azithromycin was preferred by SCSWs; possible resistance problems were minimised by addition of doxycycline. As contact tracing is difficult, public awareness was heightened through local newspaper articles. Real-time rapid syphilis tests (Abbotts) were introduced to screen at source for SCSWs who decline attending GUM clinics.
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O40 SYPHILIS PCR USE FOR DIAGNOSIS OF EARLY SYPHILIS AUDITED AGAINST ROUTINE SEROLOGICAL TESTING
BHIVA Conf 2005 Apr 20-23;11:040
P Lewthwaite1, M Guiver2, A Turner2
In 2 samples which were PCR positive, syphilis serology was positive but not felt to be consistent with recent or active infection. Of the PCR negative samples 5 had serology consistent with active or recent syphilis infection. Sensitivity was 70.1% and specificity for both PCRs to be positive was 97.8%. Given problems with conventional serological testing for syphilis PCR provides a useful addition.
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O41 OPA-TYPING CAN SUBDIVIDE NG-MAST SEQUENCE TYPES OF NEISSERIA GONORRHOEAE INTO EPIDEMIOLOGICAL RELEVANT GROUPS
BHIVA Conf 2005 Apr 20-23;11:O41
AK Morris, HM Palmer, H Young
Opa-typing can subdivide NG-MAST clusters into subgroups, some of which are supported by epidemiological data.
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O42 HIV-1 ANTIBODY AVIDITY TESTING TO IDENTIFY RECENT HIV SEROCONVERTERS
BHIVA Conf 2005 Apr 20-23;11:O42
A Chawla, M Mirfenderesky, C Donnelly, M Raza, M Johnson, AM Geretti
A HIV-1 avidity index =0.60 reliably identified HIV-1 infection acquired within the previous 30 days and was more sensitive in identifying a recent infection than a low reactivity in the screening EIA test.
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O43 NO RECENT INCREASE IN MORTALITY AMONG HIV-DIAGNOSED INDIVIDUALS WITH LONG EXPOSURE TO THERAPY: UK 1987–2004
BHIVA Conf 2005 Apr 20-23;11:O43
TR Chadborn, VC Delpech, K Sinka, BG Evans
HAART dramatically cut mortality rates in 1996 and continues to postpone death in individuals who were diagnosed with HIV in the early 1990s and those newly diagnosed since 1996.
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O44 HOW SALVAGEABLE ARE THE K65R AND L74V MUTATIONS?
BHIVA Conf 2005 Apr 20-23;11:O44
L Waters, S Mandalia, M Nelson, M Bower, BG Gazzard
The K65R mutation appears to be highly salvageable with a PI-based regimen, whether or not the backbone includes TFV, and less so with non-PI HAART. There is a trend for less success salvaging the L74V whether or not this includes a PI.
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O45 TRIPLE CLASS ANTIRETROVIRAL AGENT RESISTANCE IN A LARGE UK COHORT – PREVALENCE AND RISK FACTORS FOR ACQUISITION
BHIVA Conf 2005 Apr 20-23;11:O45
R Jones, S Mandalia, M Bower, M Nelson, B Gazzard
The need for salvage therapy is best prevented by limiting acquisition of triple class resistance.Three class resistance exists at a low level in our population. 73.6% of individuals received incompletely suppressive therapy in the pre-HAART era. Non-adherence, unstructured treatment interruption, side-effects eliciting non-adherence, concurrent illness and acquisition of resistant virus were all implicated in the development of multi-drug resistance.
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O46 VIROLOGICAL AND CLINICAL OUTCOMES IN PATIENTS WITH MULTI (THREE)-CLASS DRUG RESISTANT (MDR) HIV IN THE UK
BHIVA Conf 2005 Apr 20-23;11:O46
D Grover1, L Allen3, D Pillay1,3,4, H Green2, A Copas3, S Forsyth1, SG Edwards1 on behalf of the UK Collaborative Group on HIV Drug Resistance and UK Collaborative HIV Cohort Study (UK CHIC)
Active management of patients with MDR HIV-1 is associated with delayed time to death, and resistance test guided therapy confers virological benefit.
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O47 CD4 COUNTS AND THE RISK OF LYMPHOMA IN INDIVIDUALS WITH HIV IN THE UK
BHIVA Conf 2005 Apr 20-23;11:O47
I Reeves, M Fisher, T Hill, C Sabin, on behalf of the UK Collaborative HIV Cohort (CHIC) Steering Committee
The risk of lymphoma is increased at low CD4 counts, although the nadir CD4 does not contribute further to this risk.
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O48 A PROGNOSTIC MODEL TO PREDICT SURVIVAL IN SYSTEMIC AIDS RELATED NON-HODGKIN'S LYMPHOMA
BHIVA Conf 2005 Apr 20-23;11:O48
AM Young, J Stebbing, T Dhillon, T Newsom-Davis, C Thirlwell, T Powles, S Mandalia, M Nelson, B Gazzard, M Bower
For patients with ARL in the era of HAART, an accurate prognostic score can be established by combining the IPI with CD4 count. As patients presenting with ARL and a low CD4 count have a poor prognosis, this can be used to guide therapeutic options.
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Posters

P1 IMPROVING ACCESS AND MANAGING PATIENT FLOW IN A BUSY INNER CITY, SEXUAL HEALTH CLINIC
BHIVA Conf 2005 Apr 20-23;11:P1
M Brady1, D Crates1, G Miflin2
Improvements to service have been measurable. We have established that better analysis and management techniques can have as large an impact as simply spending resources on more of the same. Continued work to reduce waiting and transit times will further improve service quality with the ultimate aim of reducing local sexual ill-health.
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P2 TURNING THE TIDE – EFFECTIVELY MANAGING INCREASING DEMAND FOR GU SERVICES
BHIVA Conf 2005 Apr 20-23;11:P2
M Ottewill, G Dean, E Collins, D Williams
By reconfiguring services the need for follow-up appointments declined, whilst maintaining access for symptomatic patients. Patient and staff satisfaction improved, with reduced waiting times and predictable workload. These modernisation efforts increased efficiency without compromising quality of care, although additional resources are required to address asymptomatic disease.
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P2A RELEASING CAPACITY THROUGH REDUCTION IN FOLLOW-UPS
BHIVA Conf 2005 Apr 20-23;11:P2A
V Griffiths, I Ahmed-Jushuf
The follow-up:new ratio can be significantly reduced thus releasing much needed capacity. The six-sigma management tool ensures that patient processes, which contribute to the ratio, are properly evaluated and opportunities for improvement identified. It also ensures that effective controls are in place to ensure that the quality of care is not compromised. The completion date for the project is March 2005. Final data will be available at the conference.
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P3 EXPERIENCE WITH THE TEST NOT TALK (TNT) CLINIC FOR ASYMPTOMATIC MEN
BHIVA Conf 2005 Apr 20-23;11:P3
D Martin, J Barter, R Pittrof
Screening by receptionists identified patients suitable for a high volume, and low cost screening.
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P4 DO GUM PATIENTS WANT CHAPERONES?
BHIVA Conf 2005 Apr 20-23;11:P4
M Osmond1, C Newey1, D Mercey2, E Jungmann3, S Edwards1
This study shows the majority of patients do not want a chaperone, but if offered one, this should be during the consultation.
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P5 FINDING OUT WHAT PRIMARY CARE WANTS FROM GUM AND DELIVERING IT
BHIVA Conf 2005 Apr 20-23;11:P5
DJ Clutterbuck, M Sutherland, N Harrison, C Thomson, J Donald, Edinburgh GUM CLIP team, Edinburgh GUM GP Liaison Group
The protocol directed GPs to a helpline that was incorporated into the existing nurse triage service. Other findings are guiding the further development of STI services.
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P6 HIV WORKLOAD AND PATIENT COMPLEXITY RATINGS
BHIVA Conf 2005 Apr 20-23;11:P6
HR Gumley, N Rees, CA Sabin, D Ransom, M Youle, MA Johnson
Rising patient numbers have led to a huge increase in workload. Activity/casemix trends among Trusts must be monitored on a regular and comparable basis so that we can be better prepared for future growth and diversity as well as the changing commissioning needs of Trusts for the particular cohort of patients for whom they provide care.
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P7 HIV ADMISSIONS IN A SOUTH LONDON TEACHING HOSPITAL
BHIVA Conf 2005 Apr 20-23;11:P7
M Aboud, S Hussain, L Collins, N Larbalastier, B Peters, R Kulasegaram
Our study showed that a significant proportion of HIV admissions are late presenters with preventable morbidity. Improved testing and public awareness remain a priority.
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P8 ARE WE A HAPPY LOT? EVALUATION OF A WALK-IN GU SERVICE
BHIVA Conf 2005 Apr 20-23;11:P8
J Dhar, J Watt, A Needham
Increase in demand with no corresponding growth in resources has precipitated a considerable decrease in the satisfaction levels for both staff and patients, and will be discussed. Walk in STI service, though a viable option, needs adequate long-term resources.
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P9 DOES A CLOSED APPOINTMENT SYSTEM IMPROVE ACCESS?
BHIVA Conf 2005 Apr 20-23;11:P9
S Bhaduri, C Minton, M Mann
Call analysis correlated with the HPA survey results suggesting the closed 48 hour booking system may genuinely improve access although further research is required in this area.
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P9A RECOGNISING THE POTENTIAL OF NON-REGISTERED NURSES TO INCREASE CAPACITY – ANOTHER PHASE IN MODERNISING GUM SERVICES
BHIVA Conf 2005 Apr 20-23;11:P9A
V Griffiths, S Butler, I Ahmed-Jushuf
Rapid STI screening is feasible within GUM for asymptomatic patients. This service is comparable to the chlamydia-screening programme – indeed more value added as patients get offered tests for syphilis and HIV. Rapid screening services improve the ‘patients process’, and releases capacity of registered clinicians to see symptomatic patients.
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P10 I’m OK
BHIVA Conf 2005 Apr 20-23;11:P10
P Handy, J Richards
Popular with patients. Encourages attendance. Enables rapid detection of asymptomatic infection.
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P11 IMPROVING ACCESS – BLUSH AND CREATE A NEW WEBSITE (WWW.GUMNEWCASTLE.NHS.UK)
BHIVA Conf 2005 Apr 20-23;11:P11
RS Pattman and R Hackett
The site was launched in October by Newcastle Falcons Rugby Football Club and was supported by representation from the Sexual Health Unit, DoH amid local publicity. Further detail and information on feedback/usage will be presented.
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P12 TIME TO USE TEXT APPOINTMENT REMINDERS IN GENITOURINARY MEDICINE (GUM) CLINICS
BHIVA Conf 2005 Apr 20-23;11:P12
CE Cohen, S Mandalia, AM Waters, AK Sullivan
Our clinic patients favoured reminder-texts to mobile phones, 2–3 days before appointments. Pilots in other specialties reduced did not attend (DNA) rates by 38%. We plan to pilot this service for chronic problem clinics, to reduce the high non-attendance rate.
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P13 RESULTS BY TEXT – PREFERRED BY PATIENTS, TRANSFORMING WORK PATTERNS
BHIVA Conf 2005 Apr 20-23;11:P13
J Clarke1, Y Taylor1, PJR Harkin2
A review of the impact at December 2004 revealed over 250 texts sent per month. A reduction of over 60% in nurse-led telephone clinics workload freed clinical staff to develop new screening services. Secretaries saw an 85% reduction in results letter requests. The text messaging results service was acceptable to patients, released nursing time into clinic, and has modernised the approach to patient care.
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P14 MOBILE PHONE TEXT MESSAGING TO GIVE RESULTS TO PATIENTS IN A DISTRICT GENERAL HOSPITAL GENITOURINARY MEDICINE CLINIC
BHIVA Conf 2005 Apr 20-23;11:P14
O McQuillan, R Hewart, E Morgan
Text messages are a safe way to give results and deliver a high level of patient and staff satisfaction.
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P15 THE NATIONAL SEXUAL HEALTH STRATEGY AND THE NEW GENERAL PRACTITIONERS' CONTRACT: POLES APART OR RECONCILABLE?
BHIVA Conf 2005 Apr 20-23;11:P15
FEA Keane1, S Gray2, J Tilbury3, N Saulsbury1
This is the first time, to our knowledge, that such a formal agreement has been reached, allowing real progress to be made in implementation of the National Sexual Health Strategy in Cornwall.
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P16 THE NEED OF MEN’S HEALTH CLINICS
BHIVA Conf 2005 Apr 20-23;11:P16
C O'Connor1, M O'Connor2, J Byrne2, H Myles2, S O'Connor2, S O’Shea2
76% desired a male specific health clinic. Death rates are higher here than internationally (8% v 2%). Outside of GP, STI clinics are the preference site for consultation. In view of HIV being an increased risk factor for TC it seems appropriate that Sexual Health Clinics should add Men's Clinics.
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P17 OVERCOMING THE BARRIERS TO GP INVOLVEMENT IN THE DIAGNOSIS AND MANAGEMENT OF HIV INFECTION
BHIVA Conf 2005 Apr 20-23;11:P17
A Bailey1, M Fisher1, R Barker2, G Dean1
A primary care focused course can enhance the role of GPs in co-management and may help reduce levels of undiagnosed HIV.
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P18 ISSUES IMPACTING ON HIV SERVICE UPTAKE BY AFRICANS IN THE UK
BHIVA Conf 2005 Apr 20-23;11:P18
F Burns1, A M Johnson2, J Nazroo3, KA Fenton1,4
HIV remains a much feared and stigmatised disease in African communities in the UK. More involvement from the African communities in the planning and implementation of health services is needed.
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P19 THE USE OF GENERAL PRACTITIONERS AMONGST HIV-POSITIVE PATIENTS
BHIVA Conf 2005 Apr 20-23;11:P19
D Robertson-Bell, S Madge, CJ Smith, MA Johnson and Nursing and Medical Staff of the Ian Charleson Day Centre
Although many HIV-positive patients have GPs, a proportion remains unaware of their patient's HIV status.
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P20 A TREATMENT ADVICE CLINIC (TAC) FOR PATIENTS ATTENDING AN HIV OUTPATIENT CLINIC: HOW DOES IT OPERATE AND WHAT DO PATIENTS THINK?
BHIVA Conf 2005 Apr 20-23;11:P20
C Griffiths1, K Miles1,2, D Aldam2, D Cornforth2, J Minton3, S Edwards2, I Williams1,2
Although evidence that TAC improves clinical outcomes is unavailable, there are clear benefits at the individual level suggesting investment in TAC is worthwhile.
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P21 THE ROLE OF THE SEXUAL HEALTH ADVISOR (SHA) IN A HOSPITAL-BASED HIV SERVICE
BHIVA Conf 2005 Apr 20-23;11:P21
P Anderson, M Murcie, A Winter, R Fox
SHA has increased uptake of STI tests and GUM attendance, yielding a significant number of diagnosis of STIs on this positive population. On going Audit to identify reasons for clients not seeing SHA.
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P22 BRASH: ASSESSING THE FIRST YEAR OF A NEW SERVICE
BHIVA Conf 2005 Apr 20-23;11:P22
C Ashton, E Stephens, H Mitchell
There was a good uptake of a new service specifically designed to meet the reproductive and sexual health needs of an HIV-positive individuals attending their treatment centre.
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P23 CD4 CELL COUNT AND STARTING ART: TRENDS IN SIX UK CENTRES 1997-2002
BHIVA Conf 2005 Apr 20-23;11:P23
W Stöhr1, D Dunn1, K Porter1, C Sabin2 on behalf of UK CHIC Study
There was a trend of deferring ART, which reflected changing BHIVA and other treatment guidelines. Further analyses are planned to examine the role of viral load and selected demographic factors on the initiation of HAART.
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P24 WHAT IS THE CLINICAL SIGNIFICANCE OF SUSTAINED LOW-LEVEL VIRAEMIA (SLLV) IN PATIENTS ON HAART?
BHIVA Conf 2005 Apr 20-23;11:P24
P Easterbrook1, L Bansi2, CA Sabin2, T Welz on behalf of the UK Collaborative HIV Cohort (CHIC) Study
A small proportion of patients on HAART have SLLV with no adverse immunological or virological consequences. The impact on the development of drug resistance need to be further evaluated.
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P25 LONG AND STRONG: EXPERIENCE OF FIRST LINE THERAPY WITH NEVIRAPINE (NVP) IN A COHORT OF ANTIRETROVIRAL (ART) NAÏVE HIV-POSITIVE PATIENTS
BHIVA Conf 2005 Apr 20-23;11:P25
AA Benzie1, NE Mackie1, CA Sabin2, RJ Weston1, J Walsh1
This is the first cohort study providing long term durability and tolerability data in ART-naïve patients commenced on NVP. Beyond the first six weeks, there was no significant hepatotoxicity related to NVP.
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P26 THE IMPACT OF FOSAMPRENAVIR AND LOPINAVIR/R DRUG LEVELS ON VIROLOGICAL OUTCOME IN PATIENTS ON THESE DRUGS IN COMBINATION
BHIVA Conf 2005 Apr 20-23;11:P26
C Slater1, S Castelino2, S McCormick2, C Tong3, R Kulasegaram1
Greater virological failure is associated with low drug levels, but this did not reach statistical significance and will be compounded by adherence. From this small review, we would recommend T1. Lopinavir levels appear key in determining response.
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P27 DOUBLE-BOOSTED PROTEASE TREATMENT USING ATAZANAVIR AND LOPINAVIR/RITONAVIR
BHIVA Conf 2005 Apr 20-23;11:P27
J Ballinger, L Swaden, S Bhagani, M Tyrer, M Youle, MA Johnson
Treatment with this double-boosted PI combination is effective in patients pre-treated with multiple combinations.
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P28 SAFETY AND EFFICACY OF ATAZANAVIR WITH LOW DOSE RITONAVIR IN A CLINIC POPULATION
BHIVA Conf 2005 Apr 20-23;11:P28
SF Forsyth1, DM Mullan1,2, MA Schuhwerk1, A Copas2, SG Edwards1, IG Williams1,2
ATZ/r was well tolerated in this clinic population and associated with significant falls in plasma cholesterol, resolution of diarrhoea in patients switching therapy. Severe mood change was seen in some patients.
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P29 THE EFFECT OF PROTON PUMP INHIBITORS ON PROTEASE INHIBITOR PLASMA CONCENTRATIONS IN THE CLINICAL SETTING
BHIVA Conf 2005 Apr 20-23;11:P29
SE Gibbons, DJ Back, SH Khoo
These data highlight the limitations of a pre-selected, diverse cohort for investigating potential drug interactions. Only carefully designed pharmacokinetic studies can address these issues.
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P30 TIPRANAVIR (TIP)/T-20 CONTAINING SALVAGE REGIME IN HIGHLY TREATMENT EXPERIENCED HIV-INFECTED PATIENTS
BHIVA Conf 2005 Apr 20-23;11:P30
U Kalidindi, M Lechelt, C Skinner, M Murphy, Y Gilleece, G Baily, C Loveday, C Orkin
Tipranavir/T20 containing regimes with optimised nucleoside/nucleotide backbone is successful in highly treatment experienced HIV-infected patients. It is acceptable and well tolerated.
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P31 T20 USE IN THE UK: IS IT OPTIMAL?
BHIVA Conf 2005 Apr 20-23;11:P31
N Perry on behalf of the T20 National audit Group
Despite the majority of patients initiating T20 in an unfavourable setting, reasonable responses were seen and T20 was well tolerated. T20 may perform better if use is optimised.
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P32 NATURAL KILLER CELL FUNCTION AND KIR RECEPTOR EXPRESSION IN HIV LONG TERM NON-PROGRESSION
BHIVA Conf 2005 Apr 20-23;11:P32
A Holmes1, G O’Connor2, F Mulcahy1, C Gardiner2
LTNPs maintain NK cytotoxicity relative to HIV regular progressors, suggesting a role for NK cells in HIV control.
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P33 EFAVIRENZ CONCENTRATIONS RESULTING FROM CO-ADMINISTRATION OF RIFAMPICIN WITH EITHER 600 OR 800 MG EFAVIRENZ
BHIVA Conf 2005 Apr 20-23;11:P33
S Gibbons, L Almond, D Back, S Khoo
There was marked interpatient variability and the datasets were unequal. However, efavirenz concentrations were comparable irrespective of dose given.
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P34 CLINICAL EXPERIENCE WITH ATAZANAVIR
BHIVA Conf 2005 Apr 20-23;11:P34
P Holmes, M Tung, M Nelson, M Bower, BG Gazzard
ATZ may be successfully utilized on PI naïve and PI experienced individuals requiring switch of antiviral agents.
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P35 SINGLE AGENT SWITCHING TO TENOFOVIR – A RETROSPECTIVE ANALYSIS
BHIVA Conf 2005 Apr 20-23;11:P35
TJ Barber, BC De Souza
Data in our cohort suggests that switching to Tenofovir is clinically beneficial in the management/stabilisation of patients with lipodystrophy. Longer follow up would be valuable. This audit was made possible thanks to an unrestricted educational grant from Gilead Sciences.
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P36 BOOSTED ATAZANAVIR USE IN AN INTRAVENOUS DRUG USER COHORT
BHIVA Conf 2005 Apr 20-23;11:P36
S Chew, J Kieran, C Bergin, F Mulcahy
There were a total of 67 patients who received ATV during the specified period. Of these, 45/67 (67.1%) were IVDU. 11/45 were on their first ART regimen, 14/45 had received more than 2 previous ART regimes. After 3 months, only 33/45 (73.3%) were still compliant with the boosted ATV containing ART regimen. The rest were either lost to follow up or still attending the clinic, but non-compliant with treatment.
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P37 THE USE OF ATAZANAVIR/RITONAVIR AS PART OF A ONCE DAILY ANTIRETROVIRAL THERAPY REGIME IN INTRAVENOUS DRUG USERS
BHIVA Conf 2005 Apr 20-23;11:P37
N Chew
Atazanavir is a favourable option in an ART regime for an IVDU to facilitate once daily directly observed therapy.
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P38 CLINICAL EXPERIENCE WITH ATAZANAVIR
BHIVA Conf 2005 Apr 20-23;11:P38
M Natha1, M Pakianathan1,2, T Sadiq1, B Marett1
ATZ/r was well tolerated and there were no discontinuations. Expected elevations in serum bilirubin were observed. Most patients commencing an ATZ/r containing regimen achieved viral suppression to <400 copies/ml at 48 weeks follow-up.
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P39 AUDIT OF CONCOMITANT PROTEASE INHIBITOR AND PROTON PUMP INHIBITOR USE
BHIVA Conf 2005 Apr 20-23;11:P39
ML Schmid, MC Bailey, MH Snow
No patient was on potentially dangerous ATV and omeprazole. However patients on ATV or ATVr/lansoprazole combination did not have reduced ATV levels. Patients on boosted or unboosted ATV requiring acid suppression may be safer to use PPIs with limited interaction like lansoprazole.
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40 ATAZANAVIR AND ACID SUPPRESSANTS – ARE DOCTORS AND PATIENTS AWARE?
BHIVA Conf 2005 Apr 20-23;11:P40
E Davies, K McCormick, C Ruddy, Y Mullens, M Bower, B Gazzard, M Nelson
Despite the fact that all patients attending our clinic are counselled regarding drug interaction issues and issued with written information when initiating atazanavir, this survey demonstrates that repeated reinforcement of such information is required at each visit. Conversely, only 1 patient had received their PPI/H2 antagonist via prescription which suggests that clinicians/HIV pharmacists seem to be well informed of the data.
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P41 EFFECTIVENESS OF TIPRANAVIR IN A CLINIC COHORT
BHIVA Conf 2005 Apr 20-23;11:P41
A Abbara, A Bhuya, L Davies, M Bower, R Popat, M Nelson, BG Gazzard
Tipranavir when used as very late therapy with no other agents is a non-successful therapeutic approach. Individuals with other active agents available respond.
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P41A A SENSITIVE CASE
BHIVA Conf 2005 Apr 20-23;11:P41A
B Killingley, MA Johnson
Specific treatment options are limited, although intravenous immunoglobulin has been used with some success. This case highlights the importance of drug toxicity in HIV disease.
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P42 PREVALENCE OF GENITAL INFECTIONS IN A COHORT OF HIV-POSITIVE PREGNANT WOMEN
BHIVA Conf 2005 Apr 20-23;11:P42
C Brookings, R Browne, P Ratcliffe, W Khan, DA Hawkins
Genital infections in pregnant women are associated with adverse pregnancy outcomes (miscarriage, preterm delivery and infant infections). The prevalence of genital infections was 52 per 100 women. We recommend that all HIV positive pregnant women should be routinely screened.
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P43 POTENTIAL CLINICAL IMPORTANCE OF ALTERED NELFINAVIR PHARMACOKINETICS IN PREGNANCY
BHIVA Conf 2005 Apr 20-23;11:P43
C Bell1, C Slater2, A DeRuiter2, H Noble3, G Taylor1
Although the study's small, retrospective and limited by relatively late first on-treatment viral load sampling the reduced rate of viral decay in pregnant women taking a nelfinavir-containing regimen suggest that the PK data are of clinical importance.
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P44 KALETRA IN PREGNANCY – EXPERIENCE OF A NORTH LONDON TEACHING HOSPITAL
BHIVA Conf 2005 Apr 20-23;11:P44
U Harrisson, S Shah, H Montgomery, S Madge, S Kinloch, M Tyrer, H Evans, Johnson M
Kaletra is a viable choice for HIV+ve pregnant women but additional monitoring during the 3rd trimester is recommended.
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P45 OUTCOMES OF PLANNED VAGINAL DELIVERY OF HIV-POSITIVE WOMEN MANAGED IN A MULTI-DISCIPLINARY SETTING
BHIVA Conf 2005 Apr 20-23;11:P45
R Browne1, EGH Lyall1,2, Z Penn1, W Khan1, DA Hawkins1
Women with viral loads of <50 copies/ml at 36 weeks should be offered the option of a planned vaginal delivery with optimal intra-partum care and senior review in labour.
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P46 HIV INFECTION RESULTS IN BODY FAT REDISTRIBUTION
BHIVA Conf 2005 Apr 20-23;11:P46
M Boothby, G Gilleran, N Crabtree, H Jaleel, M Shahmanesh
Compared to control subject, HIV infected patients who are not on antiretroviral treatment have approximately 2.5 kg (28%) loss of limb fat compared to HIV negative controls.
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P47 DECREASED INCIDENCE OF LIPOATROPHY IN A GROUP OF HIV-POSITIVE PEOPLE TAKING HAART (HIGHLY ACTIVE ANTIRETROVIRAL THERAPY) WITHOUT STAVUDINE ASSESSED BY ANTHROPOMETRY MEASUREMENTS AND REPORTED SELF–PERCEPTIONS OF BODY SHAPE CHANGES
BHIVA Conf 2005 Apr 20-23;11:P47
C Taylor, V Pribram, C Hodgson, R Goncalves, P Easterbrook
Unlike stavudine containing HAART regimes, these results demonstrate an absence of lipoatrophy but high incidence of increased abdominal girth despite very limited PI use. Increased waist size may largely be due to substantial weight gain on HAART in this population.
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P48 EXPERIENCE OF THE USE OF STATINS AND FIBRATES IN PATIENTS RECEIVING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) IN THE EDINBURGH HIV COHORT
BHIVA Conf 2005 Apr 20-23;11:P48
WI Beadles, CLS Leen, X Recabarron, R Lessells
The threshold for commencing patients in this cohort on a lipid lowering agent maybe lower than in the general population. Statins and fibrates were well tolerated. Further guidance is needed to help in the management of those patients who have poor response to these agents.
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P49 LONG-TERM EFFICACY AND SAFETY OF INJECTABLE POLY-L-LACTIC ACID FOR THE CORRECTION OF FACIAL LIPOATROPHY
BHIVA Conf 2005 Apr 20-23;11:P49
SE Barton, GJ Moyle, L Lysakova, S Brown
Physical and psychological benefits of PLLA are sustained over at least 18 months. Delayed AEs are neither serious nor severe and include mild nodularity at the treatment site.
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P50 NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTI)-RELATED HEPATIC FIBROSIS AND DECOMPENSATED PORTAL HYPERTENSION
BHIVA Conf 2005 Apr 20-23;11:P50
JA Garcia-Garcia, S Bhagani1, A Quaglia, M Tyrer, MA Johnson, G Slapak
Prolonged NRTI therapy may lead to progressive hepatic fibrosis, probably as a result of mitochondrial toxicity and non-alcoholic steatohepatitis. Clinicians should be aware of the risk of significant liver disease in patients with lipodystrophy, prolonged current or previous NRTI-use and even a moderate transaminitis. These patients should be offered early evaluation for fibrosis and portal hypertension.
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P51 THYROID DYSFUNCTION AMONGST HIV-INFECTED PATIENTS: HIV OR HAART?
BHIVA Conf 2005 Apr 20-23;11:P51
S. Pren, A Scourfield, J Smythe, M Stefanovic, R Jones, S Mandalia, AK Sullivan, MR Nelson, BG Gazzard
K65R is driven mainly by TFV/ddI ±ABC (particularly with NRTI -only regimens). PIs appear to be protective. L74V is predominantly driven by ddI/ABC or ddI/TFV; although numbers are small, PIs don't appear to confer protection.
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P52 THE PREVALENCE OF CANONICAL RESISTANCE MUTATIONS IN NAÏVE HIV-1 INFECTED PATIENTS IS LOW AND DID NOT INCREASE OVER THE TIME PERIOD OF 2000 TO 2003
BHIVA Conf 2005 Apr 20-23;11:P52
H Price, R Jones, S Mandalia, M Bower, M Nelson, B Gazzard
Acquisition of drug resistant HIV-1 has been constant over the last four years.
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P53 HOW COMMON IS THE K65R MUTATION IN CLINICAL PRACTICE?
BHIVA Conf 2005 Apr 20-23;11:P53
E Harte, P Tilston, E Wilkins, A Bonington, J Vilar, E Dunbar, S Clarke
These data demonstrate that the emergence of the K65R mutation is not as common as perhaps thought from the clinical trial setting. The data also provides further evidence of the negative correlation between K65R and the presence of TAMs.
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P54 WHICH ANTIRETROVIRAL REGIMENS DRIVE THE K65R AND L74V MUTATIONS?
BHIVA Conf 2005 Apr 20-23;11:P54
L Waters, S Mandalia, M Nelson, M Bower, BG Gazzard
K65R is driven mainly by TFV/ddI +/-ABC (particularly with NRTI -only regimens). PIs appear to be protective. L74V is predominantly driven by ddI/ABC or ddI/TFV; although numbers are small, PIs don't appear to confer protection.
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P55 DO THE MUTATIONS M046I AND I047A CONFER RESISTANCE TO KALETRA?
BHIVA Conf 2005 Apr 20-23;11:P55
M Stevanovic, H Price, R Jones, S Mandalia, M Bower, M Nelson, B Gazzard
Prior exposure to Kaletra is not required in the development of the mutations M046I and I047A. Presence of these mutations does not adversely affect virological response to Kaletra therapy as part of an HAART regimen.
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P56 THE PRESENCE OF A SINGLE CANONICAL NNRTI RESISTANCE MUTATION IN NAÏVE HIV-1 INFECTED PATIENTS REDUCES THE PROPORTION ACHIEVING VIROLOGICAL SUCCESS WHEN STARTING NNRTI-BASED REGIMENS
BHIVA Conf 2005 Apr 20-23;11:P56
H Price, R Jones, S Mandalia, M Bower, M Nelson, B Gazzard
More than half the patients treated with NNRTI regimens responded despite pre-existing resistance although response to a PI containing regimen was better.
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P57 NEVIRAPINE USE IN PREGNANT HIV-POSITIVE WOMEN – IS IT THE END? (EXPERIENCE OF A PROVINCIAL CENTRE)
BHIVA Conf 2005 Apr 20-23;11:P57
C Chapman, J Dhar
During this period the total number of pregnancies documented were 90, which included 5 miscarriages, 2 terminations and 1 stillbirth. Of the 82 pregnancies the majority were of Black African origin. 51 (57%) patients received NVP as combination therapy. 4 (7%) in this group developed side effects requiring hospitalisation, including a case of toxic epidermal necrolysis. Data will be presented indicating a shift from the recommended guidelines for the management of pregnant HIV positive women in our area post February 2004.
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P58 EXPERIENCE OF DELIVERING WOMEN WITH HIV IN AN INNER CITY LONDON HOSPITAL 1994–2002
BHIVA Conf 2005 Apr 20-23;11:P58
M Parisaei1, J Anderson2, KJ Erskine1
Based on our observations there is room for optimism about the obstetric course and outcome of pregnancy in women with HIV in a multidisciplinary setting.
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P59 HAART TO HEART. WHERE DO DHIVA DIETS FIT INTO BHIVA GUIDELINES?
BHIVA Conf 2005 Apr 20-23;11:P59
A Culkin1, C Stradling2, on behalf of DHIVA3
Clinics are measuring baseline bloods to identify patients who may be at risk of lipodystrophy. In most cases, referrals to dieticians are made and the assessment of CHD risk factors may warrant further dietetic input.
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P60 TENOFOVIR-ASSOCIATED RENAL DYSFUNCTION – CAN WE PREDICT IT?
BHIVA Conf 2005 Apr 20-23;11:P60
E Devitt, E Wallace, M Bryne, WG Powderly, G Sheehan
The contribution of tenofovir to renal dysfunction is controversial. Although elevated creatinine was not seen in clinical trials, TDF has been linked with renal tubular dysfunction in several case reports. Our cases highlight the possibility of developing renal dysfunction while on TDF, but also indicate the potential contribution of other co-morbidities.
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P61 TOXIC LEVELS OF EFAVIRENZ (EFV) TWO WEEKS AFTER STOPPING THERAPY
BHIVA Conf 2005 Apr 20-23;11:P61
G Crowe1, SH Khoo2
EFV levels rose to toxic concentrations despite co-administration with Rifampicin which is known to increase EFV metabolism. Levels fell slowly and were still in the toxic range more than two weeks after stopping therapy. Neurological toxicity was not noted until levels above 27,000 ng/ml were reached. TDM was vital to enable correct management. Further genetic investigations to sequence the CYP2B6 gene are being undertaken.
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P62 THE SNAIL'S PROGRESS: A CASE REPORT OF SCHISTOSOMIASIS IN THE ERA OF HAART
BHIVA Conf 2005 Apr 20-23;11:P62
S de Silva1, J Walsh2, M Brown3
This patient probably acquired S. mansoni many years previously, but only experienced symptoms following initiation of HAART. This immune reconstitution appears to have resulted in an acute inflammatory response to his chronic infection. This phenomenon is likely to take on further significance with the increasing availability of antiretroviral medication in the tropics.
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P63 HAART IMPROVES OUTCOME FROM HIV-ASSOCIATED TTP
BHIVA Conf 2005 Apr 20-23;11:P63
S Roedling, RF Miller, M Scully, H Cohen, R Starke, SJ Machin, SG Edwards
We highlight the importance of HIV testing all patients presenting with TTP. Treatment with plasma exchange and HAART is associated with a high rate of complete remission. Relapse occurs if HAART is stopped.
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P64 OPSOCLONUS-MYOCLONUS SYNDROME FOLLOWING THE INITIATION OF HAART
BHIVA Conf 2005 Apr 20-23;11:P64
J Hutchinson1,3, AS Pym1, RWH Walker2, PA Brex2, S El Gadi3
Nevertheless she made a gradual and eventually almost full recovery over two months. OMS is thought to be immune mediated. The appearance of the condition following a rapid and steep rise in CD4 count suggests OMS could be a rare manifestation of Immune Reconstitution Inflammatory Syndrome (IRIS).
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P65 PLASTIC SPECULA: CAN WE EASE THE PASSAGE?
BHIVA Conf 2005 Apr 20-23;11:P65
L Kozakis, J Vuddamalay, P Munday
We feel that the clinician should now feel more confident that if a difficult examination requires the use of a lubricant, the test results will not be compromised.
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P66
BHIVA Conf 2005 Apr 20-23;11:P66

Abstract: withdrawn as requested
P67 A COMPARISON OF SELF-TAKEN VULVO-VAGINAL AND CERVICAL SAMPLES FOR THE DIAGNOSIS OF CHLAMYDIA TRACHOMATIS INFECTION BY PCR
BHIVA Conf 2005 Apr 20-23;11:P67
R Bendall1, FEA Keane2, N Saulsbury2, L Haddon2
Self-taken vulvo-vaginal samples are an acceptable alternative to cervical samples for C. trachomatis diagnosis.
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P68 COMPARISON OF THE SENSITIVITY AND ACCEPTABILITY OF MEATAL SWABS WITH ENDOURETHRAL SWABS FOR CHLAMYDIA TRACHOMATIS NAAT TESTING IN MEN
BHIVA Conf 2005 Apr 20-23;11:P68
B Elawad, KN Sankar and CF Dickson
Meatal swabs are more acceptable to men than endourethral swabs. Meatal swabs achieved high sensitivity, but the low lower 95% C.I. makes it unsatisfactory alternative to endourethral sampling. Meatal swabs may have place when endourethral swab is not tolerated and urine specimen unavailable. Design of a specific meatal swab may improve sensitivity. Additional assessment examining acceptability of self-collected swabs would be of value.
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P69 WHY WE DO NOT REVIEW NGU MORE THAN ONCE?
BHIVA Conf 2005 Apr 20-23;11:P69
T Theobald1, C O'Connor2, F Berkt3
Increasing workloads in GUM clinics necessitates re-evaluation of work practices. A recent articlei states that 34% of clinics in UK do not require male patients with NSU re-attend. A review of literature showed paucity of evidence for either practice. Traditional practice was evaluated.
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P70 PREVALENCE OF GENITAL INFECTION IN WOMEN ATTENDING PRIOR TO TERMINATION OF PREGNANCY (TOP)
BHIVA Conf 2005 Apr 20-23;11:P70
G Crowe, F Chhibber, S Amin
Women seeking TOP will accept screening for STIs and HIV, and have a high prevalence (9.9%) of these infections. Follow-up of positive patients is assisted by the screening process being carried out within DOSH but despite this only 75% of those requiring follow-up, attended. We intend to pilot a dedicated telephone followup clinic within the TOP service to try and address this need.
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P71 HOW MOLECULAR TESTS FOR GONORRHOEA INFECTION FIT INTO A MODERNISED GENITOURINARY MEDICINE SERVICE
BHIVA Conf 2005 Apr 20-23;11:P71
C Ryan, G Kudesia, GR Kinghorn
Gonorrhoea screening by SDA alone, using the chlamydia screening sample, is feasible for the majority of asymptomatic GUM patients. Assessment of specific risk factors in the routine patient history identifies those in whom additional tests for microscopy and culture should be taken. Only a few women missed by risk factor assessment require repeat examination and additional culture tests prior to treatment.
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P72 OUTBREAK OF GONORRHOEA LINKED TO INTERNET USE AMONG MEN WHO HAVE SEX WITH MEN
BHIVA Conf 2005 Apr 20-23;11:P72
CA Ison1, A Rea2, SA Collins2, IMC Martin1, N Bilek3, BG Spratt3
Acquisition of gonorrhoea and onward transmission within a rural town occurred through contact initiated via the internet or cruising, which has public health implications since they involve a high frequency of anonymous sexual contact and mixing of individuals from a wide geographical area.
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P73 GETTING IT RIGHT THE FIRST TIME: AN AUDIT OF GONORRHOEA MANAGEMENT IN A HIGH PREVALENCE AREA
BHIVA Conf 2005 Apr 20-23;11:P73
I Reeves, M Tenant-Flowers
This audit supports doubt over the utility of TOC and highlights the importance of appropriate initial therapy and sensitivity testing. Attempts to address the issues raised in this audit include: targeted patient information, maintaining open-access clinics and educating local GPs.
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P74 CHANGE FROM MICROSCOPY AND CULTURE TO GONORRHOEA STRAND DISPLACEMENT ASSAY – IS THERE AN IMPACT ON CLINICAL CARE?
BHIVA Conf 2005 Apr 20-23;11:P74
C Slater3, M Hawkins3, D Lewis3, E Fox1, J Klein2
Use of SDA with selective microscopy and culture has not compromised patient care. The impact of false positive tests is difficult to quantify and positive gonorrhoea SDA results should always be confirmed by culture.
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P75 SYPHILIS OUTBREAK IN WALSALL: EPIDEMIOLOGY AND LESSONS FOR CONTROL AND PREVENTION
BHIVA Conf 2005 Apr 20-23;11:P75
A Joseph1, M Pallan2, S Chandramani1, I Morrall1
Syphilis outbreak was occurring in two separate settings. Targeted multifaceted outreach programmes to include community venues and CSW's are necessary to combat further spread.
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P76 THE SYPHILIS OUTBREAK IN NORTHERN IRELAND
BHIVA Conf 2005 Apr 20-23;11:P76
C Emerson, A Lynch, S Gray, C Cunningham, RD Maw
Initially the contacts were mostly from Dublin, as the outbreak gained momentum syphilis was contracted within Northern Ireland. The cohort was not generally associated with high number of sexual contacts, multiple anonymous partners or specific locations. The challenge is to educate both patients and health care professionals as to sexual health issues, specifically the risk associated with casual oral sex by MSM.
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P77 SYPHILIS IN NOTTINGHAM - PREDOMINANTLY A HETEROSEXUAL DISEASE
BHIVA Conf 2005 Apr 20-23;11:P77
K Ponnusamy, P Goold, C J Bignell, C A Bowman
Heterosexual transmission accounted for 83.5% of the cases in this local outbreak. Diagnosis relied heavily on serology despite the high prevalence of clinical signs. Close collaboration with local prostitute outreach project (POW) resulted in enhanced screening of CSWs.
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P78 UK NATIONAL AUDIT OF EARLY SYPHILIS MANAGEMENT
BHIVA Conf 2005 Apr 20-23;11:P78
H McClean, D Daniels, C Carne, P Bunting, R Miller on behalf of the
A national audit of 781 early syphilis cases presenting during 2002–03 in UK genitourinary medicine clinics was conducted in late 2004, organised through the Regional Audit Groups. Data were aggregated by Region, allowing practice in Regions to be compared to the UK national guidelines and national averages.
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P79 WOMEN AND MEN WITH HERPES SIMPLEX (HSV) – TELLING A NEW PARTNER AND THE IMPACT ON SEXUAL RELATIONSHIPS
BHIVA Conf 2005 Apr 20-23;11:P79
M Nicholson1, L Waters2, S Barton2
Most individuals with genital HSV infection divulge this information to new partners and the majority experienced positive responses. There is a trend for non-disclosure amongst the recently diagnosed.
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P80 TOPICAL 5% IMIQUIMOD CREAM IN THE MANAGEMENT OF ANOGENITAL WARTS UNRESPONSIVE TO FOUR WEEKS OF STANDARD TREATMENT
BHIVA Conf 2005 Apr 20-23;11:P80
K Aderogba, I Fernie, I Samuel
5% imiquimod cream demonstrated good efficacy and was well tolerated. Complete responses were better in females with no ethnic differences observed.
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P81 SHOULD ALL CONFIRMED CASES OF CHLAMYDIA TRACHOMATIS BE REFERRED TO A GENITOURINARY MEDICINE (GUM) CLINIC?
BHIVA Conf 2005 Apr 20-23;11:P81
A Davies, A Chiganze, H Birley
The majority of cases of chlamydia infection can be adequately managed in primary care and routine referral to GUM may therefore not be justified.
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P81a TEST > TEXT > TREATMENT: TEXT MESSAGING SERVICE (TMS) IMPROVES THE TIME TO TREATMENT OF CHLAMYDIA TRACHOMATIS INFECTION AND REDUCES THE COST OF RESULT PROVISION
BHIVA Conf 2005 Apr 20-23;11:P81
AS Menon-Johansson, F McNaught, S Mandalia, AK Sullivan
Patients with genital CT infection are diagnosed and receive treatment sooner since the introduction of TMS. Significant savings in costs and staff time were seen following the introduction of this service.
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P82 PREVALENCE OF CHLAMYDIA IN PATIENTS ATTENDING FOR TERMINATION OF PREGNANCY
BHIVA Conf 2005 Apr 20-23;11:P82
S Bhaduri, C Minton, M Mann
In view of the lower incidence of chlamydia in TOP attendees, particularly in attendees over 30 years of age, further work is required to look at the cost effectiveness of chlamydia screening in TOP in this older age group.
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P83 CHLAMYDIAL CONJUNCTIVITIS RESULTING FROM DIRECT EJACULATION INTO THE EYE
BHIVA Conf 2005 Apr 20-23;11:P83
S Rackstraw, ND Viswalingam, BT Goh
Chlamydial conjunctivitis can result from direct ejaculation into the eyes. This mode of transmission may underestimated as a history of ejaculation into the conjunctiva is not normally asked for.
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P84 MICROSCOPIC CERVICITIS, WILL YOU TREAT?
BHIVA Conf 2005 Apr 20-23;11:P84
R Moussa
105 female patients were treated for microscopic cervicitis from a total of 437 patients examined, i.e. 24% of female clinic attenders. In this study, chlamydia was diagnosed nearly 3 time as often in patients with cervicitis (17), as those without (6). With the increase in GUM attenders and the increased number of STIs diagnosed, how should we manage cervicitis? Is treating and contact tracing a waste of resources, or is it an opportunity for preventing PID and tubal infertility?
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P85 LYMPHOGRANULOMA VENERUM IN HIV-POSITIVE HOMOSEXUAL MEN: IS AN OUTBREAK EMERGING IN LONDON?
BHIVA Conf 2005 Apr 20-23;11:P85
NT Annan1, J Dunning1, NA Smith1, K McLean1, B Azadian1, N MacDonald2, C Ison2, M Nelson1
Given the outbreaks in Western Europe and the number of cases presenting to our clinic in recent months we conclude that increased awareness among clinicians is essential to facilitate early diagnosis, treatment and prevent onward transmission of both LGV and HIV. Close collaboration between clinic staff and those in microbiology has been vital.
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P86 THE DEMOGRAPHY OF GONORRHOEA IN WALES – AN ANALYSIS FROM THE GRASP STUDY
BHIVA Conf 2005 Apr 20-23;11:P86
CM Davies1, D Thomas2, M Lyons2, H Birley3, R Das4, E Rudd5, C Ison6
Gonorrhoea cases have continued to increase in contrast to national data, highlighting the necessity of local surveillance to inform public health.
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P87 TELEPHONIC FOLLOW-UP OF GONORRHOEA: A STEP IN THE RIGHT DIRECTION
BHIVA Conf 2005 Apr 20-23;11:P87
MK Malu, KW Radcliffe
Outcome of management of cases of gonorrhoea with telephonic follow-up is satisfactory and a step in right direction towards the modernization of GUM services.
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P88 GONORRHOEA TREATMENT RESPONSE AFTER CHANGE TO TREATMENT GUIDELINES
BHIVA Conf 2005 Apr 20-23;11:P58
M Tung1, A Kingston1, L Low1, T Annan1, B Azadian2, AK Sullivan1
The use of cefixime or ceftriaxone for uncomplicated gonorrhoea infection is effective clinically and microbiologically with no cases of treatment failure.
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P89 HIGH RATES OF NEISSERIA GONORRHOEA CONTACTS ABROAD REDUCED PARTNER NOTIFICATION
BHIVA Conf 2005 Apr 20-23;11:P89
R Buckley, P O'Grady, A Wyer, F Mulcahy
This review concurs with previous findings, however more recently partner notification in heterosexuals is reduced secondary to significant sexual contact outside country of residence.
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P90 SYPHILIS CAUSES EYE DISEASE – A CASE SERIES
BHIVA Conf 2005 Apr 20-23;11:P90
M Gupta1, R Ellks1, S Al Alabri2, C Murphy3, D Edrisinghe4, Al Pearce3, M Bradley1, NJ Beeching2
Ocular manifestations of syphilis are likely to become more common and may be severe. Syphilis should be considered in the differential diagnoses of ocular inflammation, as delay in treatment can lead to permanent visual loss.
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P91 MEN WITH HERPES SIMPLEX (HSV) - TREATMENT AND INFORMATION SATISFACTION SURVEY
BHIVA Conf 2005 Apr 20-23;11:P91
M Nicholson1, L Waters2, S Barton2
Male patients attending GU services with a first episode of genital HSV are seen within 3 days. Oral aciclovir, the commonest therapy, led to high satisfaction scores. Even within specialist services a number remain unsatisfied with the information supplied and the provision of written information by GP services was poor.
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P92 A 5-YEAR STUDY OF THE TRENDS IN INCIDENCE AND MANAGEMENT OF TRICHOMONAS VAGINALIS
BHIVA Conf 2005 Apr 20-23;11:P92
A Ezeokoli, M Nathan
Trichomonas vaginalis remains a significant sexually transmitted disease in our locality which also has a high prevalence of HIV infection.
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P93 THE CHANGING FACE OF STIS IN PREGNANCY IN LIMERICK, IRELAND OVER 15 YEARS
BHIVA Conf 2005 Apr 20-23;11:P93
C O'Connor, J Clancy
A large increase in foreign nationals is noted. Even in the most distal clinics increased clinical awareness of less common diagnoses and co-operation is essential to help prevent congenital transmission of preventable diseases.
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P94 IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME (IRIS)-ASSOCIATED KAPOSI SARCOMA
BHIVA Conf 2005 Apr 20-23;11:P94
C Thirlwell, AM Young, T Newsom-Davis, T Dhillon, T Powles, S Mandalia, M Nelson, B Gazzard, M Bower
Patients with KS who start HAART may be at risk of IRIS progression of KS.
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P95 SIMILAR HIGH FREQUENCY OF DETECTION OF PPD-SPECIFIC CD4+ LYMPHOCYTES IN BRONCHO-ALVEOLAR LAVAGE IN HIV POSITIVE AND NEGATIVE PATIENTS WITH ACTIVE TB
BHIVA Conf 2005 Apr 20-23;11:P95
RAM Breen, K Dheda, JP Dilworth, I Cropley, M Beckles, MA Johnson, G Janossy, MCI Lipman
A similar high frequency of CD4+ lung lymphocyte responses to PPD are demonstrated in HIV positive and negative subjects, even in the presence of marked CD4 lymphopenia. This lungorientated, rapid immunological technique may have diagnostic utility in all patients with TB.
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P96 HEPATITIS B VACCINE SERVICE: STAYING ON TOP OF THE AUDIT CYCLE
BHIVA Conf 2005 Apr 20-23;11:P96
AS Menon-Johansson, K Coyne, A Rajkumar, P Randell, A McOwan
Clear audit recommendations to modernizing service delivery have improved vaccine uptake over three audit cycles. Introducing POCT could capture those patients who currently defer vaccine until their serology result is known.
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P97 DOES HEPATITIS B ULTRA-RAPID VACCINATION WORK IN HIVPOSITIVE PEOPLE? A COMPARATIVE STUDY OF HIV-POSITIVE AND HIV-NEGATIVE VACCINE RECIPIENTS
BHIVA Conf 2005 Apr 20-23;11:P97
L Rubinstein, G King, MG Brook
Ultra-rapid vaccination of HIV+ people seems to be as effective as longer schedules in terms of early antibody response.
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P98 COMPARISON OF TWO ACCELERATED HEPATITIS B VACCINATION SCHEDULES – COMPLETION AND IMMUNE RESPONSE
BHIVA Conf 2005 Apr 20-23;11:P98
RK Ellks, H Sugunendran
This study shows that the two schedules have no significant difference in completion rates, and no significant difference in attendance for antibody check. The anti-HBs response is significantly lower with the 0,7,21 vaccine. The widespread use of this schedule should now be reconsidered.
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P99 PREVALENCE OF HEPATITIS C IN URBAN SEXUALLY TRANSMITTED INFECTIONS (STI) CLINIC FOR MEN WHO HAVE SEX WITH MEN (MSM): IS SCREENING NECESSARY AND IS IT COST EFFECTIVE?
BHIVA Conf 2005 Apr 20-23;11:P99
G Courtney1, L Jones2, M Crean2, S Keating1
The prevalence of Hepatitis C in HIV negative MSM is low even in the context of a recent local syphilis epidemic and rising rate of HIV in this population. Generalised screening is not cost effective in this population however targeted testing in those with a sexual history identifying increased risk (IVDU/ partner IVDU) and in HIV+ cases remains important.
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P100 TREATMENT AND OUTCOMES OF HCV TREATMENT IN HIV-HCV CO-INFECTED PATIENTS 2001–2004
BHIVA Conf 2005 Apr 20-23;11:P100
J Lambourne, G Farrell, H McDermott, S Woods, C Bergin, F Mulcahy
SVR rates compare favourably to mono-infected data. Increased awareness of HCV treatment toxicities, use of supportive growth factors to enable use of full dose HCV therapies and knowledge of HAART interactions enable favourable therapeutic outcomes.
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P101 TREATMENT OUTCOMES OF HEPATITIS C INTERVENTION WITH PEGYLATED INTERFERON AND RIBAVIRIN IN HEPATITIS C/HIV CO-INFECTED HAEMOPHILIACS
BHIVA Conf 2005 Apr 20-23;11:P101
J Kieran, J Lambourne, G Farrell, S Chew, C Bergin, F Mulcahy, B White, B Nolan
Pegylated interferon and ribavirin is an effective and well tolerated treatment in co-infected haemophiliacs.
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P102 USE OF PEGYLATED INTERFERON-ALPHA (PEG-IFN) WITH OR WITHOUT RIBAVIRIN IN THE TREATMENT OF ACUTE HCV IN HIV-POSITIVE INDIVIDUALS
BHIVA Conf 2005 Apr 20-23;11:P102
M Danta1*, JM Turner2*, R Johnstone2, RM Lascar2,3, MA Johnson4 GM Dusheiko1, IG Williams2,3, RJC Gilson2,3, S Bhagani4
The optimal treatment schedule for acute HCV in HIV co-infection is not known but our experience suggests that peg-IFN alone has poor efficacy.
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P103 HCV-SPECIFIC T-CELL RESPONSES OF ACUTELY HCV INFECTED INDIVIDUALS WITH AND WITHOUT HIV
BHIVA Conf 2005 Apr 20-23;11:P103
M Danta1*, N Semmo3*, J Northfield3, D Brown1, G Dusheiko1, P Fabris4, S Bhagani2, P Klenerman3
Failure of early immunological control of HCV in HIV-positive individuals is supported by the lack of breadth of the CD4 responses to the non-structural proteins and late elevation of cytokines.
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P104 HEPATITIS C (HCV) SCREENING: WHAT SHOULD GENITOURINARY MEDICINE BE DOING?
BHIVA Conf 2005 Apr 20-23;11:P104
PM Williams, A Edwards
Using our modified guidelines we would not miss cases of HCV and we reduced unnecessary requests by 50%.
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P105 HIV-ASSOCIATED T-CELL NON-HODGKIN LYMPHOMA
BHIVA Conf 2005 Apr 20-23;11:P105
T Powles, T Dhillon, AM Young, C Thirlwell, T Newsom-Davis, M Nelson, B Gazzard, M Bower
There were no differences in immunological parameters or survival duration between patients with T-NHL and B-NHL. We suggest that aggressive T-NHL could be included as an AIDS defining malignancy along with high grade B-NHL.
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P106 HODGKIN’S DISEASE IN THE ERA OF HAART – SINGLE INSTITUTION EXPERIENCE
BHIVA Conf 2005 Apr 20-23;11:P106
T Powles, C Thirlwell, AM Young, T Newsom-Davis, T Dhillon, S Holmes, P Nelson, B Gazzard, M Bower
Even in the HAART era, patients with HD present with advanced stage disease, however the survival for these patients is improving with aggressive therapeutic strategies.
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P107 PULMONARY KAPOSI SARCOMA IN ERA OF HAART
BHIVA Conf 2005 Apr 20-23;11:P107
T Newsom-Davis, T Dhillon, AM Young, T Powles, C Thirlwell, M Nelson, M Bower
The median survival for pKS is 1.6 years in this cohort which compares favourably with quoted rates of 3–10 months from the pre-HAART era. However, the prognosis of pKS remains poor and is significantly worse than for KS without lung involvement.
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P108 NO CARDIOTOXICITY OBSERVED WITH LIPOSOMAL ANTHRACYCLINES FOR KAPOSI SARCOMA
BHIVA Conf 2005 Apr 20-23;11:P108
T Dhillon, AM Young, C Thirlwell, T Newsom-Davis, R Jones, MR Nelson, BG Gazzard, M Bower
We have observed no clinically significant episodes of cardiotoxicity amongst this cohort of patients despite high cumulative dosages of liposomal anthracyclines.
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P109 CLINICOPATHOLOGICAL FEATURES OF 12 CASES OF HIV-ASSOCIATED MULTICENTRIC CASTLEMAN'S DISEASE
BHIVA Conf 2005 Apr 20-23;11:P109
H Dharmana, A Roy, AM Young, S Cox, M Nelson, BG Gazzard, M Bower
The rather non-specific clinicopathological features at presentation may account for the prolonged duration of symptoms prior to diagnosis of MCD.
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P110 UNDER-REPORTING OF TUBERCULOSIS AMONG HIV-INFECTED INDIVIDUALS DIAGNOSED IN THE UK
BHIVA Conf 2005 Apr 20-23;11:P110
V Delpech1, J Forde1, M Lipman2, D Antoine3, B Evans1
TB is now a leading cause of HIV related morbidity in the UK. High co-infections among black-African individuals reflect the high prevalence of HIV and TB in their country of origin. Although estimates are subject to matching limitations, the high proportion of under-reporting of tuberculosis among HIV individuals is concerning and warrants further investigation.
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P111 HIV/TUBERCULOSIS CO-INFECTION RECEIVING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY
BHIVA Conf 2005 Apr 20-23;11:P111
RAM Breen1, RF Miller2, T Gorsuch3, A Schwenk3, J Ballinger1, L Swaden1, CJ Smith2, MA Johnson1, MCI Lipman1
Good virological responses are seen in the majority of our cohort, demonstrating that anti-tuberculosis and anti-retroviral therapy can be successfully combined.
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P112 INTRAVENOUS PENTAMIDINE IS INFERIOR TO TRIMETHOPRIMSULPHAMETHOXAZOLE FOR TREATMENT OF PNEUMOCYSTIS JIROVECII PNEUMONIA (PCP)
BHIVA Conf 2005 Apr 20-23;11:P112
J Helweg-Larsen, T Benfield, C Atzori, RF Miller
Compared to TMP-SMX treatment of PCP with IV PENT has a 3.2-fold risk of death at 3 months, which is due to its inferior efficacy as first and second-line therapy.
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P112a SIMULTANEOUS PULMONARY AND EXTRAPULMONARY INFECTION WITH MULTIPLE STRAINS OF MYCOBACTERIUM TUBERCULOSIS IN AN IMMUNOCOMPROMISED PATIENT: A CASE REPORT
BHIVA Conf 2005 Apr 20-23;11:P112a
J Lambourne1, N Gibbons2, J Keane3, C Bergin1
Cases of mixed infection are increasingly recognised and it appears that co-infecting strains of MTB are not necessarily equally distributed between pulmonary and extra-pulmonary sites. This highlights the importance of culture and sensitivity testing and isolate identification of all samples obtained from distinct sites in patients with MTB infection.
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P112b A CASE OF PROLONGED IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME
BHIVA Conf 2005 Apr 20-23;11:P112b
EJ Morris, EF Monteiro
IRIS can be prolonged and difficult to manage. Montelukast may have a role in its management.
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P112c CONTACT TRACING BY HIV GENOTYPIC RESISTANCE TEST RESULTS
BHIVA Conf 2005 Apr 20-23;11:P112c
C Kamutasa, OE Williams, S McAndrew, H Bailey
Genotypic resistance test results enabled accurate contact tracing in a seemingly unrelated cluster.
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P112d CASE REPORT: HIV AND SERONEGATIVE ARTHROPATHY AND ROLE OF METHOTREXATE
BHIVA Conf 2005 Apr 20-23;11:P112d
RAM Varma, M Nathan
The effects of steroid use in patients with HIV is established as a risk for the development of opportunistic infection and KS. The effects of methotrexate are not as clear and there is very little literature of the interaction between HIV and AS.
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P112e A CASE OF OPTIC PERINEURITIS
BHIVA Conf 2005 Apr 20-23;11:P112e
A Checkley, P Hay
Syphilitic optic perineuritis is characterised by optic disc oedema with normal visual acuity, pupillary responses and intracranial pressures, and normal visual fields except for an enlarged blind spot. It is a rare manifestation of neurosyphilis, thought to represent an extension of basal meningeal inflammation to the optic nerve sheaths. It is differentiated from papilloedema by a normal CSF opening pressure, and from papillitis by normal visual acuity and pupillary responses. It has also been described in meningococcal meningitis, viral meningoencephalitis, rickettsial infections and sarcoidosis.
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P113 EXPEDITED PARTNER THERAPY (EXPT): IS IT FEASIBLE AND ACCEPTABLE TO SEXUAL HEALTH CLINIC ATTENDERS IN THE UK?
BHIVA Conf 2005 Apr 20-23;11:P113
L Sutcliffe1, J Cassell1, C S Estcourt1,2, JL Chapman2, G Brook3
Many sexual health services are unable to meet current targets for partner notification for acute STIs. We believe that innovative models of partner management including patient delivered therapy, using modern communication technology, should be evaluated. We present detailed patient consultation data addressing feasibility and acceptability of expedited partner therapy in a high risk population.
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P113A WHAT POTENTIAL DO PATIENTS PRESENTING TO PRIMARY CARE HOLD FOR EFFECTIVE STI CONTROL INTERVENTIONS?
BHIVA Conf 2005 Apr 20-23;11:P113A
JA Cassell, L Sutcliffe, C H Mercer, MG Brook, E Jungmann, J Ross, GR Kinghorn, J Stephenson, A M Johnson on behalf of the PATSI collaboration.
Patients with high risk sexual behaviour often refer themselves to primary care, rather than to specialist sexual health services. Expedited treatment is required for such patients, since attendance at primary care delays definitive treatment, and some patients may fall ‘through the net’ between services.
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P114 YEAH BUT, NO BUT, YEAH BUT ... WHAT INFORMATION ARE YOUNG BRITONS GETTING ABOUT SEXUAL HEALTH?
BHIVA Conf 2005 Apr 20-23;11:P114
V Lee, K Walsh, E Foley
Although information about sexual health is common in young womens' magazines, there is far less information about STI’s. With the increasing awareness for asymptomatic screening magazines may provide a good vehicle in which to disseminate more information about STI’s.
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P115 DESIGNED BY YOUNG PEOPLE FOR YOUNG PEOPLE: DESCRIPTION AND REVIEW OF A SPECIALIST SEXUAL HEALTH CLINIC IN HAMMERSMITH AND FULHAM
BHIVA Conf 2005 Apr 20-23;11:P115
CE Cohen, NA Smith, S Bennett, J Marshall, S Mandalia, KA McLean
This open-access clinic, operating after school hours, with different registration facilities in a separate clinic area, has found high rates of STIs and teenage pregnancy. The increasing numbers of yearly attendances, testifies to the success of our approach and necessity to expand this service.
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P116 A REVIEW OF A NURSE-LED SEXUALLY TRANSMITTED INFECTION SCREENING SERVICE, INCLUDING LABORATORY PROVISION, IN A YOUNG PERSON'S CLINIC AFTER 9 MONTHS
BHIVA Conf 2005 Apr 20-23;11:P116
K Jones, B Beeching, C Jones, M Devine, J Davies, P Roberts, C Bates
A nurse led STI screening service, including laboratory provision, in a community setting is acceptable to clients. More than 96% of clients seen were managed within the service. Evidence of infection was found in 444 (62.1%); achieved rates of HIV tests offered and contacts traced fell within national targets (DH 2002, SSHA 2004).
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P117 A DESCRIPTION OF THE SEXUAL RISK BEHAVIOURS OF COLLEGE STUDENTS WHEN THEY TRAVEL ABROAD
BHIVA Conf 2005 Apr 20-23;11:P117
R Buckley, F Mulcahy
Many perceive their risk as lower than their behaviour suggests. Addressing this behaviour requires a health promotion campaign challenging how holidays are promoted and addressing the influence of alcohol and drugs on sexual health and correct use of condoms.
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P118 SEX WORK PRACTICES AND CONDOM USE IN FEMALE SEX WORKERS IN SYDNEY
BHIVA Conf 2005 Apr 20-23;11:P118
J Fox1, RL Tideman1, S Gilmore1, C Marks1, I van Beek2, A Mindel1
International SWs used condoms less consistently than Local SWs. Speaking Thai or Chinese and previous sex work in Thailand were the only independent variables showing an association with inconsistent condom use. Condom use with non-paying partners was poor.
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P119 HETEROSEXUAL MEN AND WOMEN ARE LESS LIKELY TO USE THE INTERNET TO LOOK FOR SEX THAN GAY MEN
BHIVA Conf 2005 Apr 20-23;11:P119
J Elford1, G Bolding1, M Davis1, L Sherr2, G Hart3
While heterosexual men and women are less likely to use the Internet to look for sexual partners than gay men, those who do so may be at elevated risk for STI.
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P120 IS ADVICE ON CONDOM USE FROM HIV CLINIC STAFF ASSOCIATED WITH SEXUAL RISK BEHAVIOUR AMONG HIV-POSITIVE GAY MEN?
BHIVA Conf 2005 Apr 20-23;11:P120
G Bolding1, M Davis1, LL Sherr2, G Hart3, J Elford1
Two-thirds of respondents had been advised by HIV clinic staff to use condoms in specific situations but there was no association between receiving this advice and their sexual behaviour.
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P121 IS ADVICE ON CONDOM USE FROM HIV CLINIC STAFF ASSOCIATED WITH SEXUAL RISK BEHAVIOUR AMONG HIV-POSITIVE GAY MEN?
BHIVA Conf 2005 Apr 20-23;11:P121
G Bolding1, M Davis1, LL Sherr2, G Hart3, J Elford1
Two-thirds of respondents had been advised by HIV clinic staff to use condoms in specific situations but there was no association between receiving this advice and their sexual behaviour.
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P122 SURVEILLANCE DATA ON HIV AND OTHER SEXUALLY TRANSMITTED INFECTIONS (STIS) IN THE UK IN 2003: CAN WE REACH TARGETS SET IN THE NATIONAL STRATEGY FOR SEXUAL HEALTH AND HIV?
BHIVA Conf 2005 Apr 20-23;11:P122
V Delpech, K Sinka, C Lowndes, J Parry, B Evans, N Gill on behalf of the HIV/STI Department
Current national surveillance data on the intersecting epidemics of HIV and other STIs in the UK will be presented within the context of targets of Sexual Health Strategy to reduce the undiagnosed prevalence and transmission of STIs and HIV.
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P123 IS THERE A HETEROSEXUAL EPIDEMIC OF HIV IN THE UK?
BHIVA Conf 2005 Apr 20-23;11:P123
PJ White, GP Garnett
The evidence does not indicate a heterosexual HIV epidemic currently occurring in the UK. However, transmission rates are increasing and there is no room for complacency.
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P124 THE USE OF GEOGRAPHICAL INFORMATION SOFTWARE (GIS) IN SEXUALLY TRANSMITTED INFECTIONS MAPPING
BHIVA Conf 2005 Apr 20-23;11:P124
R Arms, A Wright, MR Pakianathan
GIS is a useful in mapping access patterns of populations to GUM services. It may also have a role in identifying ‘hotspots’ of disease, thus assisting in targeted disease control initiatives. GIS maps will be presented at the meeting.
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P125 STISS: DEVELOPING A NATIONAL WEB-BASED STI CODING SYSTEM IN SCOTLAND
BHIVA Conf 2005 Apr 20-23;11:P125
AJ Winter1, C Thompson2 on behalf of the STISS steering group
The new STISS system has greatly improved data collection and quality and allows timeous reporting of STI trends and positivity rates.
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P126 FOLLOW-UP TO ESTABLISH THE PROBABLE ROUTE OF INFECTION FOR INDIVIDUALS DIAGNOSED WITH HIV BETWEEN 1997 AND 2003 IN ENGLAND, WALES AND N IRELAND
BHIVA Conf 2005 Apr 20-23;11:P126
VL Gilbart, KJ Sinka, RD Smith, S Dougan, BG Evans
Detailed follow-up provides a more complete understanding of the changing epidemic in the UK, information fundamental to the appropriate targeting of prevention efforts.
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P127 LATE PRESENTATION OF HIV INFECTION - MORE EVIDENCE OF HEALTH INEQUALITIES?
BHIVA Conf 2005 Apr 20-23;11:P127
S Kegg, S Mitchell, J Russell
Black African men remain a difficult to reach group for early elective HIV testing. The impression that seeking HIV care drives migration from high prevalence/resource-poor countries would appear to be a largely false one.
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P128
BHIVA Conf 2005 Apr 20-23;11:P128
Abstract: Withdrawn as requested
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P129 PATIENT PREFERENCES FOR PARTNER NOTIFICATION
BHIVA Conf 2005 Apr 20-23;11:P129
A Apoola1, KW Radcliffe2, S Das3, V Robshaw1, G Gilleran2, M Kumari3, M Boothby2, R Rajakumar1
Provider referral is less acceptable to patients than patient referral for partner notification*. Notifying contacts through a letter seems to be more acceptable than phoning, text messaging or email**.
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P130 WHO FAILS TO ATTEND FOLLOWING CONTACT TRACING?
BHIVA Conf 2005 Apr 20-23;11:P130
R Finch1, G Bell2, KE Rogstad2
Poorer outcomes for provider referral are strongly associated with non-white ethnicity, and young age is almost statistically significant; there is a trend for association with male gender and poverty. This gives a useful insight into which populations find access to sexual health services most difficult, and where other control strategies (e.g. screening programmes) may be targeted most effectively.
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P131 STAKEHOLDER PERSPECTIVES ON DELIVERING SEX AND RELATIONSHIPS EDUCATION (SRE) IN TOWER HAMLETS
BHIVA Conf 2005 Apr 20-23;11:P131
T Fernandez, J Chapman, C Estcourt
Data highlights that consumer involvement is crucial for organisational and personnel development of delivery plans for SRE.
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P132 ONE-STOP SHOP VERSUS COLLABORATIVE INTEGRATION: WHAT IS THE WAY FORWARD?
BHIVA Conf 2005 Apr 20-23;11:P132
RS French1, C Fenton1, M Gerressu1, A Graham2, D Gray2, C Salisbury2, J Coast2, S Hollinghurst2, A Robinson1, K Miles1, CH Mercer1, K Rogstad3, J Stephenson1
Despite a policy commitment to developing OSS services, the evidence gap around the impact and appropriateness of this approach is substantial.
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P133 PSYCHOLOGICAL AND PSYCHOSEXUAL IMPACT OF HIV INFECTION IN AN OLDER POPULATION
BHIVA Conf 2005 Apr 20-23;11:P133
S Delamere, F Mulcahy, S Clarke
This study demonstrates a significant morbidity associated with the aging HIV population.
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P134 DID THE ‘BRAZILIAN’ KILL THE PUBIC LOUSE?
BHIVA Conf 2005 Apr 20-23;11:P134
NR Armstrong, JD Wilson
Sexual behaviour changes cannot account for this discordant pattern of STIs so there must be another explanation. The drop in pubic lice in women was around 2000 and coincided with the introduction of new trends in pubic hair removal. Full breakdown of the figures will be presented and correlated with pubic hair removal practices.
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P135 CHARACTERISTICS OF PATIENTS DECLINING AN HIV TEST IN A GENITOURINARY MEDICINE CLINIC
BHIVA Conf 2005 Apr 20-23;11:P135
J Zhou1, R Webb2, S Ghosh1 ST Sadiq2, MR Pakianathan1
A routine testing policy for HIV within GUM clinics does not guarantee universal uptake. While patients perceived to be at risk are more likely to test, a significant proportion of patients with risk factors continue to decline testing. Further detailed analysis will be presented at the meeting.
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P136 DO DIFFERENCES IN ACCESS TO GUM CLINICS OR HIV TESTING BEHAVIOUR OF AFRICAN MEN AND WOMEN ACCOUNT FOR THE HIGH PROPORTION OF WOMEN TESTING HIV-POSITIVE IN THE UK?
BHIVA Conf 2005 Apr 20-23;11:P136
K Bond, I Begum, EF Fox
Women and men were equally likely to be offered and accept an HIV test in our clinic. More men than women attended. This study did not demonstrate that greater testing of women than men in GUM accounts for the high proportion of new infections in women.
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P137 KNOW4SURE – A COMMUNITY-BASED RAPID HIV POINT OF CARE TEST (POCT) CLINIC
BHIVA Conf 2005 Apr 20-23;11:P137
R Mugezi1, A Barrat1, A Wilkinson3 A Waters1, A McOwan2, AK Sullivan1
A large proportion of individuals testing were at low risk for HIV, reflected in the relatively low diagnosis rate. Current interventions are underway to increase the attendance of individuals at higher risk. Rapid testing and 'out of hours' services are preferred.
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P138 ACCEPTABILITY OF VOLUNTARY HIV TESTING AMONG NHS STAFF: RESULTS FROM A QUESTIONNAIRE-BASED SURVEY
BHIVA Conf 2005 Apr 20-23;11:P138
M Hamill1,2, S Murphy2
Of the first 69 respondents: 75.4% were female, 23.3% male, 1.4% no data available (NDA). Ethnicity: 11.6% black British, 30.4% white British, 8.7% Asian British, 5.8% Caribbean, 11.6% African, 11.6% Asian, 2.9% black other, 13% white other and 4.3% NDA. 38% were nurses, 19% doctors, 16% clerical/administrative, 7% healthcare assistants, 20% other. 92.4% understood the terms HIV/AIDS, NDA 5.8%. 39% had a previous HIV test. None were known HIV positive. 42% worked in areas offering routine HIV testing, 55% did not, NDA 3%. 62% would consider having an HIV test, 38% would not.
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P139 EFFECTS OF RESTRICTIONS TO HIV-POSITIVE PEOPLE TRAVELLING TO THE USA
BHIVA Conf 2005 Apr 20-23;11:P139
M Mahto, E Wilkins
The majority of HIV patients travel without the waïve visa, many with insufficient planning and advice; in nearly 10% of patients, this led to discontinuation of therapy without medical advice.
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P140 WHAT IMPACT CAN AN HIV CONFERENCE HAVE ON THE LIVES OF PEOPLE LIVING WITH HIV?
BHIVA Conf 2005 Apr 20-23;11:P140
B Evans
Changing Tomorrow had a significant impact on the lives of participants living with HIV.
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P141 NON DISCLOSURE OF HIV-POSITIVE STATUS
BHIVA Conf 2005 Apr 20-23;11:P141
N NÌ Rathaille, S Flynn, J Herbst, O Halvey, E O'Donoghue, F Mulcahy
This research revealed a complex and broad range of difficulties around the issue of disclosure. This may necessitate a considered, individualised approach when working on disclosure issues and the need for further research.
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P142 HIV OPT-OUT INCREASES THE OFFER AND UPTAKE OF HIV TESTS IN PATIENTS AT LOW RISK FOR HIV (LRP) IN A GENITOURINARY MEDICINE (GUM) CLINIC
BHIVA Conf 2005 Apr 20-23;11:P142
H Price, I Thompson, J Birchall, C Newey, E Musgrave, F Smith, AM Waters, AK Sullivan
The introduction of HIV opt-out for low HIV risk patients increased the number of HIV tests offered and performed. The increase in LRP uptake appears to be due to increased offer rather than increased proportion accepting the offer, suggesting this was not influenced by a change in staff input beyond the opt out process.
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P143 HIV TESTING AND THE SEXUAL HEALTH STRATEGY: ARE WE ‘TARGETING’ THE RIGHT PEOPLE?
BHIVA Conf 2005 Apr 20-23;11:P143
I Reeves, M Poulton, M Tenant-Flowers
National strategy targets for HIV testing can be achieved but do not necessarily result in uptake of testing amongst those at high risk. Further work is needed to identify ways to increase uptake in certain groups. Sensitive, non-invasive testing may offer a solution.
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P144 BRIDGING THE GAP – REDUCING UNDIAGNOSED HIV INFECTION THROUGH TARGETED TRAINING IN NON-SPECIALIST SETTINGS
BHIVA Conf 2005 Apr 20-23;11:P144
J Roberts, M Ottewill, G Dean, DR Churchill, M Fisher
A focused course improves confidence in HIV testing and targeted referral to GUM. It has minimal effect on testing frequency but may assist in identifying a small number of infections.
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P145 SUCCESSFUL IMPLEMENTATION OF A NEW HIV TESTING SERVICE IN AN INNER-CITY PRIMARY CARE PRACTICE
BHIVA Conf 2005 Apr 20-23;11:P145
R Bickersteth1, A Benhene Poku2, SGG Sekweyama2, B Bailey1, EF Fox1
It is possible to set up an HIV testing service in collaboration with primary care colleagues, which successfully targets at-risk individuals who have not previously tested for HIV. Given the high DNA rate for results, alternative methods of informing patients of their results should be considered.
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P146 UPTAKE OF HIV TEST IS ENHANCED BY A SPECIAL POST-CARNIVAL 'KNOW4SURE' CLINIC OFFERING RAPID HIV POINT OF CARE TESTING (POCT)
BHIVA Conf 2005 Apr 20-23;11:P146
R Mugezi1, A Wilkinson3, U Kalidini2, R Betourney1, A Waters1, J Anderson2, AK Sullivan1
Promotion of an event specific clinic increased the proportion of individuals from a target population attending. The availability of rapid HIV POCT appears to influence testing behaviour.
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P147 UNUSUAL MODE OF TRANSMISSION OF HIV
BHIVA Conf 2005 Apr 20-23;11:P147
C Emerson, C Cunningham, SP Quah
We present this subject to highlight the importance of careful history taking. Exposure risk data is extremely useful in helping counsel patients prior to HIV testing but as this case illustrates must not be used in a rigid way.
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P148 NON-DISCLOSURE OF PREVIOUSLY KNOWN HIV SEROPOSITIVITY IN PATIENTS NEWLY DIAGNOSED WITH HIV INFECTION
BHIVA Conf 2005 Apr 20-23;11:P148
M Natha1, A Newell1, M Pakianathan1,2 South West London HIV and GUM Clinical Services Network
The supposition that patients with low viral loads may have a non-B clade viral subtype may not always be accurate. Therapeutic drug monitoring and genotypic resistance testing can also be useful. Three out of our five cases had extensive multi-class resistance. In all cases, disclosure occurred after multiple clinic attendances. Clinicians should consider the possibility of HIV status non-disclosure and previous exposure to antiretrovirals when seeing newly diagnosed patients with HIV.
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P149 THE COMPLEXITY OF TRAVELLING WITH HAART
BHIVA Conf 2005 Apr 20-23;11:P149
MA Schuhwerk1, J Richens2, H Wyss1, L Kirkpatrick1, C Ashton1, RH Behrens3
Travelling on HAART has many complex issues and needs appropriate discussion with the HIV positive individual.
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P150 HOW ACCURATELY DO PATIENTS WITH HIV KNOW THEIR VIRAL LOAD AND CD4 CELL COUNT?
BHIVA Conf 2005 Apr 20-23;11:P150
G Bolding1, M Davis1, L Sherr2, G Hart3, J Elford1
Most HIV positive gay men correctly reported whether their viral load was detectable or not and half knew their CD4 cell count to within 50 cells/mm3.
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P151 DIAGNOSTIC VALUE OF BONE MARROW (BM) SAMPLING IN HIV-INFECTED PATIENTS IN THE ERA OF HAART
BHIVA Conf 2005 Apr 20-23;11:P151
MJ Llewelyn, M Noursadeghi, A Dogan, SG Edwards, RF Miller
BM sampling continues to have a diagnostic utility in HIV infected patients in the era of HAART.
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P152 VITAMIN D DEFICIENCY IN HIV-SEROPOSITIVE INDIVIDUALS
BHIVA Conf 2005 Apr 20-23;11:P152
AJ Tunbridge, E Ronan, S Naylor, DH Dockrell, SC Metcalf
Mild vitamin D deficiency is common in HIV positive individuals and shows a weakly positive correlation with CD4 T-lymphocyte numbers.
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P153 HIV INFECTION AND SEXUALLY TRANSMITTED INFECTIONS AMONG PERSONS WITH INSECURE IMMIGRATION OR SEEKING ASYLUM IN THE UK
BHIVA Conf 2005 Apr 20-23;11:P153
V Lee1, E Foley1, R Patel1, JM Tobin2
A small proportion of the group were diagnosed HIV antibody positive, yet its prevalence (4%) is higher than that of the general population in the UK. A smaller number of STI’s were diagnosed yet in all cases these were asymptomatic. In view of this higher level of serious infection targeted screening services should be made available at an early stage to this group.
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P154 FIVE YEARS OF NON-OCCUPATIONAL POST-EXPOSURE PROPHYLAXIS (NONOPEP) IN A SOUTH LONDON TEACHING HOSPITAL
BHIVA Conf 2005 Apr 20-23;11:P154
S Day, A Mears, K Bond, R Kulasegaram
NONOPEP prescription has increased in the last six months possibly due to enhanced public awareness. NONOPEP is prescribed following predominantly ‘high-risk’ exposures with recommended combinations. Follow up attendance rates are poor.
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P155 IMPACT OF BASHH GUIDELINES UPON PEP PROVISION FOLLOWING SEXUAL EXPOSURE TO HIV
BHIVA Conf 2005 Apr 20-23;11:P155
A Beattie, S Roedling, SG Edwards, P Benn
The majority of PEP is issued within guidelines and since their introduction prescribing practice appears unchanged at MMC. Practice may be most influenced by these guidelines outside GUM settings or where prior demand has been low.
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P156 IMPACT OF RAISING AWARENESS OF POST EXPOSURE PROPHYLAXIS FOR HIV INFECTION FOLLOWING SEXUAL EXPOSURE
BHIVA Conf 2005 Apr 20-23;11:P156
S Roedling1, I Reeves2, A Beattie1, S Edwards1, A Copas1, M Fisher2, P Benn1
Post-campaign demand for PEP following sexual exposure has significantly increased. Time to initiation and completion rates remain unchanged.
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P157 STI SELF-TREATMENT, STI PROPHYLAXIS AND AUTO-PEP
BHIVA Conf 2005 Apr 20-23;11:P157
A Menon-Johansson
STI self-treatment and prophylaxis is reported by a significant proportion of clinic attendees. Further research, especially in the community, is required to determine the full extent and implications of this practice.
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P158 EXPERIENCE IN PROVIDING TECHNICAL ASSISTANCE TO THE ARV ROLL-OUT PROGRAM IN KWA-ZULU NATAL (KZN), SOUTH AFRICA: THE KINGS COLLEGE-NELSON MANDELA UNIVERSITY PARTNERSHIP
BHIVA Conf 2005 Apr 20-23;11:P158
S Barrett1, L Campbell2, C Ball1, R Pawinski3, K Moshal4, P Easterbrook1
The partnership has contributed to improvements in both clinical care and streamlining of clinic operational procedures at PSH. We plan to extend to additional sites in 2005.
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P159 WHY DO HIV-POSITIVE PATIENTS DROP OUT OF ARC ACCESS PROGRAMMES? EXPERIENCE FROM A NEWLY ESTABLISHED ARV CLINIC IN KWA-ZULU NATAL (KZN), SOUTH AFRICA
BHIVA Conf 2005 Apr 20-23;11:P159
S Barrett1, L Campbell2, R Pawinski3, T Welz1 P Easterbrook1
One-quarter of patients referred for treatment did not complete the prerequisite training and were therefore ineligible for ARVs. Young adults were least likely to drop out. Qualitative interviews are in progress to further explore reasons for drop-out. Preliminary data suggest travel distance and transport money as obstacles to attendance.
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P160 WHY ARE HIV-INFECTED CARE WORKERS RELUCTANT TO ATTEND AN ARV CLINIC? EXPERIENCE FROM THE PORT SHEPSTONE HOSPITAL ROLLOUT PROGRAMME IN KWA-ZULU NATAL, SOUTH AFRICA
BHIVA Conf 2005 Apr 20-23;11:P160
S Barrett1, L Campbell2, R Pawinski3, P Easterbrook1
Concerns about confidentiality remain a key barrier to improving HCW access to ARV therapy. Strategies in progress at PSH include a staff education programme on the benefits of ARVs and knowing your HIV status, and the establishment of an off-site clinic.
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P161 REACHING THE PARTS FREE ARVS DO NOT REACH: A SUSTAINABLE UK SPONSORSHIP PROGRAMME FOR STAFF WITH HIV IN A TANZANIAN HOSPITAL
BHIVA Conf 2005 Apr 20-23;11:P161
J Meadway, K Collins
A sustainable ARV programme has provided great benefit to hospital staff. Expertise in HIV management, monitoring, dispensing, and adherence support have been developed in readiness for an extensive programme when free ARVs become available.
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Printed Abstracts

PA1 CLINICAL NURSE SPECIALIST LED GUM SERVICE FOR HIV-POSITIVE MEN
BHIVA Conf 2005 Apr 20-23;11:PA1
Y Dass, C Bell, C Marfo, J Walsh
Safer sex was discussed with all men. Previous studies indicate HIV positive men prefer a GUM service within their HIV centre. This new service was introduced to reflect this finding. During this review the service was well utilised, the high rates of infection reflect a continuing need for this service.
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PA2 THE EPIDEMIOLOGY, CLINICAL FEATURES, AND DIAGNOSIS OF WOMEN WITH TRICHOMONIASIS IN A SOUTH LONDON SEXUAL HEALTH CLINIC: 2003–2004
BHIVA Conf 2005 Apr 20-23;11:PA2
M Natha1, J Watson1, C Fernandez2
The mean age of 28.8 years is lower than that quoted in other studies. Most patients were symptomatic at presentation. The rate of co-infection with chlamydia was high, we should consider giving empirical treatment for chlamydia in patients diagnosed with T. vaginalis infection. Routine test of cure could be stopped.
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PA3 REVIEW OF CASES REFERRED TO GENITOURINARY MEDICINE BY COMMUNITY PAEDIATRICS/FORENSIC MEDICAL EXAMINER
BHIVA Conf 2005 Apr 20-23;11:PA3
C Thompson
Awareness of STI risk in SCAN patients allows co-ordinated and comprehensive examination and appropriate screening.
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PA4 AUDIT OF CHILD PROTECTION ISSUES IN UNDER 15 YEAR OLDS ATTENDING A DEPARTMENT OF GENITOURINARY MEDICINE
BHIVA Conf 2005 Apr 20-23;11:PA4
C Thompson
No cases of un-addressed child protection concerns were identified in patients aged <15 years.
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PA5 KAPOSI’S SARCOMA PROGRESSING DURING PREGNANCY – LACK OF SUPPRESSION BY HCG
BHIVA Conf 2005 Apr 20-23;11:PA5
B Gazzard, C Thirlwell, L Waters, T Powles, M Nelson, M Bower
We report two cases of KS presenting and progressing during pregnancy when hCG levels are extremely high. This contradicts two previously reported cases where spontaneous remissions of KS during pregnancy where observed. Moreover this observation contradicts the laboratory findings of KS response to hCG.
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PA6 SWITCHING TO ONCE DAILY ANTIRETROVIRAL THERAPY
BHIVA Conf 2005 Apr 20-23;11:PA6
L McDonald, R Arjoonsingh, M Chikohora, MG Brook
A high proportion of patients who are suitable for o.d. therapy will decide to change if offered the choice.
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PA7 RECEPTION TRIAGE IN THE HIV EMERGENCY CLINIC
BHIVA Conf 2005 Apr 20-23;11:PA7
M Raychaudhuri, M Poulton, M Solmon
Reception triage has been helpful in improving the appropriate use of the HIV emergency service. Further work is planned to develop nurse triage and encourage increased use of GP services.
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PA8 HYPERTROPHIC HERPES SIMPLEX GENITALIS IN HIV-1 INFECTION
BHIVA Conf 2005 Apr 20-23;11:PA8
A Holmes, M McMenamin, C Bergin, F Mulcahy
Hypertrophic HSV is unusual, even in the setting of HIV [3/1200 in our cohort, all African], difficult to treat, and may predispose to dysplastic changes.
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PA9 ACCEPTABILITY OF THE ROLE OF ADVANCED NURSE PRACTITIONER (SEXUAL HEALTH): A COMPARISON STUDY WITH THE SENIOR HOUSE OFFICER (SHO) ON PATIENTS ATTENDING FOR SEXUAL HEALTH SCREENING IN THE GENITO-URINARY AND INFECTIOUS DISEASES CLINIC (GUIDE), ST JAMES HOSPITAL, DUBLIN
BHIVA Conf 2005 Apr 20-23;11:PA9
S Delamere, G Courtney, V Wong
In this sexual health clinic, the investigation has shown that patients are equally satisfied with the care provided by the ANP as they are with that offered by the SHO.
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PA10 A REVIEW OF SERVICE DELIVERY IN A COMMUNITY-BASED HIV SERVICE: 1989-2004
BHIVA Conf 2005 Apr 20-23;11:PA10
S Dawson, N Desmond, C Woods, C Cornish, B Brett, F Hawkins
This review shows that the vast majority of HIV care can be provided from such a community base should clinicians with the interest and skills wish to develop it.
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PA11 RECURRENT CRYPTOCOCCAL MENINGITIS IN A HIV POSITIVE MAN DESPITE HAART AND INDUCTION/MAINTENANCE THERAPY. CAN CD4 COUNTS MISLEAD?
BHIVA Conf 2005 Apr 20-23;11:PA11
C Cunningham, C Emerson, RD Maw
In July 2004 he presented with arm weakness, confusion and seizures. CD4 count 200 cells/mm3, Serum and CSF cryptococcal Ag positive, MRI Brain showed focal lesions. Therapy: I.V. Ambisome for 3 weeks (with marked clinical improvement). On discharge CSF Ag titre 1:2, culture negative and continued maintenance therapy of Fluconazole 400mg. He remains well with quarterly CSF surveillance. Interestingly viral loads were undetectable throughout.
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PA12 HIV-ASSOCIATED PULMONARY ARTERIAL HYPERTENSION (PAH)
BHIVA Conf 2005 Apr 20-23;11:PA12
C Cunningham, C Emerson, RD Maw
On repeat six-min walk testing at 2 months she covered 186m with no desaturation. Most recent Echo revealed a RVSP 61 mmHg, RVEDD 43 mm. This case illustrates that combination treatment with HAART and Bosentan may significantly improve functional and haemodynamic parameters in a disease previously considered to have a uniformly poor prognosis.
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PA13 DIAGNOSING HEPATITIS C (HCV): AN OPPORTUNITY LOST?
BHIVA Conf 2005 Apr 20-23;11:PA13
H Wankowska
In this clinic, no definite cases of HCV, would have been missed if tests were offered only to patients with ‘risk’ history. A patient's history is an excellent guide to risk of HCV.
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PA14 AUDIT OF VIROLOGICAL AND IMMUNOLOGICAL OUTCOME OF A PATIENT GROUP ON TREATMENT WITH TENOFOVIR (TDF) AND DIDANOSINE (ddI) PLUS EFAVIRENZ (EFV) OR NEVIRAPINE (NVP)
BHIVA Conf 2005 Apr 20-23;11:PA14
K Forbes, M Murphy, C Skinner, G Baily, Y Gilleece, C Orkin
3 individuals on ddI+ TDF + EFV/NVP-containing regimes experienced virological failure and the Δ CD4 was small.
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PA15 AUDIT OF SEXUALLY TRANSMITTED INFECTIONS (STI), HEPATITIS B (HBV) AND HEPATITIS C (HCV) MONITORING IN HIV POSITIVE PATIENTS
BHIVA Conf 2005 Apr 20-23;11:PA15
M Pammi, IH Ahmed, K Mian, A Ahmed
We are not achieving the standard for STI screening in sexually active HIV+ patients. In patients who were screened a significant proportion of STI were identified. Although majority were screened for HBV/HCV, a significant proportion of them were not appropriately vaccinated. STI screen must be offered at least once a year and HBV vaccination should be offered in those who are susceptible.
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