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11th Annual Conference of the British HIV Association20–23 April 2005, Burlington Hotel·Dublin·Ireland |
Cite as BHIVA Conf 2005 Apr 20-23;11:xxx
where "xxx" is the abstract number.
| Oral Abstracts |
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| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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). |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| Posters |
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| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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). |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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? |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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%. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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). |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| P128 | BHIVA Conf 2005 Apr 20-23;11:P128 Abstract: Withdrawn as requested |
| 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**. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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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| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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. |
| 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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