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12th Annual Conference of the British HIV Associations29 March–1 April 2006, Brighton, UK |
Cite as: HIV Med. 2006 7(Suppl 1):page number (abstract no. xx)
Example: HIV Med 2006 (Suppl 1):11 (abstract no. P1)
| Oral Presentations Abstracts O1 to O33, pages 1 through 9 |
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| O1 | ADULTS WITH LOW CD4 CELL COUNTS THAT WERE NOT RECEIVING ANTIRETROVIRAL THERAPY IN ENGLAND, WALES AND NORTHERN IRELAND IN 2004 HIV Med 2006 7(Supplement 1):1 (abstract no. O1) Victoria Bryant, Tim Chadborn, Bela Patel and Valerie Delpech One in five individuals with low CD4 cell counts were not on ART, of which relatively few were because they were recently diagnosed. Further work will be required to investigate regional and demographic differences in the proportion not on treatment and to consider reasons why people were not on ART according to BHIVA guidelines. |
| O2 | THE DEMOGRAPHIC, CLINICAL AND VIROLOGICAL CHARACTERISTICS OF PATIENTS NEWLY DIAGNOSED WITH NON-B HIV-1 SUBTYPES IN LONDON HIV Med 2006 7(Supplement 1):3 (abstract no. O2) Ana Garcia, Clare Booth, Gaia Nebbia, Anurhada Chawla and Anna Maria Geretti The genetic diversity of HIV-1 continues to increase in London. Although non-B subtypes are commonly associated with immigration from Africa or Asia, they are no longer restricted to non-indigenous populations. Transmitted drug resistance is nearly entirely confined to MSM with subtype B at the present time. |
| O3 | INCIDENT NON-B CLADE HIV-1 INFECTION IN WHITE GAY MEN INFECTED IN UK BETWEEN 2000 AND 2005 HIV Med 2006 7(Supplement 1):4 (abstract no. O3) Julie Fox, Simon Dustan, Steve Kaye, Myra McClure and Sarah Fidler We report five cases of non-B clade HIV-1 infection amongst white gay men recently infected with HIV-1 in London between 2000 and 2005. There is current sexual transmission of multiple subtypes and recombination among white homosexual men in London. |
| O4 | WHY ARE CHILDREN STILL BEING INFECTED WITH HIV? EXPERIENCES IN PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV IN A COMPLEX SOUTH LONDON UNIVERSITY HOSPITAL POPULATION HIV Med 2006 7(Supplement 1):1 (abstract no. O4) Candice McDonald, Jack Lambert, Tanya Welz, Daya Nayagam, Mary Poulton and Jan Welch The low transmission rate of 2% in the multicultural population served by this hospital attests to the efforts of a multidisciplinary care team dedicated to the care of this frequently hard-to-reach population. More importantly, in utero infection in these children may have been avoided by starting antiretroviral therapy at an earlier stage than is suggested by BHIVA guidelines. |
| O5 | DOES ZIDOVUDINE MONOTHERAPY (MZDV) IN PREGNANCY PREDISPOSE TO THE EMERGENCE OF RESISTANCE? HIV Med 2006 7(Supplement 1):2 (abstract no. O5) Phillip Read1, Sinead Costelloe2, Jane Mullen2, Siobhan O’Shea2, Fiona Lyons1, Phillip Hay3, Jan Welch4, Nick Larbalestier1, Graham Taylor5 and Annemiek de Ruiter1 Results to date from this cohort support the strategy of selective mZDV in preventing MTCT of HIV-1 without the development of significant resistance. |
| O6 | THE REPRODUCIBILITY AND CLINICAL SIGNIFICANCE OF HIV VIRAL-LOAD BLIPS IN PATIENTS ON STABLE FIRST-LINE HAART HIV Med 2006 7(Supplement 1):2 (abstract no. O6) Gaia Nebbia, Clare Booth, Colette Smith, Ana Garcia-Diaz, Andrew Phillips, Margaret Johnson and Anna Maria Geretti Blips occurred in 24% of patients on stable first-line HAART, but did not impact on long-term virological and CD4 responses. On repeat testing, 75% of blips showed detectable viraemia. Blips contained either wildtype or drug-resistant virus, but resistant mutants appeared to derive from previous drug failures. |
| O7 | SMART STRATEGIES FOR MANAGEMENT OF ANTIRETROVIRAL THERAPY HIV Med 2006 7(Supplement 1):2 (abstract no. O7) Adrian Palfreeman, Wafaa El-Sadr, Brian Gazzard, Jim Neaton, Fred Gordin and Abdel Babiker This effect was assessed across groups defined by nadir and baseline CD4 count; all favoured the VS arm. Following the release of these data, patients on the DC arm of SMART were asked to contact their physicians to discuss restarting ART. Follow-up of all patients in SMART continues. |
| O8 | OLDER AND WISER: CONTINUED IMPROVEMENTS IN CLINICAL OUTCOME AND HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) RESPONSE IN HIV-INFECTED CHILDREN IN THE UK AND IRELAND, 1996–2005 HIV Med 2006 7(Supplement 1):2 (abstract no. O8) Ali Judd1, Trinh Duong1, Sarah A Walker1, Pat Tookey2, Mike Sharland3, Andrew Riordan4, Hermione Lyall5, Janet Masters2, Esse Menson3, Gareth Tudor-Williams5, Karina Butler6, Sheila Donaghy3, Vas Novelli7, Catherine Peckham2 and Diana M Gibb1 Morbidity and mortality rates have continued to decline in HIV- infected children since the introduction of HAART in 1997. Short-term HAART response is improving but longer-term clinical management is complex. Provision of transitional services and continued monitoring will be essential as this treatment-experienced cohort progresses into adolescence and adulthood. *2005 data are underestimated due to reporting delay. |
| O9 | VIRAL REBOUND IN PATIENTS ON ANTIRETROVIRAL THERAPY WITH VIRAL SUPPRESSION: ASSOCIATION WITH EXTENT OF PREVIOUS VIROLOGICAL FAILURE AND TIME WITH VIRAL SUPPRESSION HIV Med 2006 7(Supplement 1):3 (abstract no. O9) Andrew A Benzie1, Loveleen K Bansi2, Caroline A Sabin2, John Walsh1 and Andrew N Phillips2 on behalf of the UK CHIC Study The rate of viral rebound diminishes markedly with increasing time with viral suppression, especially in those who have failed previous regimens. |
| O10 | PHARMACOKINETICS (PK) AND ANTIRETROVIRAL (ARV) RESPONSE TO TMC114/R AND TMC125 COMBINATION IN PATIENTS WITH HIGH-LEVEL VIRAL RESISTANCE HIV Med 2006 7(Supplement 1):3 (abstract no. O10) Akil Jackson1, Marta Boffito1, Alan Winston1, Carl Fletcher1, Anton Pozniak1, Mark Nelson1, Graeme Moyle1, Desmond Maitland1, Izabela Tolowinska1, Richard Hoetelmans2, Diego Miralles2 and Brian Gazzard1 No clinically significant PK interaction between TMC114 and TMC125 was observed. The combination was well-tolerated and showed impressive short-term efficacy against three-class-resistant HIV. Studies of this combination are warranted. |
| O11 | A RANDOMISED IMMEDIATE VERSUS DELAYED REPLACEMENT STUDY OF TRIZIVIR AS A SUBSTITUTE FOR TWO NRTIS PLUS EFAVIRENZ IN PERSONS EXPERIENCING CNS SYMPTOMS HIV Med 2006 7(Supplement 1):3 (abstract no. O11) Graeme Moyle, Desmond Maitland, Jessica Osorio, Sundhiya Mandalia and Brian Gazzard Switching from 2NRTI + EFV to Trizivir is effective and well tolerated in initial therapy patients. HADS scores and some sleep characteristics improve gradually with switching. Total, LDL and HDL cholesterol levels decline following switching. |
| O12 | PHARMACOKINETIC INTERACTIONS BETWEEN RIFABUTIN AND LOPINAVIR/RITONAVIR IN HIV-INFECTED PATIENTS WITH MYCOBACTERIAL CO-INFECTION HIV Med 2006 7(Supplement 1):3 (abstract no. O12) Hasanin Khachi, David Ladenheim, Chloe Orkin, Nada Abdelmagid and Kate Scott Our data suggests current BHIVA and CDC guidelines result in sub-therapeutic rifabutin levels. In our study one in five patients clinically deteriorated. Further formal investigations are required to establish the clinical significance of this, and determine the optimum dosing regimes for Kaletra and rifabutin in co-infected patients. Further formal investigations are required to establish the clinical significance of this, and determine the pharmacokinetic impact of changing the rifabutin dose. |
| O13 | THE EPIDEMIOLOGY OF HIV-ASSOCIATED NEPHROPATHY (HIVAN): THE LONDON HIV-NEPHROPATHY STUDY COHORT HIV Med 2006 7(Supplement 1):4 (abstract no. O13) Frank Post1, Lucy Campbell1, Paul Donohoe1, Raj Thuraisingham2, Guy Baily2, Lisa Collins3, Anthi Balitsari3, Nick Larbalestier3, Rachel Hilton3, Derek Macallan4, Debu Banerjee4, Rachael Jones5, Brian Gazzard5, John Connolly6, Simon Edwards6, Sanjay Bhagani7, John Walsh1 and Philippa Easterbrook1 In this large black African/Caribbean HIVAN cohort, the use of HAART and sustained viral suppression was associated with an improved renal outcome. |
| O14 | HEPATITIS C VIRUS (HCV) CO-INFECTION IN HIV-INFECTED PATIENTS IN THE UK COLLABORATIVE HIV COHORT (CHIC) STUDY HIV Med 2006 7(Supplement 1):4 (abstract no. O14) Joanna Turner1, Loveleen Bansi2, Richard Gilson1 and Caroline Sabin2 As there has been a move towards testing all individuals for HCV, rather than only those felt to be at high risk, the proportion of patients testing positive for HCV antibody has decreased. Further analyses will determine the incidence of HCV infection and the impact of HCV–HIV co-infection on response to HAART. |
| O15 | THE EFFECT OF HEPATITIS C VIRUS (HCV) ON HIV PROGRESSION IN A LATE SALVAGE POPULATION: RESULTS FROM THE OPTIMA (OPTIONS IN MANAGEMENT WITH ANTIRETROVIRALS) STUDY HIV Med 2006 7(Supplement 1):4 (abstract no. O15) Fiona Ewings1, Brian Angus1, Sheldon Brown2, William Cameron3, Mark Holodniy4, Tassos Kyriakides5, Joel Singer6 and Abdel Babiker1 Co-infection with HCV appears to increase the risk of mortality, but this effect might be partly explained by a shorter time to switching/stopping ART. One possible reason may be that HCV+ patients are less able to tolerate ART. |
| O16 | A 48-WEEK-STUDY OF TENOFOVIR (TDF) OR LAMIVUDINE (3TC) OR A COMBINATION OF TDF AND 3TC FOR THE TREATMENT OF CHRONIC HEPATITIS B IN HIV/HEPATITIS B VIRUS (HBV) CO-INFECTED INDIVIDUALS HIV Med 2006 7(Supplement 1):4 (abstract no. O16) R Jones1, Mark Nelson1, Sanjay Bhagani2, Martin Fisher3, Clifford Leen4, Gary Brook5, Surdalia Mandalyia1, G Reilly6, D Pillay7 and G Mathews1 At 24 weeks in 3TC-naïve subjects, combination therapy with TDF was superior. There was no statistical difference between TDF alone and 3TC. In 3TC-experienced subjects, there was no benefit in continuing with 3TC alone; adding or switching to TDF was superior. This study supports current guidelines of combination therapy in 3TC-naïve subjects. 3TC-experienced subjects should add TDF or switch to TDF depending on 3TC activity against HIV. |
| O17 | A PROGNOSTIC INDEX FOR AIDS-ASSOCIATED KAPOSI SARCOMA IN THE ERA OF HAART HIV Med 2006 7(Supplement 1):5 (abstract no. O17) Justin Stebbing, Adam Sanitt, Danish Mazhar, Mark Nelson, Brian Gazzard and Mark Bower An accurate prognostic index can be obtained for individuals with AIDS-KS in the HAART era by combining age, S stage, KS as an ADI and CD4 count. This can be used to guide therapeutic options. |
| O18 | METABOLIC SYNDROME AND ITS ASSOCIATIONS IN HIV PATIENTS HIV Med 2006 7(Supplement 1):5 (abstract no. O18) Ali Elgalib1, George Panayotakopoulos2, Michael Aboud1, Elias Skopelitis2, Kathryn Ludgate1, Alice Sharpe2, Fiona Lampe3, Allaister Duncan1, Ranjibabu Kulasegaram1, Anthony Wierzbicki1 and Barry Peters2 The patients with MS tend to be male and of a higher age group. There seems to be no effect of stage of disease or, surprisingly, the type of HAART on the incidence of MS. Our data showed that prevalence of MS among HIV patients is less than what has been reported previously, but this might be partly because of an under-reporting bias which will be corrected as missing data are retrieved. |
| O19 | CLINICAL UTILITY OF HLA-B*5701 TESTING IN A UK CLINIC COHORT HIV Med 2006 7(Supplement 1):5 (abstract no. O19) Iain Reeves, Duncan Churchill and Martin Fisher This is one of the first studies to report on B*5701 carriage rate in a UK-based clinical cohort. Testing for B*5701 significantly reduced the frequency of HSR. Incorporating this strategy into routine clinical practice is likely to lead to significant improvements in patient safety and counter the long-term toxicity of HAART. |
| O20 | APPLICATION OF AN INTERFERON-GAMMA RELEASE ASSAY TO INVESTIGATE TRANSMISSION OF MYCOBACTERIUM TUBERCULOSIS TO HIV-INFECTED PEOPLE HIV Med 2006 7(Supplement 1):5 (abstract no. O20) Ila Aggarwal1, Graeme Meintjes1, John Walsh2, Annette Jepson2, Onn Min Kon2, Marcela Simsova3, Robert Wilkinson1 and Katalin Wilkinson1 IFN-γ production in response to CyaA-CFP10 correlates with the degree of exposure to M. tuberculosis in an HIV-infected cohort. |
| O21 | MARGINAL ZONE B CELLS ARE DEPLETED IN HIV-1 INFECTION AND ARE NOT RESTORED BY ANTIRETROVIRAL THERAPY HIV Med 2006 7(Supplement 1):6 (abstract no. O21) Melanie Hart1, Alan Steel2, Sally Clark2, Jamie Whitehorn3, Donald C Henderson1, Robert Wilson4, Frances Gotch2, Graham Moyle3, Brian Gazzard2 and Peter Kelleher2 Our data suggest a possible reason for the increased risk of invasive pneumococcal disease in HIV-1 infection. Further functional studies of immune responses to pneumococcal immunisation are in progress and will be reported. |
| O22 | NATURAL KILLER CELL NKG2A EXPRESSION IS UNAFFECTED BY SHORT-TERM INCREASES IN HIV-1 VIRAEMIA DURING TREATMENT INTERRUPTION HIV Med 2006 7(Supplement 1):6 (abstract no. O22) Christopher M Mela1, Catherine T Burton1, Nesrina Imami1, Mark Nelson2, Brian G Gazzard2, Frances M Gotch1 and Martin R Goodier1 Patients with long-standing viral suppression have a greater percentage of NKG2A-expressing NK cells than those with chronic viraemia. Reduced proportions of NKG2A+ NK cells are not determined by short-term changes in viraemia; in contrast, NKG2A+ T cells are more sensitive to virus. |
| O23 | SWITCH IN C-TYPE LECTIN RECEPTOR PHENOTYPE FROM NKG2A TO NKG2C IN HIV-1 INFECTION HIV Med 2006 7(Supplement 1):6 (abstract no. O023) Christopher M Mela1, Catherine T Burton1, Nesrina Imami1, Mark Bower2, Mark Nelson2, Alan Steel2, Brian G Gazzard2, Frances M Gotch1 and Martin R Goodier1 We demonstrate a dramatic switch from NKG2A (inhibitory) to functional NKG2C (activatory) receptor-expressing NK cells in HIV-1-infected individuals with concurrent redistribution of NCR and KIR. This emergence of NKG2C+ NK cells may have consequences for the recognition and survival of infected CD4+ T cells in HIV-1-positive individuals. |
| O24 | A POLYMORPHISM REDUCING RANTES EXPRESSION IS ASSOCIATED WITH PROTECTION FROM DEATH IN HIV-POSITIVE UGANDANS HIV Med 2006 7(Supplement 1):6 (abstract no. O24) Graham Cooke1, Kerrie Tosh1, Patricia Ramaley1, Pontiano Kaleebu2, Jessica Nakiyingi2, Christine Watera2, Charles Gilks3, Neil French4, James Whitworth1 and Adrian Hill1 This first report of a non-HLA genetic association with HIV-1/AIDS disease progression in an African population reveals a genetic effect different to that reported for African-Americans. The variant previously associated with disease progression is here associated with disease protection. These findings may impact therapeutic strategies targeting the RANTES pathway in HIV infection. |
| O25 | SEXUAL BEHAVIOUR AMONG HIV-POSITIVE BLACK CARIBBEANS IN SOUTH LONDON: THE LIVITY STUDY HIV Med 2006 7(Supplement 1):7 (abstract no. O25) Sarah Gerver1, Ijeoma Solarin1, Moji Anderson1, Gillian Elam2, Kevin Fenton2 and Philippa Easterbrook1 The LIVITY study is the first comprehensive study in HIV among BCs in south London. These findings highlight ongoing risk behaviour in a proportion of patients, in particular BC HM/BM, and an important overlap with the epidemic in the Caribbean. |
| O26 | KNOWLEDGE OF HIV POST-EXPOSURE PROPHYLAXIS IN HIV-POSITIVE AND HIV-NEGATIVE MEN IN AN URBAN CLINIC POPULATION HIV Med 2006 7(Supplement 1):7 (abstract no. O26) Shamela de Silva1, Rob Miller1 and John Walsh2 This study demonstrates that most men attending this centre are unaware of PEP as an intervention to reduce HIV transmission. This includes those at highest risk of acquiring HIV and HIV-positive men having UAI with multiple partners. |
| O27 | INTENTIONAL AND UNINTENTIONAL UAI AMONG GAY MEN WHO HIV TEST IN THE UK: QUALITATIVE RESULTS FROM AN INVESTIGATION INTO RISK FACTORS FOR SEROCONVERSION AMONG GAY MEN WHO HIV TEST (INSIGHT) HIV Med 2006 7(Supplement 1):7 (abstract no. O27) Gillian Elam1, Neil Macdonald1, Kevin Fenton1, Vicky Gilbart1, Ford Hickson2, John Imrie3, Christine McGarrigle1, Robert Power3 and Barry Evans1 Consistent condom use in casual and sero-discordant sexual encounters presents a challenge for some groups of men. Interventions are required that are responsive to these men’s circumstances and wider needs. |
| O28 | BARRIERS TO VOLUNTARY CONFIDENTIAL HIV TESTING AMONG AFRICAN MEN AND WOMEN IN ENGLAND: RESULTS FROM THE MAYISHA II COMMUNITY-BASED SURVEY OF SEXUAL ATTITUDES AND LIFESTYLES AMONG AFRICANS IN ENGLAND HIV Med 2006 7(Supplement 1):7 (abstract no. O28) Gillian Elam1, Katharine Sadler1, Christine McGarrigle1, John Parry1, Oliver Davidson2, Danielle Mercey3 and Kevin Fenton1 Findings from Mayisha II confirm that the impact of discrimination and stigma is widespread within the lives of Africans in the UK and contributes to decisions to HIV test. Outreach work is having an impact on the acceptability of VCT in the community, but more action is needed to reduce HIV-related stigma and discrimination. |
| O29 | COULD PRIMARY CARE BE DOING MORE? HIV Med 2006 7(Supplement 1):8 (abstract no. O29) Fiona Burns1, Anne Johnson1, James Nazroo2, Ibidun Fakoya1, Jane Anderson3, Munyaradzi Chikohora4, Simone Ghosh5, Andy Hughes6, Eva Jungmann7, Sarah Manney8, Nneka Nwokolo9, Nina Panahmand7, Michelle Slinn10, Richard Stack9, Ann K. Sullivan9, Cheryl Tawana11, Fiona Young12 and Kevin Fenton13 These preliminary data show that primary care services are well accessed by this population. The demography alone should alert clinicians to considering HIV irrespective of health status. However, for over 80% of respondents who attended their GP, the issue of HIV testing was not broached. Work with primary care services is required to understand and overcome the barriers to discussing HIV infection for this, and all, populations. |
| O30 | POINT-OF CARE TESTING FOR HIV ANTIBODY AS A NEW MODEL OF CARE HIV Med 2006 7(Supplement 1):8 (abstract no. O30) Anuradha Chawla, Gillian Clewley, Amanda Evans, Tom Fernandez, Chris Donnelly, Umeshan Nandakumar, Clare Booth, Margaret Johnson and Anna Maria Geretti Determine showed excellent agreement with the lab-based assay. With quality assurance in place, implementation is feasible in routine clinical settings. Caution is required in the interpretation of negative Determine results in patients with symptoms suggestive of acute seroconversion. |
| O31 | MISSED OPPORTUNITIES FOR DIAGNOSING ACUTE SEROCONVERSION ILLNESS HIV Med 2006 7(Supplement 1):8 (abstract no. O31) Darshan Sudarshi, David Pao, Gary Homer, Gillian Dean and Martin Fisher Even though the majority of patients with PHI had symptoms, a significant proportion did not access healthcare. Of those who presented to non-GUM specialities, the opportunity to identify ASI was often missed. In order to reduce onward transmission, the diagnosis of PHI needs to be improved by increasing awareness of ASI within both at-risk groups and primary healthcare providers. |
| O32 | MEETING THE NEEDS AND SERVICE DEVELOPMENT FOR THE LONGER TERM FOLLOW-UP OF YOUNG PEOPLE WITH PERINATALLY ACQUIRED HIV INFECTION HIV Med 2006 7(Supplement 1):8 (abstract no. O32) Caroline Foster1, Diane Melvin1, Hermione Lyall1 and Sarah Fidler2 A proportion of young people transitioning towards adult services are highly ART-experienced with significant neurodevelopmental concerns. A dedicated long-term follow-up clinic for adults with perinatally acquired HIV infection has been established to try to meet the needs of this complex cohort. |
| O33 | CAUSE AND TIME TO TREATMENT FAILURE OF HAART AND COST OF CARE IN UK NPMS-HHC CLINICS, 1996–2002 HIV Med 2006 7(Supplement 1):9 (abstract no. O33) Sundhiya Mandalia1, Ray Brettle2, Martin Fisher2, Mark Gompels2, George Kinghorn2, Brendan McCarran2, Anton Pozniak2, Alan Tang2, John Walsh2, Ian Williams2, Mike Youle1, Brian Gazzard1 and Eddy Beck1 Median time to treatment failure for people on second-or third- line HAART was less than that of first-line, but time to treatment failure has improved dramatically over time. Around 50% of people failed because of reasons other than virological failure, immunological failure or clinical progression, and are most likely related to the occurrence of adverse events. Average hospital costs for those on first-line therapy were greater compared with second-or third-line therapy, reflecting shorter duration for onset of treatment failure for second-and third-line therapy. |
| Poster Presentations Abstracts P1 to P108, pages 11 through 38 |
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| P1 | RELATIVE ANTIVIRAL EFFICACY OF TMC-114/R AND TIPRANAVIR/R VERSUS CONTROL PI IN THE POWER AND RESIST TRIALS HIV Med 2006 7(Supplement 1):11 (abstract no. P1) Andrew Hill1 and Graeme Moyle2 Given the caveats of cross-study analysis, the efficacy benefits of TMC-114/r versus CPI in the POWER trials appear to be greater than the benefits of TPV/r versus CPI in the RESIST trials for HIV RNA suppression and CD4 rises. |
| P2 | 48-WEEK DURABLE EFFICACY AND SAFETY RESULTS OF TMC-125 IN HIV PATIENTS WITH NNRTI AND PI RESISTANCE: STUDY TMC-125-C223 HIV Med 2006 7(Supplement 1):11 (abstract no. P2) Cal Cohen1, Corklin Steinhart2, Doug Ward3, Peter Ruane4, Monika Peeters5 and Brian Woodfall5 In this study, TMC-125 showed high rates of sustained efficacy in heavily pre-treated patients with substantial NNRTI and PI resistance. These data are the first to show durable efficacy at 48 weeks with an NNRTI in subjects with NNRTI resistance. |
| P3 | EFFICACY OF TMC-114/R IN TREATMENT-EXPERIENCED HIV PATIENTS: FACTORS INFLUENCING OUTCOME IN THE POOLED 24-WEEK ANALYSIS OF POWER 1, 2 AND 3 HIV Med 2006 7(Supplement 1):11 (abstract no. P3) Anton Pozniak1, Michael Saag2, Nick Bellos3, Philippe Chiliade4, Beatriz Grinsztein5, Jean-Michel Molina6, Christine Katlama7, Sandra De Meyer8, Tony Vangeneugden8, Eric Lefebvre9 and Andrew Hill10 TMC-114 FC was the strongest predictor of regimen efficacy. The magnitude of the incremental benefit for all other factors was determined by BL TMC-114 susceptibility. TMC-114/r 600/100 mg bid was uniformly superior to CPI, regardless of CPI predicted activity. |
| P4 | POWER 3 TRIAL: 24-WEEK EFFICACY AND SAFETY RESULTS OF TMC-114/R IN TREATMENT-EXPERIENCED HIV PATIENTS HIV Med 2006 7(Supplement 1):12 (abstract no. P4) J-M Molina1, Cal Cohen2, Christine Katlama3, Beatriz Grinsztejn4, Artur Timerman5, R Pedro6, Sandra de Meyer7, Marie-Pierre de Bethune7, Tony Vangeneugden7 and Eric Lefebvre8 POWER 3 efficacy and safety results confirm and extend those observed in POWER 1 and 2. TMC-114/r 600/100 mg bid provided patients with a substantial reduction in viral load and an increase in CD4 counts, and was generally safe and well-tolerated. |
| P5 | THE INHIBITORY QUOTIENT (IQ) OF RITONAVIR-BOOSTED PROTEASE INHIBITORS (PI/R): CORRELATION WITH VIROLOGICAL RESPONSE. HIV Med 2006 7(Supplement 1):12 (abstract no. P5) Laura Waters1, Alan Winston1, Nimesh Patel1, David Back2, Saye Khoo2, Steve Bulbeck1, Anton Pozniak1, Mark Nelson1, Graeme Moyle1, Brian Gazzard1 and Marta Boffito1 NIQ may be a useful tool in predicting response to boosted-PI based regimens in ARV-exposed subjects. |
| P6 | VIROLOGICAL OUTCOME IN NAÏVE AND SWITCH PATIENTS RECEIVING TDF/DDI AS THEIR 2NRTI BACKBONE HIV Med 2006 7(Supplement 1):12 (abstract no. P6) Elizabeth Hart, Amar Javaid and Edmund Wilkins As in other studies, the 2NRTI backbone of TDF/ddI has been shown to produce unacceptably high rates of VF in naïve patients, associated with high baseline VL and NNRTI and K65R resistance. However, patients switching with an undetectable VL and no likely previous ARV failure or drug resistance may remain successfully suppressed for a prolonged period on TDF/ ddI. |
| P7 | DOES GENDER OR ETHNICITY INFLUENCE TREATMENT OUTCOMES IN ANTIRETROVIRAL-NAÏVE PATIENTS COMMENCING NNRTI-BASED HAART? HIV Med 2006 7(Supplement 1):12 (abstract no. P7) Naa-Torshie Annan, Sundhiya Mandalia, Mark Bower, Brian Gazzard and Mark Nelson We have shown that in a large NNRTI-experienced cohort there is no significant difference for gender or ethnicity with respect to time to virological success or treatment failure. |
| P8 | COST-EFFECTIVENESS OF NNRTI VERSUS PI-CONTAINING HAART REGIMENS IN UK NPMS-HHC CLINICS, 1996–2002 HIV Med 2006 7(Supplement 1):13 (abstract no. P8) Eddy Beck1, Sundhiya Mandalia1, Ray Brettle2, Martin Fisher2, Mark Gompels2, George Kinghorn2, Brendan McCarron2, Anton Pozniak2, Alan Tang2, John Walsh2, Ian Williams2, Mike Youle1 and Brian Gazzard1 People on first-line 2NRTIs + NNRTI had longest estimated time to treatment failure, lowest annual hospital costs and regimen was cost- effective compared with the PI-containing first-line regimens. Given the increasing number of people living with HIV in high, middle and low income countries, cost and cost-effectiveness of regimens are becoming increasingly important criteria for deciding which particular regimen to use for first-line HAART. |
| P9 | KALETRA MONOTHERAPY – A REAL-LIFE EXPERIENCE HIV Med 2006 7(Supplement 1):13 (abstract no. P9) Laura Waters, Steve Balbeck, Brian Gazzard and Mark Nelson In our series of drug-experienced individuals mLPV/r was associated with improved immunological parameters regardless of virological response. 50% achieved an undetectable (less than 50 copies/ml) VL and 73% a greater than 1 log10 reduction. As most subjects switched to mLPV/r for poor compliance these data support this strategy for poorly adherent drug- experienced patients. |
| P10 | TIPRANAVIR/T20-CONTAINING SALVAGE REGIMENS HIGHLY EFFECTIVE AND DURABLE IN HEAVILY PI-TREATMENT-EXPERIENCED HIV-1-INFECTED PATIENTS IN CLINICAL PRACTICE HIV Med 2006 7(Supplement 1):13 (abstract no. P10) Ravindra Gupta, Clive Loveday, Usha Kalidindi, Martin Lechelt, Celia Skinner, Maurice Murray, Guy Bailey and Chloe Orkin TPV-containing regimens showed impressive efficacy and tolerability in this heavily experienced cohort, with 42% suppressed at 21 months. Baseline TPV-RS of three or greater appeared to be predictive of failure. |
| P11 | NEVIRAPINE ONCE A DAY MAY BE SAFER THAN PREVIOUSLY THOUGHT HIV Med 2006 7(Supplement 1):13 (abstract no. P11) Jennifer Whetham, Venita Hardweir, Emma Hull, Duncan R Churchill and Martin J Fisher 2NN reported Grade 3 or 4 hepatotoxicity in 13.6% of patients starting NVP OD. NVP may be given safely OD if a lead period of bid dosing is used in predominantly Caucasian patients without HBV/CV co-infection. |
| P12 | PROSPECTIVE TRIAL TO EVALUATE THE ROLE OF THERAPEUTIC DRUG MONITORING (TDM) IN HIV-POSITIVE PATIENTS STARTING/CHANGING ANTIRETROVIRAL (ARV) REGIMEN HIV Med 2006 7(Supplement 1):14 (abstract no. P12) Nimesh Patel1, Marta Boffito1, Alan Winston1, Desmond Maitland1, Laura Waters1, Saye Khoo2, Sara Gibbons2, David Back2, David Asboe1, Mark Nelson1, Graeme Moyle1, Anton Pozniak1 and Brian Gazzard1 Despite wide variability in Ct, clinicians were reluctant to dose- modify in the minority of patients with abnormal results. TDM is a complex (though feasible) investigation to implement, and is frequently not performed correctly. The benefit of TDM in unselected patients is unclear, because patients with low Ct still responded to therapy. |
| P13 | TENOFOVIR AND DIDANOSINE IN COMBINATION WITH A BOOSTED PROTEASE? 48-WEEK CLINICAL EXPERIENCE OF BOOSTED ATAZANAVIR WITH TENOFOVIR AND DIDANOSINE HIV Med 2006 7(Supplement 1):14 (abstract no. P13) Simon Portsmouth, Lawrence Ng and Kevin Asher The combination of ddI-TDF-ATV/r was reasonably well tolerated and resulted in good virological and immunological outcomes in the majority of this treatment-experienced cohort. These data support the use of this combination in clinical practice. Safety data will be presented in the poster. |
| P14 | SUCCESS DESPITE RESISTANCE: EMTRICITABINE INTENSIFICATION OF A TENOFOVIR, DIDANOSINE AND BOOSTED-ATAZANAVIR REGIMEN IN INDIVIDUALS WITH LOW-LEVEL VIROLOGICAL FAILURE HIV Med 2006 7(Supplement 1):14 (abstract no. P14) Laura Waters, Brian Gazzard and Mark Nelson We demonstrated the successful use of FTC to intensify HAART in subjects with viraemia and a history of 3TC resistance/failure. This may be due to residual activity of FTC despite M184V and/or increased susceptibility to TFV and/or reduced viral fitness with M184V. TFV/ddI/ATV/r may lack potency in drug-experienced patients. |
| P15 | RESPONSE TO EFAVIRENZ (EFV)-CONTAINING REGIMENS IN PREVIOUSLY ANTIRETROVIRAL-NAÏVE PATIENTS: THE ROLE OF GENDER HIV Med 2006 7(Supplement 1):14 (abstract no. P15) Colette Smith1, Margaret Johnson2, Mike Youle2, Fiona Lampe1, Caroline Sabin1 and Andrew Phillips1 We found no evidence for gender differences in virological and immunological response to efavirenz-based regimens. Larger studies are necessary to further explore these questions. |
| P16 | A RETROSPECTIVE ANALYSIS OF THE EFFICACY AND TOLERABILITY OF ANTIRETROVIRAL REGIMENS CONTAINING DUAL-BOOSTED PROTEASE INHIBITORS HIV Med 2006 7(Supplement 1):15 (abstract no. P16) Tabitha Mahungu, Colette Smith, Mervyn Tyrer and Margaret Johnson DBP regimens in this treatment-experienced cohort study resulted in viral load suppression and CD4 count increase in the majority of subjects. |
| P17 | 60-WEEK CLINICAL EXPERIENCE OF BOOSTED LOPINAVIR (LPV) WITH TENOFOVIR (TNF) AND DIDANOSINE (DDI), IN TREATMENT-EXPERIENCED PATIENTS HIV Med 2006 7(Supplement 1):15 (abstract no. P17) Jessica Daniel and Simon Portsmouth Of the patients still taking lopinavir/r/TNF/ddI 76% still have an undetectable VL. It was well tolerated with only one reported serious adverse event. These data support the use of this combination in clinical practice. |
| P18 | DOES CESSATION OF DIDANOSINE (DDI) INFLUENCE CD4 COUNT RISE IN CHOLESTEROL IN INDIVIDUALS RECEIVING TENOFOVIR (TDF)/DDI AS THE NUCLEOSIDE BACKBONE? HIV Med 2006 7(Supplement 1):15 (abstract no. P18) Philippa Harris, Anet Alexanian, Rachael Jones, Sundhiya Mandalia, Mark Bower, Brian Gazzard and Mark Nelson In individuals who were receiving TDF/ddI, cessation of ddI or replacement with another antiretroviral agent was associated with improvements in CD4 count and cholesterol. It is suggested that all patients who are presently receiving TDF and ddI should be reviewed by their physicians with regard to alteration of antiretroviral backbone. |
| P19 | EMTRICITABINE MAY BE ASSOCIATED WITH GREATER CHANGES IN CHOLESTEROL THAN LAMIVUDINE HIV Med 2006 7(Supplement 1):15 (abstract no. P19) Alex McKenna, James Whitehorn, Emma Low, Mark Bower, Brian Gazzard and Mark Nelson Although median cholesterol was not different between the two groups at 6 months, a greater proportion of individuals on TFV/FTC had cholesterol >6.5 mmol/l, the level at which treatment is mandatory at our unit. Further studies should be performed on changes in cholesterol dependent on 3TC or FTC therapy. |
| P20 | ONCE DAILY ATAZANAVIR/SAQUINAVIR/RITONAVIR (ATZ/SQV/R) DOUBLE-BOOSTED PROTEASE INHIBITOR THERAPY IN TREATMENT-EXPERIENCED PATIENTS HIV Med 2006 7(Supplement 1):16 (abstract no. P20) Suneeta Soni1, Steve Mccormick1, Sara Gibbons2, David Back2, Cindy Sethi1, Annemiek DeRuiter1 and Ranjababu Kulasegaram1 Double boosting with ATZ and SQV was well tolerated in our cohort and once-daily dosing makes this combination attractive. ATZ and SQV plasma concentrations were variable but no patients had trough concentrations below target for either ATZ (100 ng/ml) or SQV (100 ng/ml). |
| P21 | A RETROSPECTIVE STUDY EXAMINING THE USE OF FOUR OR MORE ANTIRETROVIRAL AGENTS IN THE TREATMENT OF HIV INFECTION IN EDINBURGH HIV Med 2006 7(Supplement 1):17 (abstract no. P21) Michael MacKenzie, Claire McGoldrick, Alan Wilson and Clifford Leen These results identify a sizeable group of patients on FOMARVs. These regimens are being selected despite an increased potential for drug interactions and adverse events. We attempted to identify reasons for the use of FOMARVs in naïve and experienced patients. The factors influencing these treatment decisions will be discussed. |
| P22 | INDUCED SPUTUM IS A SIMPLE AND NON-INVASIVE MEANS OF COMBINING INTERFERON-γ ASSAYS WITH MICROBIOLOGY IN DIAGNOSING ACTIVE TUBERCULOSIS (TB) IN HIV-INFECTED SUBJECTS HIV Med 2006 7(Supplement 1):16 (abstract no. P22) Ronan Breen, Gareth Hardy, Felicity Perrin, George Janossy, Ian Cropley and Marc Lipman We have shown that a simple lung-orientated approach to TB immuno-diagnosis in HIV-positive individuals allows rapid microbiological and immunological investigation to be performed on a single sputum sample. |
| P23 | UTILITY OF AN ANTIGEN-SPECIFIC INTERFERON-γ ASSAY FOR THE DETECTION OF TUBERCULOSIS (TB) IN PATIENTS WITH HIV-1 INFECTION HIV Med 2006 7(Supplement 1):16 (abstract no. P23) Steve Martin1, Sally Clark2, Jake Dunning3, Breeda Ward3, Emma Low3, Donald C Henderson1, Brian Gazzard3, Anton Pozniak3 and Peter Kelleher2 ELISPOT technology to detect TB infection may be a more rapid, sensitive and specific test than TST in patients with HIV-1 infection. |
| P24 | ANALYSIS OF NATURAL-KILLER-CELL SUBSETS IN THE GASTROINTESTINAL TRACT OF HIV-1-INFECTED INDIVIDUALS HIV Med 2006 7(Supplement 1):17 (abstract no. P24) Christopher M Mela1, Alan Steel2, James Lindsay3, Brain G Gazzard2, Frances M Gotch1 and Martin R Goodier1 The gut contains a phenotypically distinct subset of NK cells, which lack CD16 and are highly activated compared to blood NK cells. Biopsies from patients with damage to the gastric mucosa, through HIV or IBD, have increased numbers of CD16+ NK cells present in the lamina propria compared to uninfected controls. This may be through infiltration into inflamed tissue or as a result of compromised capillary integrity. |
| P25 | THREE CASE HISTORIES OF ABACAVIR HYPERSENSITIVITY REACTION HIV Med 2006 7(Supplement 1):17 (abstract no. P25) Des Maitland, Rachel Jones, Brian Gazzard and Graeme Moyle These three case histories are presented to illustrate the complexity of ABC HSR as a clinical entity and the limitations of relying exclusively on genetic markers for diagnosis. They demonstrate the need for a large controlled trial to determine the appropriate application of HLA-B5701 and cutaneous patch testing in routine clinical practice. |
| P26 | FUNCTIONAL CAPACITY OF NATURAL KILLER CELLS FROM TREATMENT-NAÏVE HIV-1-INFECTED INDIVIDUALS HIV Med 2006 7(Supplement 1):17 (abstract no. P26) Martin Goodier1, Elizabeth Weiss2, Christopher Mela1, Alan Steel3, Brian Gazzard3 and Frances Gotch1 NKG2C+ NK cells are highly functional in chronically infected HIV-1-positive individuals but may have a pathogenic rather than a protective role in HIV-1 infection. |
| P27 | THE CAUSES OF IMMUNO-SUPPRESSION OF HIV-INFECTED PATIENTS IN THE ERA OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY HIV Med 2006 7(Supplement 1):17 (abstract no. P27) Kaveh Manavi Late diagnosis of HIV, poor adherence to medication, and failure to have CD4 cell recovery with treatment were the main causes of immunosuppression of studied patients. Strategies that reduce the number of patients with immunosuppression may further improve the survival of HIV- infected patients. |
| P28 | LONG-TERM VALPROATE THERAPY DOES NOT SIGNIFICANTLY ALTER THE REBOUND KINETICS OF VIRAL REPLICATION AFTER CESSATION OF ANTIRETROVIRAL THERAPY HIV Med 2006 7(Supplement 1):18 (abstract no. P28) Alan Steel1, Sally Clark1, Ian Teo1, Mark Nelson2, Sunil Shaunak1, Brian Gazzard1 and Peter Kelleher1 Further controlled studies are needed to establish the relative contribution of intensification of pre-existing ART and sodium valproate in the clearance of HIV-1 from CD4+ memory T cells. |
| P29 | ANALYSIS OF TREATMENT COSTS FOR HIV RNA REDUCTIONS, FULL VIROLOGICAL SUPPRESSION, AND CD4 INCREASES FOR TREATMENT-EXPERIENCED, HIV-INFECTED PATIENTS HIV Med 2006 7(Supplement 1):18 (abstract no. P29) Andrew Hill1, Colette Smith2 and Margaret Johnson2 Multi-antiretroviral combinations are always required due to suboptimal efficacy of individual drugs in treatment-experienced patients. Efficacy is associated with a range of costs across antiretroviral drug classes. Effects on clinical progression and toxicity could add to cost savings. |
| P30 | DIAGNOSING HIV: BETTER LATE THAN NEVER...BUT BETTER NEVER LATE HIV Med 2006 7(Supplement 1):18 (abstract no. P30) Jonathan Roberts, Melanie Ottewill, Constantine Alfrangis, Anna Cressey, Duncan Churchill and Martin Fisher Despite targeted efforts, this study, compared with previous research, showed no significant change in the proportion of new diagnoses that are late (P≤0.20). However, mortality appears to have improved in this patient group comparing our study period to that previously. The majority (62%) of individuals have previously presented to secondary care representing missed opportunities for diagnosis. This study has focused on testing in the context of symptoms but, given the number who presented to secondary care (including symptoms unrelated to HIV), an even stronger argument exists for routine testing. |
| P31 | HIV SERVICE RE-DESIGN: AN AUDIT OF THE CONTRIBUTION THAT SPECIALIST NURSES MAKE TO MANAGING PATIENTS WITH NON-COMPLEX HEALTH AND SOCIAL CARE NEEDS HIV Med 2006 7(Supplement 1):18 (abstract no. P31) Elizabeth Kirkpatrick, Enrique Castro-Sanchez, Kevin Miles, Paul Benn, Erica Allason-Jones and Simon Edwards New roles for nurses help redistribute workload so that patient- care needs are better matched with professional expertise. Such models of nurse-led care will undoubtedly help to manage the increasing HIV workload seen across the UK. Further evaluation is required to demonstrate safety, cost- effectiveness and acceptability. |
| P32 | DESIGNATED LIPID CLINICS ARE EFFECTIVE IN IMPROVING HIV-RELATED DYSLIPIDAEMIA HIV Med 2006 7(Supplement 1):19 (abstract no. P32) Susan Hopkins1, Caroline Sabin2, Devi Nair1, Colette Smith2, Marc Lipman1, Fiona Lampe2, Ronan Breen1, Mike Youle1 and Margaret Johnson1 Attendance at this clinic was associated with significant improvements in lipid measurements over the subsequent year. The use of lipid specialists and designated lipid clinics should be promoted for HIV-infected patients with dyslipidaemia. |
| P33 | DOES A DESIGNATED PEP CLINIC IMPROVE FOLLOW-UP RATES? HIV Med 2006 7(Supplement 1):19 (abstract no. P33) Iain Reeves, Eileen Nixon, Kerry Hobbs and Martin Fisher This study suggests that a designated PEP service can successfully support adherence to a course of PEP with high completion rates including 3month follow-up. The number of patients receiving PEPSE has increased in 2005, but notably, all fall within recommended indications. |
| P34 | THE UTILITY OF A MULTIDISCIPLINARY LIPODYSTROPHY SERVICE IN CLINICAL PRACTICE HIV Med 2006 7(Supplement 1):19 (abstract no. P34) Libuse Ratcliffe, Penny Lewthwaite and Edmund Wilkins The majority of patients were referred because of facial lipoatrophy for consideration for NewFill. 30% were still on a thymidine drug and many had symptoms of metabolic syndrome. The lipodystrophy clinic allowed collection of BL assessments and ARV switch. It also enabled advice on cardiovascular risk-factor-reducing and metabolic management to be given, as well as facilitating recruitment to clinical studies. |
| P35 | HIV PARTNER NOTIFICATION HAS LIMITATIONS BUT COULD REDUCE TRANSMISSION BY IDENTIFYING PRIMARY INFECTIONS HIV Med 2006 7(Supplement 1):19 (abstract no. P35) Katharine Bond, David Pao, Melanie Ottewill, Jonathan Roberts and Martin Fisher Despite high STI rates in new HIV diagnoses, many patients were not screened. PN identified more undiagnosed HIV in RPs than CPs. The contacts per case in CPs fall well below the standard for other STIs as the majority are uncontactable. Nevertheless, the association of PHI index cases with PHI contacts supports the utility of PN in identifying other individuals at the same stage of high infectivity, potentially reducing onward transmission. |
| P36 | HOW USEFUL ARE ADHERENCE SUPPORT FOLLOW-UP CLINICS FOR RECIPIENTS OF POST-EXPOSURE HIV PROPHYLAXIS FOLLOWING SEXUAL EXPOSURE (PEPSE)? HIV Med 2006 7(Supplement 1):20 (abstract no. P36) Sara Day, Ali Elgalib, David Darling, Holly Bradbury and Ranjababu Kulasegaram A clinic for PEPSE recipients that places emphasis on adherence support and recall of clinic absconders has ensured we have achieved the BASHH target for completing PEPSE and significantly improved the HIV testing rates at three and six months. |
| P37 | NURSING EXPERIENCE OF RECRUITMENT INTO A RANDOMISED CONTROL TRIAL AT PRIMARY HIV INFECTION (PHI) HIV Med 2006 7(Supplement 1):20 (abstract no. P37) Scott Mullaney1, Christopher Collister2, Ken Legg1 and Sarah Fidler1 PHI presents specific issues which, when handled in an objective, confident, and sensitive manner by expert nursing staff, do not exclude clinical trial participation. |
| P38 | ARE WE MEETING THE SEXUAL HEALTH NEEDS OF HIV-INFECTED GAY MEN? HIV Med 2006 7(Supplement 1):20 (abstract no. P38) Rashida Ferrand, Shamela De Silva, Adeshola Ezeokoli and Jonathan Cartledge HIV-infected MSM engage in high-risk sexual behaviour. Healthcare workers do not always ask about sexual activity and must be encouraged to do so consistently, and to enquire about sero-discordant partners more actively. There is limited awareness among HIV-infected men of sexual health issues. |
| P39 | FREE ANTIRETROVIRALS (ARVS) DO NOT REACH CHILDREN WHO NEED THEM BECAUSE TREATMENT CENTRES FOCUS ON ADULTS AND ATTITUDES TO TESTING ARE OUTDATED: EXPERIENCE FROM EASTERN UGANDA HIV Med 2006 7(Supplement 1):20 (abstract no. P39) Jeanette Meadway1 and Peter Olupot-Olupot2 Lack of facilities for children and outdated attitudes to testing limit access to free ARVs for children and particularly for orphans in eastern Uganda. |
| P40 | WHAT LIES AHEAD? PAEDIATRIC HIV AND FUTURE CHALLENGES FOR ADULT SERVICES HIV Med 2006 7(Supplement 1):21 (abstract no. P40) Elizabeth Hamlyn, Melinda Tenant-Flowers, Sally Hawkins and Colin Ball This cohort of patients and those in other centres will present many difficult HIV management issues including: multi-drug experience, toxicity and resistance, suboptimal viral suppression, ill health, adherence issues complicated by adolescence and complex social and sexual health needs. clinico-pathological variables and investigated whether exposure to antiretrovirals with differing CNS penetrations protects from the development of this AIDS-defining illness. |
| P41 | A PROSPECTIVE STUDY OF PARADOXICAL REACTIONS IN INDIVDUALS CO-INFECTED WITH HIV AND TUBERCULOSIS HIV Med 2006 7(Supplement 1):21 (abstract no. P41) Ronan Breen, Felicity Perrin, Ian Cropley, Sanjay Bhagani, Mervyn Tyrer, Sabine Kinloch, Susan Hopkins, Margaret Johnson and Marc Lipman 1/3 of TB+HIV+ subjects develop PR, which often has marked systemic upset and requires treatment. Baseline blood CD4 count appears more predictive of this than CD4 change, systemic inflammation or disease extent. |
| P42 | THE INFLUENCE OF HAART ON HIV-ASSOCIATED PRIMARY CEREBRAL LYMPHOMA HIV Med 2006 7(Supplement 1):21 (abstract no. P42) Danish Mazhar, Justin Stebbing, Chris Goode, Sundyha Mandalia, Mark Nelson, Brian Gazzard and Mark Bower Although their prognosis remains dismal, the HAART era has decreased the incidence and prolonged the survival of individuals with HIV-1 associated PCL. |
| P43 | THE MANAGEMENT OF MENINGEAL LYMPHOMA IN PATIENTS WITH HIV IN THE ERA OF HAART HIV Med 2006 7(Supplement 1):21 (abstract no. P43) Danish Mazhar, Christina Thirlwell, Tom Newsom Davis, Anna Mary Young, Paul Holmes, Justin Stebbing, Mark Nelson, Brian Gazzard and Mark Bower DepoCyt is safe and effective in patients with ARL and meningeal disease, and reduces the number of intrathecal administrations required. In view of other data demonstrating an improved quality of life on this regimen, it should be considered as treatment for meningeal disease in these individuals. |
| P44 | LOW SEXUAL DESIRE IN HIV-INFECTED MEN: A NEW TREATMENT? HIV Med 2006 7(Supplement 1):22 (abstract no. P44) Daniel Richardson, David Goldmeier, Graham Frize, Agnes Kocsis, Paul Lamba and George Scullard Letrozole may be a useful adjunct in the management of men on HAART who have low sexual desire. Larger studies are needed. |
| P45 | OCCULT HEPATITIS B IN HIV-INFECTED PERSONS: PREVALENCE, PREDICTIVE FACTORS AND KINETICS IN RESPONSE TO HAART HIV Med 2006 7(Supplement 1):22 (abstract no. P45) Ana Garcia1, Gaia Nebbia1, Ursula Ayliffe2, Colette Smith1, Samir Dervisevic2, Margaret Johnson1, Richard Gilson2, Richard Tedder2 and Anna Maria Geretti1 We found high and comparable rates of occult HBV infection in two independent cohorts. HBV DNA detection was intermittent and not associated with HCV serostatus, CD4, VL or ALT levels. Lack of detectable sAb was a strong predictor of occult HBV DNA+ status. |
| P46 | ACQUISITION OF GENOTYPE 1A HCV INFECTION AFTER SUCCESSFUL TREATMENT FOR GENOTYPE 3 HCV INFECTION IN AN HIVAB+ MALE HIV Med 2006 7(Supplement 1):22 (abstract no. P46) Stephen Ash, Karen Sheppard and Chrissie Green Obviously, HCV antibody tests, being non-genotypespecific, remain positive for life after a first infection even though the HCV genotype 3 was eradicated in 2002. Patients need warning that, following treatment for HCV, they are not immune to infections with other genotypes. |
| P47 | CASPOFUNGIN IN THE TREATMENT OF SEVERE PNEUMOCYSTIS JIROVECII PNEUMONIA (PCP) HIV Med 2006 7(Supplement 1):22 (abstract no. P47) Laura Waters1, Katie Darling1,J Min2, Mark Bower1, Brian Gazzard1 and Mark Nelson1 Apofungin is effective in treatment of severe PCP following failure of first-line therapy. Prospective studies will identify prognostic indicators that may determine which patients will benefit from early Caspofungin use. |
| P48 | INCIDENCE OF TUBERCULOSIS AND HIV AMONG MEDICAL PATIENTS HIV Med 2006 7(Supplement 1):23 (abstract no. P48) Nkechi Priscillia Onyeka This study examines the incidence of tuberculosis and HIV among patients attending various clinics in Abuja, Federal Capital Territory (FCT), Nigeria. A total of 1000 blood and sputum samples were collected and analysed for HIV and tuberculosis. This included 475 males and 525 females. |
| P49 | NO ASSOCIATION BETWEEN HIV DISEASE AND ITS TREATMENT AND THYROID FUNCTION HIV Med 2006 7(Supplement 1):23 (abstract no. P49) Sara Madge1, Colette Smith1, Fiona Lampe1, Mike Thomas2, Margaret Johnson3, Mike Youle3 and Mark Vanderpump§ The prevalence of overt thyroid disease was low in this cohort, suggesting screening is not warranted. |
| P50 | PROLONGED SURVIVAL IN PATIENTS WITH PROGRESSIVE MULTIFOCAL LEUCOENCEPHALOPATHY: A RETROSPECTIVE CASE SERIES HIV Med 2006 7(Supplement 1):23 (abstract no. P50) Lucy Garvey, Emma Thomson and Graham Taylor PML is associated with a high morbidity and mortality with median survivals of 131–646 days previously reported. We report the longest published survival to date of 1148 days (range 496–2639 days) in all four patients with confirmed PML presenting to our unit between 1998 and 2005. |
| P51 | THE PRESENTATION AND SURVIVAL OF PATIENTS WITH NON-CUTANEOUS AIDS-ASSOCIATED KAPOSI'S SARCOMA (AIDSKS) HIV Med 2006 7(Supplement 1):23 (abstract no. P51) Carlo Palmieri, Justin Stebbing, Danish Mazhar, Christina Thirlwell, Tom Newsom Davis, Anna Mary Young, Mark Nelson, Brian Gazzard and Mark Bower Non-cutaneous KS is a recognisable condition; patients should be treated with the standard of care as their prognosis is not inferior. This is likely to reflect a strong immune response in the era of HAART. |
| P52 | HICKMAN LINE INFECTIONS DURING THERAPY FOR HIV-ASSOCIATED LYMPHOPROLIFERATIVE DISORDERS HIV Med 2006 7(Supplement 1):24 (abstract no. P52) Emma Low, James Whitehorn, Philippa Harris, Rachael Jones, Mark Bower, Brian Gazzard and Mark Nelson A significant number of proven line infections was demonstrated. The main organisms associated with line infection were coagulase-negative Staphylococcus and Pseudomonas. The high infection rate is attributed to the high incidence of chemotherapy-related neutropaenia. |
| P53 | AUDIT OF VITAMIN AND MINERAL PRESCRIBING PRACTICES FOR HIV-POSITIVE PATIENTS HIV Med 2006 7(Supplement 1):24 (abstract no. P53) Vivian Pribram, Susanna Gilmour-White, Elizabeth Hamlyn and Melinda Tenant-Flowers Evidence is lacking to support the role of daily vitamin/mineral tabletsas a generaldietarysupplement for HIV-positive patients. This auditshowsa lack of clarity in rationale and expected outcomes, and inadequate documentation in medical notes. Clear guidelines are required to ensure prescribing is evidence-based, cost-effective and of genuine benefit to patients in future. |
| P54 | THE SAFETY OF TENOFOVIR DF (TDF) IN THE TREATMENT OF HIV INFECTION: THE FIRST 4 YEARS HIV Med 2006 7(Supplement 1):24 (abstract no. P54) Rachael Jones1, Mark Nelson1, David Cooper2, Robert Schooley3, Christine Katlama4, Julio Montaner5, Geraldine Reilly6, Sue Curtis6, Li Hsu6, Biao Lu6, Stephen Smith6, James Rooney6 and Viread Global Expanded Access Program6 TDF is well tolerated. No new major toxicities have been identified in 4 years PM surveillance. The incidence of serious renal SAEs was 0.5% amongst 10,343 patients in the EAP; risk factors included concomitant nephrotoxic agents and low CD4 cell count. Bone fractures, neuropathy and mitochondrial toxicity were reported infrequently. |
| P55 | AN OVERVIEW OF 10 YEARS OF REPORTING SUSPECTED ADVERSE DRUG REACTIONS TO HIV THERAPY THROUGH SPONTANEOUS REPORTING HIV Med 2006 7(Supplement 1):24 (abstract no. P55) Susan Kenyon and Ruth Hargreaves The Blue Card scheme produced an initial increase in reporting but this was not sustained. This may suggest that regular promotion of such schemes is necessary. Reports from patients may provide important additional information but are not a substitute for healthcare professional reporting. |
| P56 | CALCULATED CREATININE CLEARANCE (CRCL) WITH TWO EFAVIRENZ (EFV)-BASED REGIMENS IN NAÏVE PATIENTS: TENOFOVIR (TFV)/DIDANOSINE (DDI) VERSUS DDI/LAMIVUDINE (3TC) HIV Med 2006 7(Supplement 1):25 (abstract no. P56) Laura Waters, Desmond Maitland, James Hand, Graeme Moyle, Mark Nelson and Brian Gazzard In this randomised, open-label study the use of a TFV-containing regimen was not associated with significant reduction in calculated CrCl. Although baseline CrCl was significantly higher in the TFV-arm using the CG formula, this was not apparent using the MDRD calculation. |
| P57 | TENOFOVIR DOES NOT INCREASE THE INCIDENCE OF CHEMOTHERAPY-RELATED NEPHROTOXICITY HIV Med 2006 7(Supplement 1):25 (abstract no. P57) Rachael Jones, Mark Bower, Brian Gazzard and Mark Nelson Tenofovir did not increase the nephrotoxicity of anthracyclinebased chemotherapy nor was it associated with a higher frequency of renal impairment at lymphoma diagnosis. |
| P58 | AN AUDIT ADDRESSING CARDIOVASCULAR RISK IN A COHORT OF ANTIRETROVIRAL-TREATED HIV PATIENTS HIV Med 2006 7(Supplement 1):25 (abstract no. P58) Claire McGoldrick1 and Clifford Leen2 Prevalence of BP, cholesterol and glucose abnormalities were high, although some patients had no such measurements made. Failures to institute appropriate therapy for lipids, to control cholesterol with drugs or to investigate glucose abnormalities were often noted. Clearly, improvements in assessment/management of cardiovascular problems are necessary within our cohort. |
| P59 | SYSTOLIC BLOOD PRESSURE (SBP) AND MEAN TOTAL CHOLESTEROL (TC) IN HIV-INFECTED PATIENTS HIV Med 2006 7(Supplement 1):25 (abstract no. P59) Elias Skopelitis1, Kathryn Ludgate2, George Panayotakopoulos1, Ali Elgalib2, Michael Aboud2, Alice Sharp1, Alastair Duncan2, Fiona Lampe3, Ranjababu Kulasegaram2, Anthony Wierzbicki4 and Barry Peters1 Two of the main factors contributing to the CVR in the Framingham equation, BP and TC, were lower in our HIV cohort than the adult age-matched UK population. The reasons for this, e.g. increased patient awareness and better health care management of risk factors or other factors, need further investigation. |
| P60 | RENAL TOXICITY IN HIV/HEPATITIS C CO-INFECTED INDIVIDUALS EXPOSED TO TENOFOVIR AND/OR RIBAVARIN HIV Med 2006 7(Supplement 1):26 (abstract no. P60) Rachael Jones, Sundhiya Mandalia, Mark Bower, Brian Gazzard and Mark Nelson Renal toxicity was not increased in individuals exposed to both ribavarin and tenofovir. This study illustrates that these agents do not increase nephrotoxicity when used in conjunction in the control of HIV/hepatitis C coinfection. |
| P61 | 10-YEAR CARDIOVASCULAR RISK IN AN HIV COHORT: ASSOCIATIONS AND EFFECTS OF HAART HIV Med 2006 7(Supplement 1):26 (abstract no. P61) Michael Aboud1, Elias Skopelitis2, Ali Elgalib1, George Panayiotakopoulos2, Kathryn Ludgate1, Alice Sharp2, Alastair Duncan1, Tony Wierzbicki1, Ranjababu Kulasegaram1, Fiona Lampe3 and Barry Peters2 Although overall, there was a similar incidence of high CVR >20% compared with an historical age-matched HIV-negative population, several factors were associated with increased CVR. These included male gender and Caucasian ethnicity. Lack of association with HAART reflects the modest effect of lipid changes on calculated CVR. Also, the effects of HAART on CVR may not be captured by the Framingham equation. Further elucidation of the associations of increased CVR in HIV might inform management strategies and reduce long-term morbidity. |
| P62 | FISH OILS (OMEGA-3 FATTY ACID SUPPLEMENTATION) AND CARDIOVASCULAR RISK IN HIV-POSITIVE INDIVIDUALS WITH HYPERTRIGLYCERIDAEMIA HIV Med 2006 7(Supplement 1):26 (abstract no. P62) Danni Chilton1, S Mann2, Simon Edwards1 and Paul Benn1 Fish oils are safe, effective and well-tolerated. We demonstrate significant reduction in lipids and CV risk in this cohort. Additional support is required to encourage smoking cessation. |
| P63 | FIVE YEARS' EXPERIENCE OF ADMINISTERING POLYLACTIC ACID (NEWFILL) IMPLANTS TO TREAT FACIAL LIPOATROPHY IN INDIVIDUALS WITH HIV INFECTION HIV Med 2006 7(Supplement 1):26 (abstract no. P63) Stephen Ash, Paul Gomez and Marielle Perraut PLA is a safe and effective treatment with long-lasting effects for the treatment of HIV-associated facial lipoatrophy. It does, however, have some disadvantages; these may make some alternatives a better therapeutic option. |
| P64 | THE USE OF LIPID-LOWERING DRUGS IN A COHORT OF HIV-INFECTED PATIENTS: AN INTRIGUING ASSOCIATION WITH SURROGATE MARKERS HIV Med 2006 7(Supplement 1):27 (abstract no. P64) Elias Skopelitis1, Michael Aboud2, Ali Elgalib2, George Panayotakopoulos1, Kathryn Ludgate2, Alice Sharp1, Alastair Duncan2, Ranjababu Kulasegaram2, Fiona Lampe3, Anthony Wierzbicki4 and Barry Peters1 Use of LLDs in our HIV cohort, especially among those on HAART, was more frequent than in the age-matched UK population, which may in part indicate increased awareness and prompt intervention. It remains to be determined whether the favourable surrogate markers profiles are spurious or independently related to LLD use. |
| P65 | HIV-ASSOCIATED BODY SHAPE CHANGES IN WOMEN FROM AFRICAN BACKGROUNDS: A PRELIMINARY STUDY HIV Med 2006 7(Supplement 1):27 (abstract no. P65) Jane Anderson, Sarah Zettler and Selina Gann HIV-associated body shape changes result in an altered self- identity, with particular challenges for women from African backgrounds, potentially reducing social networks and support. This needs to be understood and acknowledged by clinicians when considering therapy. |
| P66 | HOW WELL DO WE TARGET HYPERLIPIDAEMIA? A STUDY TO INVESTIGATE TOTAL CHOLESTEROL RESULTS AND STATIN USE IN A CLINICAL COHORT HIV Med 2006 7(Supplement 1):27 (abstract no. P66) Rachael Jones, Emma Low, Alex McKenna, Mark Bower and Mark Nelson The majority of individuals had lipid measurements performed, with almost half having elevated cholesterol, illustrating the benefit of routine screening. Overall, more than a third of individuals with high cholesterol have received statin therapy, compared with one-tenth of those with borderline high values. This study reinforces the need for increased vigilance and intervention in individuals with elevated cholesterol values. |
| P67 | COMBINED DETECTION OF ANTIGEN AND ANTIBODY SHOULD BE THE STANDARD OF CARE FOR SCREENING OF HIV INFECTION IN POPULATIONS WITH A HIGH RATE OF SERO-CONVERSION HIV Med 2006 7(Supplement 1):28 (abstract no. P67) Simon Goldenberg, Ranjababu Kulasegaram, Barry Peters, George Panayotakopoulos and William Tong The results indicate that 10 patients would have been wrongly classified as HIV-uninfected at this stage if our laboratory performed the conventional HIV-antibody-only assay alone. Although they all subsequently became HIV-antibody-positive, there is no certainty that they would all have re-attended for testing. Furthermore, one patient would have remained antibody-negative even after the suggested 3-month window period. We suggest that the combined HIV antigen/antibody assay should be adopted as the standard of care for HIV screening, especially in populations where there is known to be a high rate of sero-conversion. |
| P68 | FOUR CASES OF PAEDIATRIC HIV INFECTION DUE TO SEROCONVERSION IN PREGNANCY: SHOULD PARTNERS BE TESTED AND/OR REPEAT THIRD TRIMESTER HIV SCREENING BE RECOMMENDED? HIV Med 2006 7(Supplement 1):28 (abstract no. P68) Siske Struik1, Gareth Tudor-Williams2, Graham Taylor2, Simon Portsmouth3, Caroline Foster2, Claire Walsh1, Christina Hanley1, Sam Walters1 and Hermione Lyall1 Weincreasinglyobserveseroconversionin pregnancy leading toinfant AIDS. This might reflect the rising incidence of new HIV in the UK and/or increased recognition of seroconversions, now that screening at booking successfully identifies most established infections. Thus, a negative antenatal test does not preclude an AIDS diagnosis in a sick infant. Also, safe sex advice and HIV screening of sexual partners should become part of normal ante-and post-natal care and repeat third trimester HIV testing, already routine in some countries, may be cost- effective in the UK. |
| P69 | STAVUDINE (D4T) AND DIDANOSINE (DDI) USE, LOW-LEVEL TRANSAMINITIS (LLT), AND HEPATIC STEATOSIS IN A COHORT OF HIV MONO-INFECTED SUBJECTS HIV Med 2006 7(Supplement 1):28 (abstract no. P69) Marco Bongiovanni1, Colette Smith2, Sanjay Bhagani3, Fiona Lampe2, Mervyn Tyrer3, Mike Youle3, Geoffrey Dusheiko4, Margaret Johnson3 and Gabrielle Slapak4 Identifying those patients at risk of liver damage may allow reversal of steato-hepatitis and reduce the risk of end-stage liver disease and ultimately transplantation. |
| P70 | IDENTIFYING EARLY HIV INFECTION: COMPARISON OF A GUANIDINE-BASED HIV IGG AVIDITY ASSAY WITH THE DETUNED EIA ASSAY (STARHS) HIV Med 2006 7(Supplement 1):29 (abstract no. P70) Anuradha Chawla, Murphy Gary, Chris Donnelly, Clare Booth, Margaret Johnson and Anna Maria Geretti The guanidine-based HIV IgG avidity assay shows very good agreement with the detuned EIA assay (κ value: 0.97). As is also recommended for the detuned assay, results of the avidity assay should be interpreted in the context of the CD4 counts, disease stage and infecting HIV-1 subtype. |
| P71 | THE CONTRIBUTION OF PRIMARY HIV INFECTION TO TRANSMISSION CLUSTERING WITHIN A LONDON HIV CENTRE HIV Med 2006 7(Supplement 1):29 (abstract no. P71) Julie Fox1, Anna Duda2, Rodney Philips2, Jonathan Weber1 and Sarah Fidler1 Phylogenetic analysis indicating case-clustering suggests a role of PHI in the onward transmission of HIV. However, genotypic analysis in the absence of sexual network studies is unable to confirm the direction of transmission. Identification of PHI and subsequent safe sex counselling must play a critical role in HIV prevention. |
| P72 | DO PRIMARY HIV-1 INFECTIONS AMONGST MSM CONTRIBUTE DISPROPORTIONATELY TO ONWARD TRANSMISSIONS IN THE UK: A PHYLOGENETIC APPROACH HIV Med 2006 7(Supplement 1):29 (abstract no. P72) Alison Brown1, Jonathan Clewley1, Stephane Hue2, Anne Johnson3, Sam Lattimore1, Valerie Delpech1, John Parry1, Deenan Pillay4, Oliver Pybus2 and O. Noel Gill1 If recently HIV-infected MSM are substantially contributing to onward transmission, HIV-testing promotion may have limited impact because such individuals will not yet have had the opportunity to have their infections diagnosed. |
| P73 | PREVALENCE OF PRIMARY GENOTYPIC RESISTANCE IN A SINGLE UK CENTRE: A COMPARISON OF PATIENTS WITH PRIMARY HIV INFECTION AND NEWLY DIAGNOSED TREATMENT-NAÏVE INDIVIDUALS HIV Med 2006 7(Supplement 1):29 (abstract no. P73) Samantha Hill1, Julie Fox2, Simon Dustan2, Steve Kaye2, Sarah Fidler2 and Nicola E Mackie1 Using a strict definition of PHI and newly diagnosed, treatment- naïve patients identified prospectively, a similar and lower rate of drug resistance is seen in both our populations than has been recently reported in the UK. |
| P74 | IMPACT OF HIV-1 SUBTYPE ON GENOTYPIC RESISTANCE TO PROTEASE INHIBITORS IN THE UK HIV Med 2006 7(Supplement 1):30 (abstract no. P74) Tanya Welz and Philippa Easterbrook In this large database of patients with diverse HIV-subtypes, novel non-B subtype-specific PR mutations were rare. However, the limited sample size after exclusion of individuals exposed to more than one PI, or with an uncommon subtype, highlights the need for collaboration with other large databases to validate these findings. |
| P75 | VIROLOGICAL FAILURE AND SUBSEQUENT RESISTANCE PROFILES IN INDIVIDUALS EXPOSED TO ATAZANAVIR HIV Med 2006 7(Supplement 1):30 (abstract no. P75) B Nathan, Rachael Jones, Alex McKenna, Paul Holmes, Mark Bower, Brian Gazzard and Mark Nelson In the previous PI-failure group, one individual developed new significant mutations, a second accumulated a secondary mutation. In the PI- naïve/PI non-failure group, three individuals accumulated secondary mutations. Ritonavir/atazanavir is not associated with the development of genotypic resistance in individuals failing this combination without previous PI failure. It is rarely associated with the acquisition of genotypic resistance in individuals with previous PI exposure. |
| P76 | PRIMARY RESISTANCE IN ANTIRETROVIRAL-NAÏVE HIV PATIENTS HIV Med 2006 7(Supplement 1):30 (abstract no. P76) Kimberley Forbes1, Simon Limb1 and Inez Ushiro-Lumb2 In a small sample of chronically infected, ARV-naïve patients, we have not found a significant level of primary resistance. This is a homogenous group, mostly of patients who acquired infection through the heterosexual route in Africa. This may reflect the lower level of exposure to ARV drugs in the country where infection was acquired. Further observation is required to confirm this data, which is in contrast to some of the recently published data. |
| P77 | BASELINE GENOTYPIC RESISTANCE IN PREGNANCY HIV Med 2006 7(Supplement 1):30 (abstract no. P77) Amanda Clarke1, MY Tung2, GP Taylor3, David A Hawkins2, Annemiek deRuiter1, Fiona Lyons1 To date, the prevalence of significant mutations in ART-naïve cases is low. Whether polymorphisms will increase the likelihood of resistance development impacting on future ART options is uncertain. |
| P78 | ASSESSING THE POSSIBILITY OF AN HIV OUTBREAK HAPPENING IN A MAJOR UK CITY USING MATHEMATICAL MODELLING HIV Med 2006 7(Supplement 1):31 (abstract no. P78) Jane White1, Matt Dorey1, Nick Britton1 and Dushyant Mital2 Mathematical modelling is a useful tool which could allow us to determine conditions under which we would predict an HIV outbreak. This could provide further information in deciding where sexual healthcare infrastructure and resources could be diverted for MSM living with HIV/AIDS. |
| P79 | COMPLETION RATES AND TOLERABILITY OF POST-EXPOSURE PROPHYLAXIS FOLLOWING SEXUAL EXPOSURE TO HIV: A PROSPECTIVE OBSERVATIONAL STUDY HIV Med 2006 7(Supplement 1):31 (abstract no. P79) Paul Benn1, Valerie Delpech2, Jody Blackham2, Gemma Phillips2 and Barry Evans2 Individuals receiving PEP frequently report side effects and require time off work. Strategies to improve follow-up, adherence and completion rates are required. |
| P80 | NO EVIDENCE OF INCREASING RISK BEHAVIOUR FOLLOWING POST-EXPOSURE PROPHYLAXIS FOR SEXUAL EXPOSURE TO HIV HIV Med 2006 7(Supplement 1):31 (abstract no. P80) Paul Benn1, Valerie Delpech2, Jodi Blackham2, Gemma Phillips2 and Barry Evans2 High rates of STIs among those testing support routine screening in all. Compared to baseline, most individuals report fewer sexual partners in the 3 months following PEP. |
| P81 | CONDOM-USE DECISION-MAKING BY HIV-POSITIVE BLACK CARIBBEANS BEFORE AND AFTER DIAGNOSIS HIV Med 2006 7(Supplement 1):31 (abstract no. P81) Moji Anderson1, Gillian Elam2, Ijeoma Solarin1, Sarah Gerver1 and Philippa Easterbrook1 Pre-diagnosis, emotional and sensual considerations, ignorance of HIV, and assumptions based on physicality and behaviour contribute to unsafe sex more than conscious risk-taking. Post-diagnosis, patients take risks for similar reasons: however, avoidance of stigma is a further factor. Unsafe sex is justified by attempts made to minimise risk and by relying on the partner to ensure safe sex. |
| P82 | HIV TESTING FOR AFRICAN PEOPLE AND MSM: COMPARING NEEDS, ACCESS AND EFFECTIVENESS IN CLINIC AND COMMUNITY SETTINGS IN A UK CITY HIV Med 2006 7(Supplement 1):32 (abstract no. P82) Peter Weatherburn1, Michael Clarke2, Karl Pye2, Kieran Sharkey2, Tonie Russell2, Clare Smith2, Katherine Maleham2, Will Devlin3 and Dushyant Mitals2 Walk-in, out-of-hours satellite HIV-testing services are feasible and acceptable in community settings and serve a more ethnically diverse and higher-risk population than in a standard SHC setting. Increasing patient choice helps reduce the burden of undiagnosed HIV infection. |
| P83 | THE ROLE OF HIV TESTING IN RISK PERCEPTIONS AND SAFER SEX STRATEGIES: QUALITATIVE RESULTS FROM AN INVESTIGATION INTO RISK FACTORS FOR SEROCONVERSION AMONG GAY MEN WHO HIV TEST HIV Med 2006 7(Supplement 1):32 (abstract no. P83) Gillian Elam1, Neil Macdonald1, Kevin Fenton1, Vicky Gilbart1, Ford Hickson2, John Imrie3, Christine McGarrigle1, Robert Power3 and Barry Evans1 HIV testing remains the cornerstone of HIV prevention, but without informed review of past sexual behaviour and understanding of the implications of a negative HIV test result, such test results are used to endorse continued risk behaviour and facilitate continued exposure to HIV transmission routes. |
| P84 | DECISIONS TO DISCLOSE AMONG HIV-POSITIVE BLACK CARIBBEANS HIV Med 2006 7(Supplement 1):32 (abstract no. P84) Moji Anderson1, Gillian Elam2, Ijeoma Solarin1, Sarah Gerver1 and Philippa Easterbrook1 Stigma and trust are powerful factors in decision-making to disclose. Patients evaluate their relationships with family and friends to mitigate potential stigmatisation as a result of disclosure. |
| P85 | BARRIERS TO HIV TESTING IN UK AFRICAN COMMUNITIES HIV Med 2006 7(Supplement 1):32 (abstract no. P85) Caroline Yandell1, Chris Salisbury1, Alison Shaw1 and Nicola Low2 This study helps us better understand the complex influences and beliefs, which may act as barriers to HIV testing amongst Africans in the UK. Raising awareness and understanding, and improving cultural competency amongst professionals may ameliorate some of these barriers. |
| P86 | SEXUAL ORIENTATION AND ACTIVITY ACCORDING TO COUNTRY OF BIRTH AMONG BLACK CARIBBEAN AND BLACK BRITISH HIV-POSITIVE INDIVIDUALS IN SOUTH LONDON: THE LIVITY STUDY HIV Med 2006 7(Supplement 1):33 (abstract no. P86) Sarah Gerver1, Ijeoma Solarin1, Moji Anderson1, Gillian Elam2, Kevin Fenton2 and Philippa Easterbrook1 Despite persisting stigma, a high proportion of BC men identified themselves as HoM/BM. There was no evidence of covert homosexual activity among BC heterosexuals, or for difference according to country of birth. |
| P87 | PUBLIC ATTITUDES ABOUT HIV AND AIDS IN GREAT BRITAIN: THE RESULTS OF A REPRESENTATIVE SURVEY HIV Med 2006 7(Supplement 1):33 (abstract no. P87) Yusef Azad While levels of knowledge about HIV transmission are relatively high, a decline in knowledge since 2000 presents a worrying trend. There is also a need to respond to the inequalities in levels of knowledge among different social groups identified. The relationship observed between increased levels of knowledge about transmission and anti-discriminatory attitudes gives encouragement to educative initiatives aimed at challenging stigma and discrimination. |
| P88 | HOW DOES DISPERSAL BY THE NATIONAL ASYLUM SUPPORT SERVICE (NASS) AFFECT THE HEALTH OF ASYLUM SEEKERS LIVING WITH HIV? A STUDY OF CLINICIANS' VIEWS AND EXPERIENCES HIV Med 2006 7(Supplement 1):33 (abstract no. P88) Hannah Bate and Yusef Azad Following lobbying, NASS had accepted a number of recommendations for change in the dispersal of HIV-positive asylum seekers, including: the potential for dispersal to be delayed; the need for satisfactory arrangements for continuity of care according to the treating clinician; and an obligation for accommodation providers to arrange registration with a GP. The report made additional recommendations for better promotion of voluntary HIV-testing in initial accommodation centres; clearer instruction on the need for HIV-positive asylum seekers to alert clinicians when a dispersal notice has been given; mechanisms for improved transfer of patient information between healthcare providers in areas from and to which patients are dispersed; and better social and psychosocial support for HIV-positive asylum seekers. The charity will continue to examine the issue of dispersal of asylum seekers living with HIV. |
| P89 | THE IMPORTANCE OF RELIGION FOR PEOPLE LIVING WITH HIV HIV Med 2006 7(Supplement 1):33 (abstract no. P89) Jane Anderson1, Jonathan Elford2, Fowzia Ibrahim2 and Cecilia Bukutu2 Religion is central to the lives of most black African men and women with diagnosed HIV; religion also has an important place in the lives of some gay men with HIV. The role of faith leaders in supporting members of their congregation living with HIV needs to be explored further as does the influence of religion on use of HIV medication. |
| P90 | UNDERSTANDING VARIATION IN PRESCRIBING OF INJECTABLE THERAPY: THE ROLE OF PHYSICIAN ATTITUDES AND BELIEFS HIV Med 2006 7(Supplement 1):34 (abstract no. P90) Robert Horne1, Mike Youle2, Martin Fisher3, Ranjababu Kulasegaram4 and Vanessa Cooper1 Doctors varied in their beliefs about injectable ARVs, and their beliefs influenced prescribing. |
| P91 | THE DIAGNOSIS OF HIV IN AFRICAN MEN LIVING IN LONDON: A QUALITATIVE STUDY HIV Med 2006 7(Supplement 1):34 (abstract no. P91) Jane Anderson1 and Lesley Doyal2 The impact of a diagnosis of HIV on men's sense of self worth, strength and identity was profound and influenced their use of available services. These challenges must be recognised in designing diagnostic and treatment services for African men living with HIV. |
| P92 | EATING DISORDERS AND BODY IMAGE IN HIV CLINIC ATTENDERS HIV Med 2006 7(Supplement 1):34 (abstract no. P92) Karen Klassen1 and Lucy Serpell2 Early results suggest that eating problems may be overrepresented amongst HIV-positive men and women. This may have implications for the management of HIV and for medication compliance. It may be useful to screen HIV clinic attenders for eating problems. |
| P93 | DISCRIMINATION EXPERIENCED BY PEOPLE LIVING WITH HIV HIV Med 2006 7(Supplement 1):34 (abstract no. P93) Jonathan Elford1, Jane Anderson2, Fowzia Ibrahim1 and Cecilia Bukutu1 Nearly one-third of patients diagnosed with HIV said they had been discriminated against because of their infection; half of those experiencing discrimination said this involved a healthcare worker. Tackling HIV discrimination in the healthcare setting should be given priority. |
| P94 | PEOPLE WITH DIAGNOSED HIV: RISK OF CROSS-INFECTION WITHIN A RELATIONSHIP HIV Med 2006 7(Supplement 1):35 (abstract no. P94) Jonathan Elford1, Jane Anderson2, Fowzia Ibrahim1 and Cecilia Bukutu1 Among people diagnosed with HIV who were in a relationship (married, co-habiting or living apart), 40–50% had an HIV-positive partner. Patients with HIV were more likely to report unprotected sex with an HIV- positive partner than with a partner of unknown or negative HIV status. While 'positive–positive' unprotected sex does not present a risk of HIV transmission to an uninfected person, there is a risk of cross-infection with resistant virus with a primary partner. |
| P95 | RECTAL TUBERCULOSIS AND LYMPHOGRANULOMA VENEREUM CO-INFECTION: A CASE REPORT HIV Med 2006 7(Supplement 1):35 (abstract no. P95) Michael Aboud, John A White and Ranjababu Kulasegaram Tuberculosis is often HIV-related and is an AIDS-defining illness. In the UK, the incidence of tuberculosis in HIV is increasing. This case highlights an atypical presentation of tuberculosis within the current outbreak of LGV. |
| P96 | GUILLAIN BARRÉ SYNDROME FOLLOWING IMMUNE RECONSTITUTION ASSOCIATED WITH ANTIRETROVIRAL THERAPY FOR HIV INFECTION HIV Med 2006 7(Supplement 1):35 (abstract no. P96) Esmerelda Teo, Alex Azwa, Philippa Harris, Rachael Jones, Brian Gazzard and Mark Nelson Guillain Barré Syndrome (GBS), although rare, may be a presenting feature of primary HIV infection. However, we report a unique case of GBS occurring one month after the initiation of antiretroviral (ARV) therapy (Truvada and efavirenz). A 26-year-old homosexual male presented with difficulty walking, associated with ascending paraesthesia. |
| P97 | AVASCULAR NECROSIS (AVN) OF KNEE AND ANKLE: IMPROVEMENT WITH CALCITONIN HIV Med 2006 7(Supplement 1):35 (abstract no. P97) Mailini Raychaudhuri, Mary Browning and Humphrey Birley A 55-year-old HIV-positive man, diagnosed in 1991, and treated with a variety of antiretroviral agents since 1995, presented in September 2003 with rapidly increasing pain in the right knee. Later, pain developed in the left ankle. He had no systemic symptoms or signs of inflammation. In April 2003, stavudine was changed to tenofovir due to lipodystrophy, hyperlipidaemia, NIDDM and past MI. |
| P98 | PLASMA HYPERVISCOSITY SYNDROME SECONDARY TO HIV INFECTION: A CASE REPORT HIV Med 2006 7(Supplement 1):36 (abstract no. P98) Claire Ryan1, Olufunso Olarinde1, George Kinghorn1 and Beverley Paul2 Previous case reports have shown that plasma exchange is useful in the short-term symptomatic control of this syndrome and, in one case, HAART was shown to reverse the hyper-gammaglobulinaemia and raised PV. What we can extrapolate from this case is that plasma exchange alone appears to be an effective management for the longer term when HAART is unavailable. |
| P99 | CMV CHOLANGIOPATHY IN HIV-INFECTED MAN FOLLOWING HAART: IMMUNE RECOVERY INFLAMMATORY SYNDROME HIV Med 2006 7(Supplement 1):36 (abstract no. P99) Rohan Bupage and Kathir Yoganathan This case illustrates CMV-CA occurring in a patient who was commenced on HAART. Despite rapid decline of HIV RNA and improvement in CD4 count following HAART, our patient clinically deteriorated. In the view of this paradoxical clinical worsening, it was proposed this case is most likely a manifestation of IRIS. In conclusion, CMV cholangiopathy can present as IRIS in HIV-infected patients and should be considered in the differential diagnosis of abnormal LFTs. |
| P100 | A CASE REPORT OF SERONEGATIVE PULMONARY LEISHMANIASIS IN AN HIV-HEPATITIS C CO-INFECTED PATIENT HIV Med 2006 7(Supplement 1):36 (abstract no. P100) Andrew A Benzie1, Robert D Goldin2 and John Walsh1 We describe an antiretroviral-naïve 38-year-old Portuguese man with HIV/HCV co-infection [CD4 cell count 210 cells/µl (6%), viral load 34 053 copies/ml]. He presented in April 2005 with 6-month history of intermittent episodes of high fever, dry cough and shortness of breath on exertion. Over time, each episode had increased in severity. |
| P101 | AN UNUSUAL CAUSE OF ABNORMAL CHEST RADIOGRAPH IN AN HIV-INFECTED PATIENT HIV Med 2006 7(Supplement 1):36 (abstract no. P101) Sumit Bhaduri1, Phillip Nottingham2 and Kathir Yoganathan3 DH is an acute infection with fever, dry cough and breathlessness, and is progressive and potentially fatal in immunocompromised patients. Military tuberculosis and Pneumocystis carinii pneumonia are important differential diagnoses. DH is often described in endemic areas, but our patient did not visit endemic areas and only had pulmonary involvement. Clinicians should be aware of this unusual cause of pulmonary infiltrates due to histoplasmosis in immunocompromised HIV-positive patients, even those living in non-endemic areas. |
| P102 | SEEING DOUBLE: BILATERAL RETINITIS WITH DIFFERENT PATHOGENS IN A PATIENT WITH ADVANCED HIV INFECTION HIV Med 2006 7(Supplement 1):37 (abstract no. P102) Brendan Payne1, Ashley Price1, David Cottrell2 and Matthias Schmid1 A 41-year-old woman presented with visual disturbance in the left eye [visual acuity (VA) 6/24] 3 months after an untreated episode of left-sided maxillary shingles. There was acute retinal necrosis and peripheral retinal detachment in the left eye and a small area of retinitis in the right. Intravenous ganciclovir (5 mg/kg bid) was given for 7 days pending polymerase chain reaction (PCR) results. |
| P103 | HIV AND SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) HIV Med 2006 7(Supplement 1):37 (abstract no. P103) Tabitha Mahungu, Sabine Kinloch and Margaret Johnson Coexisting systemic lupus erythematosus (SLE) and HIV is a rare occurrence with fewer than 30 published cases. Overlapping immunological and clinical manifestations pose diagnostic and management challenges. The growing HIV epidemic in the developing world within a SLE-susceptible sub-population may increase these numbers. We describe a 41-year-old female African patient diagnosed with asymptomatic HIV and pancytopaenia. |
| P104 | LOPINAVIR-ASSOCIATED HEPATOTOXICITY IN A PREGNANT WOMAN: A CASE REPORT HIV Med 2006 7(Supplement 1):37 (abstract no. P104) Sherie Roedling and Eva Jungmann The observed potentially life-threatening hepatotoxicity in this case is likely to be lopinavir-associated. Although this is a single case, it highlights the need to explore less-hepatotoxic regimens in pregnant women with low-level viraemia who wish to opt for vaginal delivery. There is an urgent need for better surveillance of adverse maternal events in addition to foetal and obstetric outcomes. |
| P105 | NEUROCYSTICERCOSIS WITH COMMUNICATING HYDROCEPHALUS IN AN HIV-POSITIVE SUBJECT HIV Med 2006 7(Supplement 1):37 (abstract no. P105) Patrick Lillie, Mirella Parsonage, Gavin Barlow and Hiten Thaker Aggressive neurocysticercosis, with basilar meningitis, has previously been reported in immunosuppressed patients and in HIV. We describe a case where effective treatment given to a HIV-positive patient has been successful, in a patient not currently taking antiretroviral medication. |
| P106 | LYMPHOGRANULOMA VENEREUM (LGV) PRESENTING AS HAEMORRHAGIC PROCTITIS: FIRST CASES FROM WALES HIV Med 2006 7(Supplement 1):38 (abstract no. P106) Anona Blackwell and Kathir Yoganathan Rectal bleeding is a common complaint and, particularly in relatively rural areas such as ours, patients may attend their general practitioner, gastroenterologist or colorectal surgeon who may be unaware of the patient's sexual orientation or of the possibility of LGV or HIV leading to inappropriate and delayed treatment. |
| P107 | SYPHILIS RE-INFECTION IN HIV-POSITIVE MEN: A NEW CHALLENGE HIV Med 2006 7(Supplement 1):38 (abstract no. P107) Chitra Babu, 1Orla McQuillan, Sai Murng, Steve Higgins, Ashish Sukthankar and Margaret Kingston HIV-positive status is a strong predictor of syphilis re-infection in homosexual men. High-risk sexual behaviour levels and overall cure rate were similar in both HIV-positive and -negative groups. Serological cure rates following single dose benzathine penicillin were comparable to those following prolonged penicillin courses, regardless of HIV status. Safer sex messages should target HIV-positive homosexuals. |
| P108 | LYMPHOGRANULOMA VENEREUM (LGV) IS STRONGLY ASSOCIATED WITH HIV INFECTION IN MEN WHO HAVE SEX WITH MEN (MSM) HIV Med 2006 7(Supplement 1):38 (abstract no. P108) Collins Iwuji, Gillian Dean and Duncan Churchill The majority of cases of LGV were seen in MSM with HIV infection. Half of all HIV-infected patients had a detectable viral load. Coinfection with other STIs was common. There is an obvious risk that patients acquiring infection with LGV may transmit or become infected with HIV and other STIs; active case-finding and treatment might limit the spread of HIV and other STIs. |
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