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Ninth International Congress on Drug Therapy in HIV InfectionGlasgow, UK - 9-13 November 2008 |
Cite as: J Int AIDS Soc 2008 Nov 10, 11(Suppl 1):P118
where P118=abstract number
Meeting abstracts: A single PDF containing all abstracts in this Supplement is available here.
| Keynote Presentations |
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| K1 | PATHOGENESIS OF HIV INFECTION: IMPLICATIONS FOR TREATMENT AND PREVENTION J Int AIDS Soc 2008, 11(Suppl 1):K1 doi:10.1186/1758-2652-11-S1-K1 HC Lane The immune systems of patients with HIV infection are characterized by an immunodeficiency that develops in the setting of a global immune activation and a complex array of HIV-specific immune responses. The immunodeficiency of HIV infection is the result of a decrease in both memory and naïve CD4+ T cells. Imaging studies of the total body CD4+ T cell pool reveal global depletion within all lymphoid tissues. |
| K2 | HOW WILL WE USE THE NEW ART DRUGS? J Int AIDS Soc 2008, 11(Suppl 1):K2 doi:10.1186/1758-2652-11-S1-K2 C Katlama Combined antiretroviral therapies have revolutionized the prognosis of HIV disease transforming an almost uniformly lethal disease into a chronic one with an estimated survival of several decades on effective antiretroviral therapy. |
| K3 | THE IMPLICATIONS BEYOND PUBLIC HEALTH IF WE DON'T MANAGE THE HIV EPIDEMIC J Int AIDS Soc 2008, 11(Suppl 1):K3 doi:10.1186/1758-2652-11-S1-K3 A Whiteside Public health is the study and practice of managing threats to the health of a community; paying special attention to the social context, and focusing on improving health through society-wide measures such as vaccination or changing behaviours. Public health has, to date, played a limited role in HIV/AIDS interventions. The human rights discourse quickly came to dominate HIV/AIDS and it tends to protect the rights of individual over the society. |
| Oral Presentations |
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| O1 | GLOBAL IMPACT OF HIV DRUG RESISTANCE J Int AIDS Soc 2008, 11(Suppl 1):O1 doi:10.1186/1758-2652-11-S1-O1 D Pillay ART roll-out is bringing many benefits to infected individuals in the resource-poor world. A large number of studies on ART use in the developed world have informed our understanding on the determinants of ART success and implications of failure. However, there are a number of differences between resource-rich and -poor environments which will impact on the nature of HIV drug resistance. Firstly, virological monitoring (viral load and resistance testing) is unlikely to accompany much roll-out. Thus, treatment switch will be guided more by clinical, than virological/immunological criteria. |
| O2 | TRENDS IN TRANSMITTED HIV DRUG RESISTANCE AMONG NON-B SUBTYPES IN THE UK J Int AIDS Soc 2008, 11(Suppl 1):O2 doi:10.1186/1758-2652-11-S1-O2 D Chilton1,3, L Harrison1, H Green1, S Lattimore2, V Delpech2 and D Pillay1 These data suggest that TDR is significantly lower amongst non-B subtypes, with the presence of TDR decreasing more rapidly over calendar year in this group. However, we cannot exclude testing bias, especially in earlier years. Reassuringly, TDR is mainly confined to one drug class. Despite the widespread use of NNRTI in the developing world, NNRTI resistance remains significantly lower in non-B subtypes. There is a proportional increase in the resistance tests done in naïve individuals with non-B subtypes, reflecting guidelines. |
| O3 | HIV-1 CLADE C RESISTANCE GENOTYPES AFTER FIRST VIROLOGICAL FAILURE IN A LARGE COMMUNITY ART PROGRAMME J Int AIDS Soc 2008, 11(Suppl 1):O3 doi:10.1186/1758-2652-11-S1-O3 C Orrell1, RP Walensky2, E Losina2, KA Freedberg2 and R Wood3 Prevalence of primary resistance in a sample of ART-naïve clade C HIV-infected individuals in South Africa is low. An NNRTI-based initial ART regimen remains appropriate for most naïve individuals. Patients failing first-line ART have generally developed resistance to both NNRTIs and NRTIs, the two drug classes used in first-line therapy. The emergence of the K65R mutation, without tenofovir use, is unexpected and worrisome. Current second-line ART options remain viable, but close ongoing surveillance of resistance patterns is critical to optimize clinical care. |
| O4 |
NNRTI MUTATIONS ARE EFFICIENTLY TRANSMITTED WITHIN CLUSTERS OF NEW HIV INFECTIONS J Int AIDS Soc 2008, 11(Suppl 1):O4 doi:10.1186/1758-2652-11-S1-O4 BG Brenner1, T d'Aquin Toni1, M Roger2, JP Routy3, D Moisi1 and MA Wainberg1 A significant proportion of new HIV infections in our community arise from untreated persons, who are often unaware of their serostatus, at early stages of infection, and this further results in onward transmission of both wild-type and drug-resistant infections. NNRTI mutations are detected within transmission clusters to a far higher extent than are mutations associated with other drug classes. |
| O5 | IMPORTANCE OF DETECTING MINORITY VARIANTS IN THE CLINICAL MANAGEMENT OF HIV J Int AIDS Soc 2008, 11(Suppl 1):O5 doi:10.1186/1758-2652-11-S1-O5 D Kuritzkes HIV-1 drug resistance is an important cause of antiretroviral failure. Although standard genotypic and phenotypic tests can detect drug resistance in many cases, both are limited in their capacity to detect variants present as minority members of the viral population, particularly at levels below 5–10%. |
| O6 | DRUG INTERACTIONS THAT REALLY MATTER J Int AIDS Soc 2008, 11(Suppl 1):O6 doi:10.1186/1758-2652-11-S1-O6 SH Khoo Recognising and managing drug-drug interactions (DDI) has become a necessary part of antiretroviral therapy. One study has identified significant DDIs in around one in five patients receiving ARVs (antiretroviral therapy) in the USA, ~20% of which could have resulted in decreased exposure to HIV drugs. |
| O7 | PREVALENCE OF DRUG INTERACTIONS BETWEEN ANTIRETROVIRAL AND CO-ADMINISTERED DRUGS AT THE MOI TEACHING AND REFERRAL HOSPITAL (AMPATH), ELDORET, KENYA J Int AIDS Soc 2008, 11(Suppl 1):O7 doi:10.1186/1758-2652-11-S1-O7 GK Kigen1, S Kimaiyo2, DJ Back1, SE Gibbons1, E Sang2, IG Edwards1, A Owen1 and SH Khoo1 Clinically significant DIs were common, affecting over 1/4 patients receiving ART in Kenya, yet are frequently not recognized. Although TB medications accounted for a significant proportion of DIs, we identified other important interactions involving ARVs and azoles, as well as antimalarials. Given the relative lack of laboratory monitoring and widespread use of FDCs, strategies need to be developed urgently to avoid important drug interactions, to identify early markers of toxicity, and to manage unavoidable interactions safely, in order to reduce risk of harm, and to maximize the effectiveness of mass ARV deployment in Africa. |
| O8 | TO OVERDOSE OR UNDERDOSE? THE QUESTION OF KALETRA IN CHILDREN IN THE UK/IRISH COLLABORATIVE HIV PAEDIATRIC STUDY (CHIPS) J Int AIDS Soc 2008, 11(Suppl 1):O8 doi:10.1186/1758-2652-11-S1-O8 AS Walker1, KL Boyd1, K Doerholt2, H Lyall3, E Menson4, K Butler5, P Tookey6, A Riordan7, D Shingadia8, A Judd1, G Tudor-Williams3 and DM Gibb1 In summary, younger or stunted/wasted children or those with prior AIDS/higher VLs received higher doses. Doses were higher with capsules/tablets, likely reflecting overrather than under-dosing when solid formulations cannot achieve exact doses. However, we found no clear evidence that higher doses improved VL suppression. |
| O9 | EFAVIRENZ AND RIFAMPICIN IN THE SOUTH AFRICAN CONTEXT: IS THERE A NEED TO DOSE INCREASE EFAVIRENZ WITH CONCURRENT RIFAMPICIN THERAPY? J Int AIDS Soc 2008, 11(Suppl 1):O9 doi:10.1186/1758-2652-11-S1-O9 C Orrell1, K Cohen2, P Ive3, I Sanne3 and R Wood1 In our population there is no reduction in middose EFV concentrations with concomitant RFN therapy. The pharmacogenetic profile cytochrome p450 isoenzyme, particularly the 2B6 isoenzyme, in this South African population may differ from the other populations where the majority of pharmacokinetic work has been completed. It was not necessary to increase the dose of EFV during concomitant TB therapy in this South African population. |
| O10 | IMPACT OF EFAVIRENZ AND NEVIRAPINE ON PHARMACOKINETICS OF LOPINAVIR/RITONAVIR AS TABLETS AND CAPSULES IN AFRICAN PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):O10 doi:10.1186/1758-2652-11-S1-O10 C Kityo1, AS Walker2, F Lutwana3, F Ssali4, R Nalumenya3, D Tumukunde4, J Kawiya5, P Munderi6, A Reid7, CF Gilks8, DM Gibb2 and SH Khoo9 When co-administered with NVP or EFV in African patients, LPV AUC and C12 are higher with 3 tablets BD and lower with 2 tablets BD compared to 4 capsules BD. Higher plasma levels on 3 tablets BD may lead to greater longterm toxicity, whereas low plasma C12 on 2 tablets BD may increase the risk of virological failure. However, AUC on 4 caps BD was lower than expected, and tablet AUC variability was higher than expected. Further PK sampling is therefore ongoing to estimate PK parameters in African patients taking 2 LPV/r tablets BD without NNRTIs. |
| O11 | SECONDLINE ART IN THE DEVELOPING WORLD J Int AIDS Soc 2008, 11(Suppl 1):O11 doi:10.1186/1758-2652-11-S1-O11 J Hakim The best strategies to identify and manage firstline ART failure and the best ways to choose secondline ART combinations in the developing world are inevitably pragmatic and often based on expert opinion rather that hard evidence. |
| O12 | WHERE ARE WE WITH NATIONAL AND INTERNATIONAL GUIDELINES? J Int AIDS Soc 2008, 11(Suppl 1):O12 doi:10.1186/1758-2652-11-S1-O12 E Katabira Some believe that such guidelines will reduce costs of commodities by facilitating bulk purchases. However, others are of the view that universal guidelines may negatively affect those countries that are not supported by PEOFAR and the like. |
| O13 | SEEK AND TREAT FOR OPTIMAL PREVENTION OF HIV/AIDS (STOP HIV/AIDS) J Int AIDS Soc 2008, 11(Suppl 1):O13 doi:10.1186/1758-2652-11-S1-O13 JSG Montaner This program labelled "Seek and Treat for Optimal Prevention of HIV & AIDS" (STOP HIV & AIDS), will aim to decrease AIDS-related diseases and death among those already infected with HIV and to decrease the emergence of new HIV infections in BC. Lessons learned from this initiative should assist in the development of public health policy aimed to expand HAART coverage with the dual goal of decreasing AIDS-related morbidity and mortality and assisting traditional prevention efforts aimed to reduce HIV incidence. |
| O14 | HIV/TB: WHEN IS IT SAFE TO START HAART? J Int AIDS Soc 2008, 11(Suppl 1):O14 doi:10.1186/1758-2652-11-S1-O14 R Wood Therefore, the optimum timing of ART initiation may be earlier in the course of TB treatment for patients in resource-limited settings compared to those in highincome settings. Much interest has rightly focussed on the optimum timing of ART in relation to TB treatment. However, the potentially more important problem of delays in the care pathway has received little attention. |
| O15 | HIV DISEASE MANAGEMENT AND CHALLENGES IN EASTERN EUROPE AND CENTRAL ASIA J Int AIDS Soc 2008, 11(Suppl 1):O15 doi:10.1186/1758-2652-11-S1-O15 A Bobrik This is also compounded by methodological issues, like existing controversy among local professionals over many adjuvant interventions with the effectiveness proven elsewhere, e.g. preventive izoniazide treatment, substitution treatment, etc. The future challenges for the region will also probably include gradual increase in drug resistance and long-term sustainability, as more and more countries of Eastern Europe and Central Asia become ineligible for HIV grants from GFATM. |
| O16 | HIV AND THE BRAIN: NEURO-INFLAMMATION LONG-TERM, CNS CONTROL OF HIV REPLICATION, BRAIN DISEASE IN SUPPRESSED PATIENTS AND DIFFERENTIAL PENETRATION OF DRUGS J Int AIDS Soc 2008, 11(Suppl 1):O16 doi:10.1186/1758-2652-11-S1-O16 D Clifford When HIV therapies are categorized according to their effectiveness in the brain or CSF, recent evidence supports better cognitive outcomes with more highly effective drug regimens. Ongoing research is critical to determine if outcomes of HIV therapy can be improved by selection of drugs with better CNS penetrating properties. |
| O17 | RATE OF CHANGE IN CD4 COUNTS IN PATIENTS WITH STABLE HIV VIREMIA J Int AIDS Soc 2008, 11(Suppl 1):O17 doi:10.1186/1758-2652-11-S1-O17 AN Phillips1, B Ledergerber2, JR Bogner3, K Lacombe4, A Wiercinska-Drapalo5, P Reiss6, O Kirk7, JD Lundgren8 and A Mocroft1 The results from our study would suggest that some treatment with cART is better than none, but also that better CD4 count increases are obtained by using a PI or ritonavir-boosted PI-based regimen than by using an NNRTI-based regimen. Patients were not randomised to treatment and confounding by indication cannot be ruled out. Patients with stable viremia unable to fully suppress HIV replication should continue therapy and consideration should be given to the use of a PI-based regimen. |
| O18 | CD4-GUIDED STI IN PATIENTS RESPONDING TO HAART J Int AIDS Soc 2008, 11(Suppl 1):O18 doi:10.1186/1758-2652-11-S1-O18 F Maggiolo1, M Airoldi1, A Callegaro1, C Martinelli2, A Dolara3, T Bini4, G Gregis1, P Quinzan1, V Ravasio1 and F Suter1 CD4-guided STIs may be a possible alternative strategic option for chronically infected individuals responding to HAART provided that CD4 decrements would be steadily maintained above a safe threshold. STIs warrant further careful prospective evaluation especially to investigate virologic and clinical outcomes in the very long period. |
| O19 | THE FOTO STUDY: 24-WEEK RESULTS SUPPORT THE SAFETY OF A 2-DAY BREAK ON EFAVIRENZ-BASED ANTIRETROVIRAL THERAPY J Int AIDS Soc 2008, 11(Suppl 1):19 doi:10.1186/1758-2652-11-S1-O19 C Cohen1, A Colson1, G Pierone2, E DeJesus3, F Kinder4, R Elion5, D Skiest6, A Habel1, J Jensen1, J Garb7 and H Schrager1 These data confirm the success of a Five-day On/ Two-day Off strategy for maintaining virologic suppression for at least 24 weeks on EFV/TDF/FTC. Follow-up is ongoing to further assess durability. This treatment strategy could significantly reduce antiretroviral drug costs, which is especially important in resource-scarce areas. |
| O20 | OPTIMISING PAEDIATRIC TREATMENT FOR LONG TERM SURVIVAL. ADULT SURVIVORS OF CONGENITAL HIV INFECTION - WHAT PROBLEMS WILL THEY HAVE? J Int AIDS Soc 2008, 11(Suppl 1):O20 doi:10.1186/1758-2652-11-S1-O20 H Lyall In the short term, this question has been addressed in PENTA 11 (paediatric structured treatment interruption trial - data to be presented at HIV9); long-term follow up of these trial patients and national cohorts will be very important in helping to elucidate this question of competing long-term drug and/or HIV effects. |
| O21 | TREATMENT INTERRUPTION IN CHILDREN WITH CHRONIC HIV-INFECTION: THE RESULTS OF THE PAEDIATRIC EUROPEAN NETWORK FOR TREATMENT OF AIDS (PENTA) 11 TRIAL J Int AIDS Soc 2008, 11(Suppl 1):O21 doi:10.1186/1758-2652-11-S1-O21 DM Gibb1, A Compagnucci2, H Green3, M Lallemant4, Y Saidi2, N Ngo-Giang-Huong4, C Taylor3, L Mofenson5, F Monpoux6, MIG Tomé7, M Marczyñska8, D Nadal9, U Wintergerst10, S Kanjavanit11, H Lyall12, C Giaquinto13 and J Moye4 In summary, PENTA 11 was the first randomised trial of planned treatment interruptions (PTIs) in children with chronic HIV infection. In this pilot study we observed no deaths or serious clinical events. Overall, fewer PTI children were suppressed < 50 c/ml at 72 weeks (analysis of resistance results is ongoing) and CD4 recovery after PTI appeared better in younger children. However, longer-term assessment of all children after restarting ART will be required to fully assess risks and benefits of PTI in this population. |
| O22 | ANTIRETROVIRAL PREGNANCY REGISTRY (APR) AT 10,000 PROSPECTIVE REPORTS J Int AIDS Soc 2008, 11(Suppl 1):O22 doi:10.1186/1758-2652-11-S1-O22 KP Beckerman1, D Covington2, K Dominguez3, A Scheuerle4, VX Vannappagari5, DH Watts6 and H Tilson7 In summary, prospectively collected APR data have not detected an overall increase in birth defects following in utero ARV exposure during organogenesis. We continue to follow two trends that do not reach statistical significance. |
| O23 | THE EARLY AIDS EPIDEMIC IN THE U.S.: VIEWS FROM ATLANTA AND HOLLYWOOD J Int AIDS Soc 2008, 11(Suppl 1):O23 doi:10.1186/1758-2652-11-S1-O23 H Jaffe In retrospect, these recommendations made before the identification of HIV were essentially correct and serve to illustrate the power of the epidemiologic method to understand the transmission and natural history of new infectious diseases in advance of identifying their causes. |
| O24 | CRYPTOGENETIC LIVER DISEASE, STEATOSIS, PORTAL HYPERTENSION, TRANSAMINITIS AND ANTIRETROVIRALS J Int AIDS Soc 2008, 11(Suppl 1):O24 doi:10.1186/1758-2652-11-S1-O24 S Pol In summary, there are several causes of liver abnormalities in HIV-infected patients which require first to be recognised, second to be clearly analyzed and third treated when possible. The initial liver evaluation of any HIV-infected patient appears to be necessary to better understand the future occurrence of liver abnormalities. The place of non-invasive markers of fibrosis in this setting remains debatable. |
| O25 | WHAT'S NEW IN HEPATITIS C? J Int AIDS Soc 2008, 11(Suppl 1):O25 doi:10.1186/1758-2652-11-S1-O25 V Soriano The prospects for new specific anti-HCV agents are coming slowly. HCV protease inhibitors (e.g. telaprevir), nucleoside analogs (e.g. R-1626), and four different classes of non-nucleoside HCV polymerase inhibitors are rapidly progressing in clinical development. Drug resistance in HCV will be very challenging for most of these agents, and accordingly, as in the HIV field, combination therapy is the way to go on. Although the new drugs will be combined with pegylated interferon and ribavirin in a first moment, the prospects for combining new agents moving off interferons are eagerly searched. |
| O26 | SURROGATE MARKERS FOR LIVER DAMAGE (I.E. HOW CAN WE MEASURE THE EXTENT OF FIBROSIS AND DISEASE WITHOUT BIOPSY) J Int AIDS Soc 2008, 11(Suppl 1):O26 doi:10.1186/1758-2652-11-S1-O26 M Puoti The diagnostic accuracy of TE is high for detecting cirrhosis and good for diagnosis of significant liver fibrosis. However, the performance of TE is low for discriminating mild fibrosis from significant liver fibrosis, which might limit the applicability of this technique in clinical practice. |
| O27 | PATHOGENESIS OF NON-AIDS MORBIDITIES IN HIV DISEASE AND IMPLICATIONS FOR MANAGEMENT J Int AIDS Soc 2008, 11(Suppl 1):O27 doi:10.1186/1758-2652-11-S1-O27 S Deeks However, this procedure has been insufficiently validated in patients with human immunodeficiency virus (HIV) and HCV co-infection. The diagnostic accuracy of TE is high for detecting cirrhosis and good for diagnosis of significant liver fibrosis. However, the performance of TE is low for discriminating mild fibrosis from significant liver fibrosis, which might limit the applicability of this technique in clinical practice. |
| O28 | CARDIOVASCULAR DISEASE; HIV, ART, IMMUNODEFICIENCY, PRO-INFLAMMATION AND OTHER FACTORS J Int AIDS Soc 2008, 11(Suppl 1):O28 doi:10.1186/1758-2652-11-S1-O28 JD Lundgren The age-and gender-adjusted incidence of cardiovascular disease is higher in HIV-infected populations than in the general population. This talk will discuss the possible reasons for this excess risk, and suggest rational approaches of how best to reduce it. |
| O29 | RELATION BETWEEN ADVERSE EFFECTS OF ARV TREATMENT AND UNDERLYING RISK IN NUMBER NEEDED TO TREAT TO HARM (NNTH) - MYOCARDIAL INFARCTION AND ABACAVIR USE J Int AIDS Soc 2008, 11(Suppl 1):O29 doi:10.1186/1758-2652-11-S1-O29 JD Kowalska1, O Kirk1, A Mocroft2, L Høj1, N Friis-Møller1, P Reiss3 and JD Lundgren4 It is possible to increase NNTH values for any group of patients on abacavir by decreasing the underlying risk of MI. Therefore, if underlying risk of MI can be reduced, the NNTH for a given therapy will increase, meaning that the therapy can be administered to more people without causing additional harm. |
| O30 | PREDICTING THE SHORT-TERM RISK OF DIABETES IN HIV-INFECTED PATIENTS IN THE D:A:D COHORT: THE D:A:D STUDY GROUP J Int AIDS Soc 2008, 11(Suppl 1):O30 doi:10.1186/1758-2652-11-S1-O30 K Petoumenos1, E Fontas2, SWWorm3, RWeber4, S De Wit5, M Bruyand6, CA Sabin7, P Reiss8, W El-Sadr9, A d'Arminio Monforte10, N Friis-Møller3, JD Lundgren3 and MG Law1 The D:A:D equation performed well in predicting the short-term of DM in the validation dataset, and for specific subgroups fared better than the Framingham algorithm. |
| O31 | MANAGEMENT OF RENAL DISEASE IN HIV INFECTION FOR THE HIV PHYSICIAN J Int AIDS Soc 2008, 11(Suppl 1):O31 doi:10.1186/1758-2652-11-S1-O31 I Williams With a relatively high prevalence of renal dysfunction and with both HIV and non-HIV causes and contributing factors, it is important for the HIV physician to have a good understanding of the aetiology, screening methods and management strategies for kidney disease in the HIV-infected patients. |
| O32 | BONE DISEASE AND HIV - TOGETHER FOR THE LONG TERM J Int AIDS Soc 2008, 11(Suppl 1):O32 doi:10.1186/1758-2652-11-S1-O32 P Mallon These questions can only be answered by large scale prospective studies from which HIV-specific, evidence-based guidelines can be derived. In order to appropriately manage long-term bone health in HIV-infected patients, research strategies and sufficient access to monitoring are needed to address the deficits in our knowledge and enable appropriate monitoring of this condition in the HIV setting so that this challenge to the long-term health of HIV-infected patients is effectively managed and the potential resulting morbidity limited. |
| O33 | HIGH HIV VIRAL LOAD INHIBITS OSTEOBLAST FUNCTION AND SIGNALLING J Int AIDS Soc 2008, 11(Suppl 1):O33 doi:10.1186/1758-2652-11-S1-O33 NS Chew1, EJ Cotter1, PP Doran1 and WG Powderly2 These data demonstrate bioactivity of HIV in the setting of osteoblast cell culture. Serum obtained from HIV patients with high VL effected significant changes in the bone phenotype, as evidenced by reduced capacity for calcium deposition. Intriguingly, this functional effect was mirrored by changes in the expression of the osteogenic transcription factor RUNX-2. These findings support the hypothesis that HIV itself, in addition to the well described effect of ART, can modulate bone phenotype and at least in part, drive the osteopenia and osteoporosis which is increasingly seen in HIV patients. |
| O34 | HIV, IMMUNE DEFICIENCY AND MALIGNANCY J Int AIDS Soc 2008, 11(Suppl 1):O34 doi:10.1186/1758-2652-11-S1-O34 AE Grulich Until recently, it was accepted that only a few specific types of cancer were associated with the immune deficiency associated with HIV infection. Although it is known that a number of other cancers occur at increased rates, most studies have concluded that these cancers occur at increased rates because of lifestyle risk factors for cancer in people with HIV, rather than a direct effect of immune deficiency |
| O35 | PATTERNS OF VIRAL SUPPRESSION ON CART AS PREDICTORS OF UNCONTROLLED VIREMIA AFTER STARTING A NEW ANTIRETROVIRAL AFTER 1 JANUARY 2003 J Int AIDS Soc 2008, 11(Suppl 1):O35 doi:10.1186/1758-2652-11-S1-O35 J Reekie1, A Mocroft1, B Ledergerber2, M Beniowski3, B Clotet4, J van Lunzen5, AChiesi6, C Pradier7, L Machala8 and JD Lundgren9 The number of previous rebounds and the percentage of time suppressed whilst on cARTwere both strong predictors of future uncontrolled viremia after starting a new ARV. Hence, the history of patterns of viral response to cART regimens should be an integrated component in deciding monitoring strategies and adherence counseling for patients whenever a change in cART is made. |
| O36 | OPPORTUNISTIC INFECTIONS IN IMMUNOCOMPROMISED BUT VIROLOGICALLY SUPPRESSED HIV-1 INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):O36 doi:10.1186/1758-2652-11-S1-O36 WP Bannister1, A Mocroft1, O Kirk2, P Reiss3, A d'Arminio Monforte4, JM Gatell5, M Fisher6, H Trocha7, A Rakhmanova8 and JD Lundgren2 Achieving virological suppression in immunocompromised patients is important for reducing the risk of OIs. Patients on cART have a much lower risk of death than those not receiving cART, regardless of viral suppression. Part of this difference in risk of death may be due to terminally ill patients being taken off cART and warrants further analysis of deaths caused by OIs and deaths caused by non-OIs. |
| O37 | TREATMENT DISCONTINUATION AND VIROLOGICAL FAILURE AMONGST HIV-POSITIVE INDIVIDUALS STARTING SECOND-LINE COMBINATION ANTIRETROVIRAL THERAPY (CART) J Int AIDS Soc 2008, 11(Suppl 1):O37 doi:10.1186/1758-2652-11-S1-O37 CJ Smith1, FC Lampe1, M Youle2, MA Johnson2 and AN Phillips1 The median time to making at least one ARV switch on a second-line regimen was comparable to that seen on first-line regimens. Although VF appeared more common on second-line than on first-line regimens, perhaps because this is a group who are more predisposed to VF, response rates were still excellent. |
| O38 | HIV-TB CO-INFECTION AND TB DRUG RESISTANCE: AN EMERGING THREAT TO HIV AND TB PROGRAMMES J Int AIDS Soc 2008, 11(Suppl 1):O38 doi:10.1186/1758-2652-11-S1-O38 GH Friedland This presentation will review drug-resistant tuberculosis globally, with particular reference to South Africa, describe its interaction with the HIV epidemic and resultant consequences, and suggest measures necessary for controlling MDR and XDR TB in this context. A successful clinical and public health response necessitates infusion of new resources, earlier case finding, attention to airborne infection control, new TB diagnostics and therapeutics and development of new strategies, including increased collaboration between TB and HIV programs. |
| O39 | FACTORS ASSOCIATED WITH POOR CLINICAL OUTCOME AMONG HIV-INFECTED PATIENTS WITH TUBERCULOSIS (TB) IN EUROPE AND ARGENTINA. THE HIV/TB COLLABORATIVE STUDY J Int AIDS Soc 2008, 11(Suppl 1):O39 doi:10.1186/1758-2652-11-S1-O39 D Podlekareva1, A Mocroft2, FA Post3, V Riekstina4, JM Miro5, H Furrer6, M Bruyand7, A Panteleev8, E Girardi9, JJ Toibaro10, J Caylá 11, R Miller12, N Obel13, A Skrahin14, E Malashenkov15, JD Lundgren16, O Kirk16 and HIV/TB study group16 In conclusion, there were substantial differences in the clinical management of HIV-TB co-infected patients across Europe and Argentina, including less use of cART and more extensive use of second-line anti-TB drugs, presumably partly due to widespread TB drug resistance in populations from E. These factors may partly explain the 3–4 fold higher one-year mortality rate after a TB diagnosis in this region, and deserve immediate public health attention. |
| O40 | PHARMACOKINETICS (PK) OF ONCE-DAILY ETRAVIRINE (ETR) WITHOUT AND WITH ONCE-DAILY DARUNAVIR/RITONAVIR (DRV/R) IN ANTIRETROVIRAL-NAÏVE HIV-1 INFECTED ADULTS J Int AIDS Soc 2008, 11(Suppl 1):O40 doi:10.1186/1758-2652-11-S1-O40 J Lalezari1, E DeJesus2, O Osiyemi3, P Ruane4, Z Haigney1, R Ryan5, B Polsonetti6, TN Kakuda5 and J Witek6 Addition of DRV/r QD to ETR QD had no significant impact on ETR PK and exposure to ETR was adequate with and without DRV/r. PK data and short-term safety and efficacy support further clinical investigation of ETR 400 mg QD in HIV-1 infected patients. |
| O41 | 48-WEEK DATA FROM STUDY AVX-201 - A RANDOMISED PHASE IIB STUDY OF APRICITABINE IN TREATMENT-EXPERIENCED PATIENTS WITH M184V AND NRTI RESISTANCE J Int AIDS Soc 2008, 11(Suppl 1):O41 doi:10.1186/1758-2652-11-S1-O41 P Cahn1, J Altclas2, M Martins3, M Losso4, I Cassetti5, S Cox6 and DA Cooper7 ATC provided significant and durable antiviral activity over the 48-week treatment period, with a favourable safety profile and no evidence of resistance development. Sustained and improved responses in viral load and CD4 cells were seen from week 24 to week 48. The greatest improvements were seen in the 3TC arm: patients switching from 3TC to ATC at week 24 nearly doubled their CD4 cell increase from week 24 to 48, but still lagged behind those receiving ATC for the full 48 weeks. Patients receiving 3TC for the first 24 weeks underwent a greater number of ART re-optimisations than those receiving ATC. ATC has the potential to provide significant, very well tolerated antiviral activity and to enable construction of a potent, durable regimen in treatment-experienced patients. |
| O42 | EFFICACY AND SAFETY OF 48-WEEK MAINTENANCE WITH QD ATV VS ATV/R (BOTH + 2NRTIS) IN PATIENTS WITH VL < 50 C/ML AFTER INDUCTION WITH ATV/R + 2NRTIS: STUDY AI424136 J Int AIDS Soc 2008, 11(Suppl 1):O42 doi:10.1186/1758-2652-11-S1-O42 JF Delfraissy1, S Moreno2, J Sanz-Moreno3, G Carosi4, V Pokrovsky5, A Lazzarin6, G Pialoux7, A Balogh8, E Vandeloise8 and G Leleu9 These results are consistent with the proven efficacy of atazanavir in naïve pts and suggest that for those pts who have achieved undetectability under ATV/r, switching to unboosted ATV may be an option that results in simplification of treatment regimen. |
| O43 | WHEN TO START THERAPY? THE PATIENT'S VIEWPOINT J Int AIDS Soc 2008, 11(Suppl 1):O43 doi:10.1186/1758-2652-11-S1-O43 G Cairns1 and K Alcorn2 Several international treatment guidelines now recommend that antiretroviral therapy should be initiated in all patients with a CD4 count below 350 cells/mm3. However, about 57% of UK patients are currently diagnosed with CD4 counts under 350, and 20% of patients currently with CD4 counts under this figure and diagnosed for longer than three months are not taking ARVs [1]. |
| O44 | DO THE DISADVANTAGES OF LATE INITIATION OF HAART PERSIST IN PATIENTS ACHIEVING AND MAINTAINING VIRAL LOAD (VL) SUPPRESSION FOR A YEAR ON HAART? J Int AIDS Soc 2008, 11(Suppl 1):O44 doi:10.1186/1758-2652-11-S1-O44 LJ Waters1, M Fisher2, J Anderson3, C Wood4 and CA Sabin5 Individuals starting HAART at CD4 counts ≤100 cells who maintain VL suppression for a year have lower median CD4 counts by 4 years after HAART. However, CD4 increases in this group are greater than those in patients starting at higher CD4s, suggesting that any disadvantage may be lost over time if patients can maintain VL suppression. |
| O45 | RISK OF NEW AIDS-DEFINING EVENTS IN PATIENTS WITH ADVANCED IMMUNODEFICIENCY DURING SUPPRESSIVE HAART: RESULTS FROM THE GERMAN CLINSURV COHORT J Int AIDS Soc 2008, 11(Suppl 1):O45 doi:10.1186/1758-2652-11-S1-O45 A Zoufaly1, C Kreuzberg1, M An der Heiden2, C Kollan2, O Hamouda2 and J van Lunzen1 Immune-discordance is a risk factor for a new ADE while on HAART during the first year of suppressed viremia. After this time the incidence of ADE decreases dramatically even in patients with prolonged immunodeficiency. The risk is highest in patients who fail to increase CD4 counts to >100 cells/µl. Strategies to raise or maintain a CD4 count above at least 100 cells/μl could prevent most ADE in this patient group. See Figure 1. |
| O46 | RESISTANCE DEVELOPMENT IN VIROLOGICAL FAILURES WITH DRV/R OR LPV/R: 96-WEEK ANALYSIS OF THE PHASE III TITAN TRIAL IN TREATMENT-EXPERIENCED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):O46 doi:10.1186/1758-2652-11-S1-O46 S De Meyer1, E Lathouwers1, I Dierynck1, E De Paepe1, B Van Baelen1, T Vangeneugden1, F Tomaka2, MP de Béthune1 and G Picchio2 In this treatment-experienced, LPV-naïve patient population, the overall VF rate with DRV/r was half compared to LPV/r. Furthermore, the majority of DRV/r VFs did not develop primary PI mutations or NRTI RAMs and preserved susceptibility to PIs and NRTIs. |
| O47 | EFFICACY AND SAFETY OF MARAVIROC IN TREATMENT-EXPERIENCED (TE) PATIENTS INFECTED WITH R5 HIV-1: 96-WEEK COMBINED ANALYSIS OF THE MOTIVATE 1 AND 2 STUDIES J Int AIDS Soc 2008, 11(Suppl 1):O47 doi:10.1186/1758-2652-11-S1-O47 WD Hardy1, R Gulick2, HB Mayer3, G Fätkenheuer4, M Nelson5, J Heera3, N Rajicic6 and J Goodrich3 MVC+OBT resulted in durable viral suppression through week 96 in these TE patients with R5 HIV-1. Pooled analyses revealed no new or unique safety signals between 48 and 96 weeks. Serious adverse events, Category C events and malignancies occurred with similar frequency among treatment groups. |
| Poster Presentations |
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| P1 | CLINICAL EFFECT OF INTERLEUKIN-2 (IL-2) IMMUNO-ADJUVANT TREATMENT IN HIV+ ADVANCED NAÏVE PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P1 doi:10.1186/1758-2652-11-S1-P1 C Tincati1, M Cesari2, L Meroni2, F Bai1, GM Bellistrì1, M Galli2, ME Moroni2, A d'Arminio Monforte1 and GM Marchetti1 In advanced naïve patients, IL-2 adjuvant therapy is efficacious in inducing a rapid and significant CD4 reconstitution, in most cases sustained up to 18 months. The finding of a reduced prevalence of patients developing AIDS-defining conditions suggests a possible efficacy in functional immune enhancement which may translate into earlier clinical benefit. |
| P2 | EFFICACY AND SAFETY OF TMC278 IN TREATMENT-NAÏVE, HIV-INFECTED PATIENTS: WEEK 96 DATA FROM TMC278-C204 J Int AIDS Soc 2008, 11(Suppl 1):P2 doi:10.1186/1758-2652-11-S1-P2 JM Molina1, C Cordes2, P Ive3, A Vibhagool4, S Vanveggel5, P Williams5 and K Boven6 Over 96 weeks, TMC278 demonstrated a high, sustained virological response rate and was generally well tolerated with lower incidences of rash, nervous system and psychiatric AEs, and less lipid increases than EFV. |
| P3 | IMPACT OF ANTIRETROVIRAL DOSING AND DAILY PILL BURDEN ON VIRAL REBOUND RATES IN NAÏVE PATIENTS RECEIVING A TENOFOVIR-BASED REGIMEN J Int AIDS Soc 2008, 11(Suppl 1):P3 doi:10.1186/1758-2652-11-S1-P3 A Ammassari1, P Lorenzini1, F Maggiolo2, G Sterrantino3, A Corpolongo1, G Rizzardini4, N Abrescia5, A Chirianni5, M Foggia6, C Mussini7, N Gianotti8, M Andreoni9, CF Perno9 and A Antinori1 Once-a-day dosing of tenofovir-based regimens, especially when combined with low daily pill burden, favourably impacts on maintenance of virological response in cART-naive patients. Higher baseline CD4 cell count independently protects from loss of virological efficacy. |
| P4 | THE SAFETY AND EFFICACY OF TENOFOVIR DF IN COMBINATION WITH LAMIVUDINE AND EFAVIRENZ IN ANTIRETROVIRAL-NAÏVE PATIENTS THROUGH 7 YEARS J Int AIDS Soc 2008, 11(Suppl 1):P4 doi:10.1186/1758-2652-11-S1-P4 JVR Madruga1, I Cassetti2, A Etzel3, JMA Suleiman4, Y Zhou5, AK Cheng5 and J Enejosa5 Through 7 years of therapy, the once-daily regimen of TDF+3TC+EFV demonstrated sustained antiretroviral activity with continued immunologic recovery in antiretroviral- naïve patients and was not associated with limb fat loss or progressive bone loss, nor was it associated with declines in estimated GFR. |
| P5 | EFFECTS OF NRTI BACKBONE ON HIV RNA, CD4 COUNTS AND LIPIDS FOR FIRST-LINE BOOSTED PI-BASED HAART: META-ANALYSIS OF 12 CLINICAL TRIALS IN 4,896 PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P5 doi:10.1186/1758-2652-11-S1-P5 AM Hill1 and WA Sawyer2 This systematic meta-analysis of standardised HIVRNA < 50 copy efficacy data at week 48, using the FDA TLOVR algorithm, suggests higher efficacy for first-line use of a TDF/FTC NRTI backbone, relative to use of ABC/3TC. However, CD4 increases were similar across the range of NRTIs and PIs used. Lipid profiles also differed by choice of NRTI backbone or boosted PI. |
| P6 | A STUDY TO EVALUATE THE EFFICACY, SAFETY AND TOLERABILITY OF CO-ADMINISTERED LOPINAVIR/RITONAVIR (LPVR) AND NEVIRAPINE (NVP) IN HIV-INFECTED ADULTS J Int AIDS Soc 2008, 11(Suppl 1):P6 doi:10.1186/1758-2652-11-S1-P6 TW Mahungu1, LJ Else2, CJ Smith3, Z Cuthbertson1, D Podlekareva4, P Hay5, UB Dragsted4, SH Khoo2, MA Johnson1, DJ Back2 and M Youle1 In this predominantly antiretroviral-naïve cohort, at 48 weeks 79% of the patients remaining on the NRTI-sparing regimen had HIV-RNA < 50 copies/ml. These figures are comparable with previously reported figures in similar treatment strategies. |
| P7 | SIMILAR VIROLOGICAL RESPONSE RATES FOR ART-NAÏVE SUBJECTS STARTING KVX + LPV/R OR TVD+ LPV/R. DATA FROM THE PROSPECTIVE OBSERVATIONAL STAR COHORT J Int AIDS Soc 2008, 11(Suppl 1):P7 doi:10.1186/1758-2652-11-S1-P7 E Wolf1, A Trein2, W Schmidt3, A Baumgarten4, H Jaeger5 and HJ Stellbrink6 This prospective non-interventional study so far fails to show a difference in antiviral response between subjects using KVX or TVD in conjunction with LPV/r adjusted for baseline VL and CD4 cells. The lack of a significant difference for KVX or TVD use confirms the results of the HEAT study in an observational setting. |
| P8 | EFFICACY AND SAFETY BY BASELINE HIV-RNA AND CD4 COUNT IN TREATMENT-NAÏVE PATIENTS TREATED WITH ATAZANAVIR/R AND LOPINAVIR/R IN THE CASTLE STUDY J Int AIDS Soc 2008, 11(Suppl 1):P8 doi:10.1186/1758-2652-11-S1-P8 J Uy1, R Yang2, A Thiry2, J Absalon2, A Farajallah1, JF Maa1 and D McGrath2 Lower response rates at higher baseline HIV-RNA were seen for both ATV/r and LPV/r. The trend for lower response rates at lower baseline CD4 cell counts for LPV/r observed in the ITT analysis did not appear to be present in the on-treatment analysis. ATV/r and LPV/r had consistent adverse event (AE) profiles within each arm by baseline HIV-RNA. More AEs, most commonly diarrhea and nausea, were observed with LPV/r at low baseline CD4 cell counts. |
| P9 | DIFFERENCES IN CD4 COUNT INCREASES IN VETERANS STARTING ANTIRETROVIRAL THERAPY WITH LOPINAVIR/RITONAVIR OR EFAVIRENZ J Int AIDS Soc 2008, 11(Suppl 1):P9 doi:10.1186/1758-2652-11-S1-P9 RJ Bedimo1, H Drechsler1, M Holodniy2, M Pasley3 and W Woodward3 Efavirenz (EFV) and lopinavir/ritonavir (LPV/r) are both recommended as preferred backbone agents for combination antiretroviral therapy (cART) in treatment-naïve patients. Meta-analyses have suggested there is a difference in the magnitude of CD4 cell count response. |
| P10 | IMMUNE RESTORATION DURING HAART: 8-YEAR FOLLOW-UP IN HIV-POSITIVE PATIENTS WITH SUSTAINED VIROLOGICAL SUPPRESSION J Int AIDS Soc 2008, 11(Suppl 1):P10 doi:10.1186/1758-2652-11-S1-P10 L Malincarne, A Sgrelli, G Camanni, R Papili, D Francisci and F Baldelli In our study, patients with sustained viral suppression experienced a significant immune recovery over 8 years of HAART. We found that complete immune recovery was achieved only in patients with baseline CD4+ cell count >350/ml. This observation strengthens the hypothesis that starting HAART at CD4+ cell counts < 50/µl could not be adequate to obtain a complete immunological recovery. |
| P11 | EVALUATING AFFORDABLE SCREENING MARKERS TO DETECT HIV-1-INFECTED UGANDAN ADULTS WITH CD4 COUNTS OF LESS THAN 200 CELLS/MUL J Int AIDS Soc 2008, 11(Suppl 1):P11 doi:10.1186/1758-2652-11-S1-P11 GM Miiro1, J Todd1, S Nakubulwa1, C Watera1, P Hughes1, P Munderi1, S Floyd2 and H Grosskurth1 Only WHO stage 3 had an acceptable sensitivity to identify patients with CD4 counts of < 200 cells/µl in this setting; whilst specificity was modest. Other screening strategies such as on-site low-cost CD4 testing need to be developed to identify patients in need of HAART in rural Africa and other resource-limited settings. |
| P12 | EFFICACY AND SAFETY OF TDF/FTC-CONTAINING FIRST-LINE HAART IN CLINICAL PRACTICE – 2-YEAR DATA FROM THE GERMAN OUTPATIENT COHORT J Int AIDS Soc 2008, 11(Suppl 1):P12 doi:10.1186/1758-2652-11-S1-P12 J van Lunzen1, G Fätkenheuer2, T Lutz3, S Klauke4, S Mauss5, H Knechten6, P Braun6, L Gallo7 and B Ranneberg7 During 2 years of follow-up, the overall safety of TVD was good; renal AEs of any grade were reported in 1.9% of patients. K65R was detected in two patients. First-line HAART with TVD plus an NNRTI or PI/r in clinical practice showed comparable efficacy to that observed in controlled clinical trials. |
| P13 | THE RAINBOW COHORT: SAQUINAVIR/R IS EFFECTIVE AND WELL TOLERATED IN ANTIRETROVIRAL THERAPY (ART)-NAÏVE PATIENTS – 48-WEEK RESULTS FROM GERMANY J Int AIDS Soc 2008, 11(Suppl 1):P13 doi:10.1186/1758-2652-11-S1-P13 H Knechten1, C Stephan2, T Lutz3, A Stoehr4, A Carganico5, G Knecht3, K Schewe6, H Jaeger7, C Mayr8, FA Mosthaf9, E Wolf10, E Wellmann11 and A Tappe11 These data confirm that SQV/r is effective and well tolerated in ART-naïve patients in the real-life clinical setting. The results of this observational cohort of treatment with the 500 mg tablet formulation of SQV are consistent with high efficacy and tolerability results seen in controlled studies with SQV/r. |
| P14 | COMPARING THE EFFICACY OF TRUVADA® AND KIVEXA® COMBINATION THERAPY IN HAART-NAÏVE INDIVIDUALS WITH DIFFERENT VIRAL LOADS J Int AIDS Soc 2008, 11(Suppl 1):P14 doi:10.1186/1758-2652-11-S1-P14 RH Daniels, BG Gazzard, P Holmes, A Scourfield, M Bower and M Nelson Truvada (emtricitabine + tenofovir) and Kivexa (abacavir + lamivudine) are combination therapies used as the nucleos(t)ide backbone in combination antiretroviral therapy. Recent reports have suggested Kivexa may be inferior to Truvada at high viral load (>100,000 copies/ml). |
| P15 | THE TOKEN STUDY: SAFETY AND EFFICACY OF TRUVADA OR KIVEXA IN COMBINATION WITH EFAVIRENZ IN TREATMENT-NAÏVE PREDOMINANTLY BLACK AFRICAN HIV PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P15 doi:10.1186/1758-2652-11-S1-P15 S Das1, J Arumainayagam2, B Kumari1, S Chandramani2, L Riddell3 and M Ghanem3 Truvada and Kivexa in combination with efavirenz in treatment-naïve predominantly black African patients are safe and effective. |
| P16 | EXPERIENCE WITH RITONAVIR/ATAZANAVIR IN HIV-POSITIVE ANTIRETROVIRAL-NAÏVE INDIVIDUALS COMMENCING THERAPY J Int AIDS Soc 2008, 11(Suppl 1):P16 doi:10.1186/1758-2652-11-S1-P16 B Graf, K Taylor, A Gupta, BG Gazzard and M Nelson Ritonavir/atazanavir is a safe and effective therapy in antiretroviral-naïve individuals requiring a protease inhibitor based therapy. |
| P17 | HAART IN HIV+ NAÏVE ELDERLY PATIENTS: IMMUNOVIROLOGICAL RESPONSE AND CLINICAL OUTCOME J Int AIDS Soc 2008, 11(Suppl 1):P17 doi:10.1186/1758-2652-11-S1-P17 BM Celesia1, F Bisicchia1, R La Rosa2, S Mavilla1, M Gussio1, MT Mughini1, F Palermo1 and R Russo1 In our experience, elderly and younger naive patients on HAART have similar immunological and virological response while hard clinical end-points tend to be more frequent in older subjects. Prospective studies are necessary to further investigate our findings. |
| P18 | (3TC) OR EMTRICITABINE (FTC) IS EFFECTIVE AND WELL TOLERATED IN NAÏVE HIV-1 INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P18 doi:10.1186/1758-2652-11-S1-P18 M Bickel1, P Gute2, A Carlebach2, A Mueller2 and S Klauke2 The combination of NVP, TDF and 3TC or FTC is effective and well tolerated in previously naïve HIV-1 infected patients even when started with low CD4 cell counts (< 200/ml) and high viral loads (>100,000 c/ml). In the latest amendment of the WHO guidelines TDF, instead of d4T, is the recommended first-line treatment in resource-limited settings. |
| P19 | COMPARISON OF THE EFFICACY AT 48 WEEKS OF FIRST-LINE ANTIRETROVIRAL TREATMENT FOR HIV INFECTION IN 1998 AND 2006: A MULTICENTRIC INVESTIGATION J Int AIDS Soc 2008, 11(Suppl 1):P19 doi:10.1186/1758-2652-11-S1-P19 F Sozio1, V Soddu2, G De Socio3, M D'Alessandro4, E Polilli1, G Madeddu2, P Bonfanti5, E Mazzotta1, J Vecchiet4, MS Mura2, T Quirino5, L Manzoli6 and G Parruti1 Our results indicate that after 48 weeks, patients treated with more recent first-line regimens have better chances of viral suppression and immune recovery than at the dawn of HAART. Adherence to therapy seems to be increased in parallel over time, and to be tightly associated with both outcomes. The independent association of better outcomes with the year of treatment and not with any other factor, including the incidence of adverse events, would suggest greater intrinsic potency of new HAART regimens. |
| P20 | RALTEGRAVIR: A POTENT AND SAFE INTEGRASE INHIBITOR WITH A FAVOURABLE IMPACT ON CARDIOVASCULAR AND LIVER PROFILE J Int AIDS Soc 2008, 11(Suppl 1):P20 doi:10.1186/1758-2652-11-S1-P20 F Blanco, M Arredondo, F Guevara, C Garrido, J Morello, S Rodríguez-Nóvoa, M Córdoba, J González-Lahoz and V Soriano Outside clinical trials, RAL shows a remarkable virological and immunological efficacy as part of salvage regimens, as well as in switch strategies in patients with undetectable viremia experiencing intolerance or toxicity to other antiretrovirals. Since the drug is safe and well tolerated, it may be worth to consider its use in earlier HIV stages, particularly in patients with cardiovascular risk and/or viral hepatitis. (Table 1). |
| P21 | POWER 1 AND 2: COMBINED FINAL 144-WEEK EFFICACY AND SAFETY RESULTS FOR DARUNAVIR/RITONAVIR (DRV/R) 600/100 MG BID IN TREATMENT-EXPERIENCED HIV PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P21 doi:10.1186/1758-2652-11-S1-P21 C Katlama1, N Bellos2, B Grinsztejn3, A Lazzarin4, A Pozniak5, S De Meyer6, T Van De Casteele6 and S Spinosa-Guzman6 POWER 1 and 2 (TMC114-C213 and C202) are randomised, controlled, Phase IIb trials designed to evaluate the long-term efficacy and safety of darunavir co-administered with low-dose ritonavir (DRV/r) in comparison with control protease inhibitor (CPIs) in treatment-experienced HIV patients. This combined analysis evaluates the final 144-week efficacy, safety and tolerability results for DRV/r 600/100 mg BID. |
| P22 | PHASE III TITAN WEEK 96 FINAL ANALYSIS: EFFICACY/SAFETY OF DARUNAVIR/R (DRV/R) VS. LOPINAVIR/R (LPV/R) IN LPV-NAÏVE, TREATMENT-EXPERIENCED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P22 doi:10.1186/1758-2652-11-S1-P22 D Bánhegyi1, C Katlama2, C Da Cunha3, S Schneider4, A Rachlis5, O Romanenko6, C Workman7, A Vandevoorde8, F Tomaka9, T Vangeneugden8 and S Spinosa-Guzman8 In this final 96-wk analysis, the primary end-point was maintained, showing non-inferiority and superiority to LPV/r in virologic response. DRV/r pts were half as likely to experience virologic failure and showed more favourable GI and lipid profiles than LPV/r pts. Rash was more common in DRV/r pts than LPV/r pts, but infrequently led to discontinuations. |
| P23 | VIROLOGICAL RESPONSE WITH FULLY ACTIVE ETRAVIRINE (ETR; TMC125) AFTER 48 WEEKS OF TREATMENT: POOLED RESULTS FROM THE DUET-1 AND DUET-2 TRIALS J Int AIDS Soc 2008, 11(Suppl 1):P23 doi:10.1186/1758-2652-11-S1-P23 N Clumeck1, B Clotet2, MA Johnson3, M Peeters4, J Vingerhoets4, G Beets4 and G De Smedt4 In patients with virus fully sensitive to ETR, the virological response was higher in the ETR + BR group than in the placebo + BR group, irrespective of ENF use or number of active background agents. These results complement current guidelines, which recommend a minimum of two active agents in any treatment regimen. |
| P24 | POWER 3 ANALYSIS: 144-WEEK EFFICACY AND SAFETY RESULTS FOR DARUNAVIR/RITONAVIR (DRV/R) 600/100 MG BID IN TREATMENT-EXPERIENCED HIV PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P24 doi:10.1186/1758-2652-11-S1-P24 A Pozniak1, K Arastéh2, JM Molina3, B Grinsztejn4, S De Meyer5, T Van De Casteele5 and S Spinosa-Guzman5 The POWER 3 144-week efficacy and safety results confirm and extend those observed at 24, 48 and 96 weeks. DRV/r 600/100 mg BID with an OBR was effective in HIV-1 infected patients with advanced disease and a high level of PI resistance, and was well-tolerated over time, indicating a sustained clinical benefit in this highly treatment-experienced population. |
| P25 | ANTIRETROVIRAL TOLERABILITY AND EFFICACY AFTER SWITCH TO SAQUINAVIR IN PI-EXPERIENCED PATIENTS: 48-WEEK ANALYSIS OF THE GERMAN RAINBOW COHORT J Int AIDS Soc 2008, 11(Suppl 1):P25 doi:10.1186/1758-2652-11-S1-P25 C Stephan1, H Jaeger2, A Carganico3, G Knecht4, T Lutz4, C Mayr5, FA Mosthaf6, S Koeppe7, M Mueller8, E Wolf9, A Tappe10, E Wellmann10 and H Knechten11 These data confirm that SQV/r is effective and well tolerated in PI-experienced, SQV-naïve patients in a real-life clinical setting. Most relevant improvements in triglycerides and total cholesterol levels were observed in patients with baseline grade III–IV elevation. |
| P26 | TIPRANAVIR IN HIGHLY ARV-EXPERIENCED PATIENTS: EFFICACY AND TOLERABILITY RESULTS FROM THE FRENCH PROSPECTIVE NADIS COHORT J Int AIDS Soc 2008, 11(Suppl 1):P26 doi:10.1186/1758-2652-11-S1-P26 C Allavena1, P Flandre2, P Pugliese3, MA Valantin4, J Izopet5, R Garraffo6, I Poizot7, ACabie8, Y Yazdanpanah9, L Cuzin10, C Duvivier11, C Katlama4 and P Dellamonica3 In this highly treatment-experienced patient population, more than 50% of the patients reached < 200 copies/mL at week 12; and 42 patients stopped TPV/r for adverse events. TPV/rcontaining regimens can be a valuable option in this highly ARVexperienced population. |
| P27 | REDUCTION IN AIDS DEFINING EVENTS/DEATHS WITH ETRAVIRINE (ETR; TMC125) COMPARED TO PLACEBO: POOLED DUET 48-WEEK RESULTS J Int AIDS Soc 2008, 11(Suppl 1):P27 doi:10.1186/1758-2652-11-S1-P27 R Haubrich1, J Eron2, M Thompson3, P Reiss4, R Weber5, M Peeters6, R Van Solingen-Ristea6, G Beets6, E Voorspoels6 and G De Smedt6 The benefit of newer antiretroviral regimens on clinical end-points for treatment-experienced, HIV-1-infected patients remains to be determined. Etravirine (ETR) demonstrated durable efficacy and safety in HIV-1 infected, treatment-experienced patients in the phase III DUET trials. We report adjudicated clinical end-points from a pre-specified pooled analysis of DUET-1 and DUET-2 after 48 weeks of treatment. |
| P28 | PATIENT RETENTION ON ANTIRETROVIRAL THERAPY PROGRAMME: RISK FACTOR ANALYSIS OF A UGANDA COHORT J Int AIDS Soc 2008, 11(Suppl 1):P28 doi:10.1186/1758-2652-11-S1-P28 EJ Mills1, P Olupot-Olupot2, C Cooper3, J Meadway4, H Boorman5, A Das5 and JSO Obbo2 LTFU remains a big problem in Mbale Regional Referral Hospital infectious disease clinic, the main ART provider for the government ministry of health system in the eastern region. Patient factors, notably gender, age, family support, social support and number of household members, were associated with LTFU at various levels of strengths of association by Odds ratio. |
| P29 | INDEED STUDY: FINAL RESULTS OF AN INDUCTION TREATMENT STRATEGY WITH ENFUVIRTIDE IN TREATMENT FAILURE PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P29 doi:10.1186/1758-2652-11-S1-P29 J Reynes1, I Pellegrin2, G Peytavin3, M Wirden4, B Giffo5, C Aquilina6, A Pinta7, N Pierre7, S Kraemer7 and V Calvez4 Addition of ENF to OB led to fast and good virological response (at least 2 log drop in VL observed in 74% of patients with initial VL > 30,000 copies/ml at week 4). During maintenance phase, in this population with a smaller than planned number of patients, we cannot conclude as to the non-inferiority of OB vs. ENF + OB at week 52. |
| P30 | CD4+ GUIDED ANTIRETROVIRAL TREATMENT INTERRUPTION. A META-ANALYSIS J Int AIDS Soc 2008, 11(Suppl 1):P30 doi:10.1186/1758-2652-11-S1-P30 A De Silvestri1, A Boschi2, C Tinelli1 and E Seminari1 This meta-analysis suggests that in patients undergoing a treatment interruption there is an increased relative risk of developing AIDS or death; this risk is decreased if a relatively high CD4+ threshold is chosen to reinitiate the treatment. The pooled risk difference was of small entity and did not reach statistical significance. |
| P31 | RALTEGRAVIR THERAPY IN HIV MULTI-EXPERIENCE PATIENTS: SAFETY AND EFFICACY J Int AIDS Soc 2008, 11(Suppl 1):P31 doi:10.1186/1758-2652-11-S1-P31 P Meraviglia1, A Capetti2, S Merli1, F Mazza1, V Micheli1 and G Rizzardini2 Raltegravir was well tolerated and efficient in all patients and showed a good metabolic, renal and liver profile in our cohort where the rate of co-infected patients was high. |
| P32 | VIROLOGICAL AND IMMUNOLOGICAL RESPONSE TO THREE BOOSTED PROTEASE INHIBITOR REGIMENS J Int AIDS Soc 2008, 11(Suppl 1):P32 doi:10.1186/1758-2652-11-S1-P32 C Baumgardt1, C Stephan1, AE Haberl1, HR Brodt1, M Stuermer2, S Klauke3, P Gute3, M Bickel1, P Khaykin1, N von Hentig1 and S Staszewski1 The virologic response to treatment was similar in between the three combinations of LOPSAQ, ATSAQ or FOSAQ, respectively. This RTI-sparing, PI-only antiretroviral therapy may be an effective option for treatment experienced patients after RTI-failure due to toxicity or resistance. The immunological outcome of both LOPSAQ and ATSAQ seems to be superior to FOSAQ. For extensively pre-treated patients at low CD cell counts, this historical option of a double-PI only combination regimen is today extended by new antiretroviral classes. |
| P33 | LONG-TERM SAFETY AND EFFICACY OF NEVIRAPINE (NVP)-BASED ANTIRETROVIRAL THERAPIES J Int AIDS Soc 2008, 11(Suppl 1):P33 doi:10.1186/1758-2652-11-S1-P33 F Rodriguez-Arrondo1, K Aguirrebengoa2, J Portu3, J Muñoz4, MA Garcia5, J Goikoetxea2, E Martinez5, JA Iribarren1, N Perez6, C Alcarez6 and B Clotet6 Results suggest that NVP-based antiretroviral therapy (either first-line, simplification, or second-line) not only provides stable immunological and virological efficacy for over 4 years, as well as a favourable safety profile with few adverse events leading to discontinuation, but also increases HDLcholesterol, which may have a protective impact on cardiovascular risk. The same safety profile was found in the subpopulation of HCV co-infected patients and individuals with CD4 cell counts above 250/mm3. |
| P34 | DIFFERENT METABOLIC AND ANTHROPOMETRIC CHARACTERISTICS OF TVD, CBV OR KVX ASSOCIATED WITH NEVIRAPINE: RESULTS FROM THE "NEVIRAPINE COMPANION" COHORT J Int AIDS Soc 2008, 11(Suppl 1):P34 doi:10.1186/1758-2652-11-S1-P34 G Guaraldi, F Adorni, S Zona, N Squillace, G Orlando, C Stentarelli, R Esposito and C Sconiamilio KVX arm displayed a greater pro-atherogenic risk profile notwithstanding lower BMI in respect to CBV and TVD. This non-randomised cohort cannot discriminate if patients with a higher underlying risk of cardiovascular disease might be initially placed on KVX or if KVX associated with NVP per se, had a poorer metabolic profile compared with the TVD and CBV arms. Careful assessment of metabolic parameters should be evaluated in people undergoing the association KVX+NEV even beyond the initial 6 months of therapy and appropriate lipidlowering therapy started if needed. |
| P35 | ANTIRETROVIRAL TREATMENT EFFICACY AFTER MUTATIONS REVERSION DURING T20 MONOTHERAPY, AN ALTERNATIVE STRATEGY IN MULTI-FAILED HIV-1 INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P35 doi:10.1186/1758-2652-11-S1-P35 S Lo Caputo1, M Santoro2, CSF Ceccherini-Silberstein2, V Svicher2, P Pierotti1, F Vichi1, R D'Arrigo3, C Gori3, CF Perno2 and F Mazzotta1 In this pilot study it was possible to build up an effective treatment where no other options were active at the moment of the study design, by reducing the number of resistance mutations. The T20-monotherapy resulted in a well tolerated treatment, from which to restart to obtain a virological success in multi-failed patients. |
| P36 | ANTIRETROVIRAL TREATMENT USE AND HIV-RNA SUPPRESSION RATES FOR 877 EUROPEAN PATIENTS IN THE ETRAVIRINE EXPANDED ACCESS PROGRAMME J Int AIDS Soc 2008, 11(Suppl 1):P36 doi:10.1186/1758-2652-11-S1-P36 E Florence1, S DeWit2, A Castagna3, E Ribera4, AM Hill5, R Ryan6, H Vanaken7, S Marks8 and Y van Delft8 The use of etravirine in the expanded access programme included a wide range of antiretrovirals in the background regimen, with a high percentage of patients showing HIV-RNA suppression below 50 copies/mL by weeks 12–24. Serious adverse events were mainly unrelated to ETR. |
| P37 | SWITCHING FROM ENFUVIRTIDE TO ETRAVIRINE – EFFICACY RESULTS FROM THE ETRAVIRINE EXPANDED ACCESS PROGRAMME J Int AIDS Soc 2008, 11(Suppl 1):P37 doi:10.1186/1758-2652-11-S1-P37 E Ribera1, E Florence2, S DeWit3, A Castagna4, B Ryan5, H Vanaken6, AM Hill7 and S Marks8 The next generation NNRTI etravirine (ETR, TMC125) and the fusion inhibitor enfuvirtide (T-20) have shown strong efficacy in the DUET and TORO trials, respectively. Switching from enfuvirtide to etravirine could improve convenience and tolerability, and reduce treatment costs. In the TMC125-C214 trial (global etravirine expanded access programme), treatment-experienced patients with undetectable HIV-RNA levels were permitted to switch from enfuvirtide to etravirine. |
| P38 | EFFICACY AND SAFETY OF AN ANTIRETROVIRAL REGIMEN CONTAINING ETRAVIRINE PLUS RALTEGRAVIR IN HIV-1 TREATMENT-EXPERIENCED PATIENTS FAILING DARUNAVIR J Int AIDS Soc 2008, 11(Suppl 1):P38 doi:10.1186/1758-2652-11-S1-P38 A Canestri1, C Blanc1, M Wirden1, G Peytavin2, N Ktorza1 and C Katlama1 An unexpectedly high rate of virological success was observed in this pilot study of patients with very limited treatment options except RAL and ETV while failing darunavir. |
| P39 | DARUNAVIR EXHIBITS A POTENT ACTIVITY AS BOOSTED PI IN SUBJECTS ON A SALVAGE ANTIRETROVIRAL REGIMEN J Int AIDS Soc 2008, 11(Suppl 1):P39 doi:10.1186/1758-2652-11-S1-P39 P Vitiello, S Ferramosca, M Lo Cicero, PDV Di Vincenzo, M Capasso, M Galli, ME Moroni and SR Rusconi We demonstrated that the immune-virological response during a DRV-including therapy was optimal in the majority of enrolled subjects. The decrease in the number of mutations during therapy is likely due to a reduced capacity in the DNA proviral integration under drug pressure and this might be confirmed by the proviral DNA quantification. |
| P40 | RALTEGRAVIR, ETRAVIRINE AND DARUNAVIR-RITONAVIR: A SAFE AND SUCCESSFUL RESCUE REGIMEN IN HIGHLY TREATMENT-EXPERIENCED HIV1-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P40 doi:10.1186/1758-2652-11-S1-P40 A Imaz1, S Villar del Saz1, MA Rivas2, A Curran1, E Caballero1, V Falco1, M Crespo1, I Ocana1, M Diaz1, E Ruiz de Gopegui2, M Riera2 and E Ribera1 Ritonavir-boosted darunavir (DRV/r) and etravirine (ETR) in DUET trials and raltegravir (RAL) in BENCHMRK trials have shown high rates of virological responses in treatmentexperienced patients with multi-drug resistant HIV-infection, particularly when used in association with two more fully active antiretroviral drugs. However, the combination of DRV/r, ETR and RAL has not been evaluated. |
| P41 | SAFETY AND EFFICACY OF TIPRANAVIR CO-ADMINISTERED WITH LOW-DOSE RITONAVIR IN PATIENTS WITH ADVANCED HIV-1 INFECTION AND LIMITED TREATMENT OPTIONS J Int AIDS Soc 2008, 11(Suppl 1):P41 doi:10.1186/1758-2652-11-S1-P41 S Esser1, A Moll2, V Cairns3, H Jaeger4, S Mauss5, J van Lunzen6 and J Goldbach7 Patients treated in the TPV EAP had advanced HIV-1 infection and were heavily pretreated. Nevertheless, they show remarkable decrease in VL and increase in CD4 cells/mL The analysis of AEs did not reveal any new safety findings or change in the known AE profile of TPV/r. Notably, in this real world treatment setting, the rate of TPV/r discontinuations due to AEs was relatively low. |
| P42 | EXPOSITION AND SEQUENCING TO ANTIRETROVIRALS IN HIV-1 PATIENTS WITH TRIPLE-CLASS ANTIRETROVIRAL FAILURE, AND HARBOURING PROTEASE RESISTANCE MUTATIONS J Int AIDS Soc 2008, 11(Suppl 1):P42 doi:10.1186/1758-2652-11-S1-P42 JM Llibre1, P Domingo2, F Blanco3, B Clotet4, AOcampo5, JA García-Henarejos6, P Geijo7, C Rosa7, J Hernandez-Quero8 and A Castro9 Patients with advanced virological failure exposed to NRTI, NNRTI and PI share specific characteristics that drive a "classical" pathway to HIV-1 resistance. This pattern is composed of a burned reverse transcriptase with TAMs, M184V, NNRTI mutations, and a variety of protease mutations that render NRTI and first generation NNRTIs and PIs inactive. Most of them started their antiretroviral treatment with mono/dual NRTI therapy. Their first PI was non-boosted. The late onset of a boosted PI has not precluded the accumulation of protease resistance mutations in these patients. |
| P43 | L76V – CLINICALLY RELEVANT RESENSITIZATION OF THE PROTEASE INHIBITORS (PIS) SAQUINAVIR (SQV) AND ATAZANAVIR (ATV) J Int AIDS Soc 2008, 11(Suppl 1):P43 doi:10.1186/1758-2652-11-S1-P43 J Vachta1, F Wiesmann1, P Braun1, R Ehret1, C Höhn1, A Tappe2 and H Knechten1 The co-existence of the L90M mutations was mostly responsible for failure of therapy in these patients. L76V was detected under LPV-, APV- and DRV-containing regimens. ATV and/ or SQV are encouraging options in deep salvage-situations with viruses carrying the L76V mutation. Maintenance of selectionpressure on L76V with APV or LPV is beneficial for a sustained therapy success in ATV- and/or SQV-containing regimens. |
| P44 | POSITIVE PREDICTIVE FACTORS IN HIV-1 PATIENTS TREATED WITH ENFUVIRTIDE PLUS AN OB THAT INCLUDE AN ACTIVE BOOSTED PI. PRELIMINARY FASTFUZ STUDY RESULTS J Int AIDS Soc 2008, 11(Suppl 1):P44 doi:10.1186/1758-2652-11-S1-P44 E Ribera1, A Antela2, JA Garcia Henarejos3, JR Arribas4, JA Oteo5, M Lopez Gomez6 and E Ferrer7 The co-existence of the L90M mutations was mostly responsible for failure of therapy in these patients. L76V was detected under LPV-, APV- and DRV-containing regimens. ATV and/ or SQV are encouraging options in deep salvage-situations with viruses carrying the L76V mutation. Maintenance of selectionpressure on L76V with APV or LPV is beneficial for a sustained therapy success in ATV- and/or SQV-containing regimens. |
| P45 | EXCELLENT SHORT-TERM CD4 RECOVERY WITH A PI- AND NRTI-SPARING REGIMEN IN TRIPLE-CLASS FAILURE HIV-INFECTED PATIENTS: RALTEGRAVIR, MARAVIROC, ETRAVIRINE J Int AIDS Soc 2008, 11(Suppl 1):P45 doi:10.1186/1758-2652-11-S1-P45 S Nozza, F Visco, A Soria, L Galli, S Salpietro, N Gianotti, E Carini, A Bigoloni, G Fusetti, G Tambussi, A Lazzarin and A Castagna Salvage therapy with RAL+ MVC+ETR showed an excellent short-term CD4 recovery. Reasons for this success could include: presence of active drugs blocking consecutive targets of viral replication, high doses of MVC required with this regimen, avoidance of ritonavir and NRTI toxicity. |
| P46 | EFFICACY AND TOLERANCE OF COMBINATION OF MARAVIROC WITH MK-0518, BOOSTED TMC-114, TMC-125, IN HEAVILY PRE-TREATED CCR5-POSITIVE PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P46 doi:10.1186/1758-2652-11-S1-P46 F Almasi, A Krivine, A Compangocci, B Silberman, L Belaebi and D Salmon Combination of TMC-114/R, TMC-125, MK-0518 and maraviroc can be a safe, good option in heavily pre-treated CCR5-positive patients which can reduce viral load 3–4 logs in 3 weeks and reach to undetectable viral load in less than 12 weeks. |
| P47 | THERAPEUTIC OPTIONS IN HEAVILY PRETREATED HIV-1 PATIENTS BASED ON THE GENOTYPIC RESISTANCE PATTERNS J Int AIDS Soc 2008, 11(Suppl 1):P47 doi:10.1186/1758-2652-11-S1-P47 D Paraskevis1, E Magiorkinis1, G Magiorkinis1, V Paparizos2, MC Lazanas3, M Chini3, H Sambatakou4, A Karafoulidou5 and A Hatzakis1 Despite the approval of new active drugs (DRV, ETV), for a considerable percentage of heavily pretreated patients there are not any fully active drugs available among the N(t)RTIs which comprise the backbone of HAART. |
| P48 | DARUNAVIR IN PATIENTS WHO FAILED ON FOS-AMPRENAVIR: EFFICACY AT WEEK 48 J Int AIDS Soc 2008, 11(Suppl 1):P48 doi:10.1186/1758-2652-11-S1-P48 S De Wit, M Delforge, K Kabeya, C Necsoi and N Clumeck Our data suggest that prior failure on fosamprenavir has limited impact on response to darunavir and that fos-amprenavir selected key mutations have low impact on DRV virological response. |
| P49 | ETRAVIRINE USE IN CLINICAL PRACTICE: 48-WEEK DATA FROM A SINGLE CENTRE COHORT J Int AIDS Soc 2008, 11(Suppl 1):P49 doi:10.1186/1758-2652-11-S1-P49 C Scott, N Khatib, M Bower, BG Gazzard and M Nelson ETV in combination with OBR is successful in achieving virological suppression in treatment-experienced patients. ETV is also an effective alternative in patients who need to switch due to drug toxicity. ETV is a well tolerated agent. |
| P50 | TRANSIENT THERAPY WITH QUADRUPLE NRTI PROVIDES IMMUNE STABILITY IN PATIENTS WITH MULTIDRUG RESISTANT HIV-1 AND NO OPTIONS FOR SUPPRESSIVE REGIMENS J Int AIDS Soc 2008, 11(Suppl 1):P50 doi:10.1186/1758-2652-11-S1-P50 A Bonjoch1, JM Llibre1, E Negredo1, J Puig1, N Pérez-Álvarez1, MJ Buzon2, J Martinez-Picado2 and B Clotet3 Our results showed better virological and immunological outcomes with standard salvage therapy than a holding therapy with TZV + TDF. However, this approach provided a stable immunologic status, better tolerability and it was not associated with clinical progression for 48 weeks of follow-up. This strategy did not jeopardize a posterior complete viral suppression when a fully active regimen could be initiated. This transient approach could be useful in pts with multidrug resistant HIV-1, toxicities or other condition that restrict active drugs while awaiting a fully suppressive regimen. |
| P51 | EFFICACY, SAFETY AND TOLERABILITY OF ENFUVIRTIDE IN A POPULATION OF PORTUGUESE HIV-1 CHRONICALLY INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P51 doi:10.1186/1758-2652-11-S1-P51 AC Miranda1, I Almeida2, J Mendez3, M Mota4, E Teofilo5, J Vera6, A Diniz7, F Maltez8, R Marques9, K Mansinho10, R Sarmento-Castro3, R Camacho10, MJ Manata11 and C Delgado12 These data from a real-life setting confirm ENF efficacy, safety and good tolerability in a non-selected patient population. Compared to TORO trials, this population achieved a better virological response, probably explained by the favorable baseline characteristics previously defined as predictive factors of successful treatment. |
| P52 | SWITCH FROM ENFUVIRTIDE (ENF) TO RALTEGRAVIR (RAL): A SIMPLIFICATION OPTION FOR HEAVILY PRETREATED HIV PATIENTS (PTS) J Int AIDS Soc 2008, 11(Suppl 1):P52 doi:10.1186/1758-2652-11-S1-P52 F Gatti, A Matti, P Nasta, G Cologni, S Costarelli and G Carosi The switch from ENF to RAL was efficacious and well tolerated in a small cohort of heavily pretreated HIV pts; this ARV change may represent a sort of 'simplification' option formultiresistant pts taking ENF with at least another active drug in the regimen. |
| P53 | EFFICACY AND SAFETY OF SWITCHING FROM LOPINAVIR/R TO ATAZANAVIR/R IN SUPPRESSED PATIENTS RECEIVING A LPV/R-CONTAINING HAART: ATAZIP 96-WEEK RESULTS J Int AIDS Soc 2008, 11(Suppl 1):P53 doi:10.1186/1758-2652-11-S1-P53 J Mallolas1, D Podzamczer2, P Domingo3, P Echeverría4, E Ribera5, F Gutierrez6, H Knobel7, J Cosín8, E Ferrer2, JA Arranz9, V Roca10, J Pich11, E de Lazzari11 and JM Gatell1 Switching toATV/r in virologically suppressed patients who were receiving a LPV/r-containing HAART provided comparable and durable efficacy with improved lipid parameters. |
| P54 | 48-WEEK OUTCOMES FOLLOWING SWITCH FROM AZT/3TC TO FTC/TDF (TVD) VS. CONTINUING ON AZT/3TC: 48-WEEK INTERIM ANALYSIS OF THE RECOMB TRIAL J Int AIDS Soc 2008, 11(Suppl 1):P54 doi:10.1186/1758-2652-11-S1-P54 E Ribera1, B Clotet2, E Martínez3, V Estrada4, J Sanz5, J Berenguer6, R Rubio7, F Pulido7, M Larrouse3, ACurran1, E Negredo2, P Ferrer8 and ML Álvarez8 Through 48 weeks, switching from a suppressive HAART regimen containing AZT/3TC to TVD, was well tolerated, maintained efficacy and led to a significant improvement in limb fat content. Additionally, haemoglobin and hematocrit significantly improved for patients switched from AZT/3TC to TVD. |
| P55 | FREE TRIAL: INDUCTION THERAPY WITH ART (ABACAVIR/LAMIVUDINE/LOPINAVIR/R) FOLLOWED BY MAINTENANCE REGIMEN WITH TRIPLE NRTI, COMPARED TO CONTINUED ART J Int AIDS Soc 2008, 11(Suppl 1):P55 doi:10.1186/1758-2652-11-S1-P55 HG Sprenger1, CHH ten Napel2, R Vriesendorp3, IM Hoepelman4, JC Legrand5, PP Koopmans6, ME Kasteren7, B Bravenboer8, RW ten Kate9, PHP Groeneveld10, TS van der Werf1, EH Gisolf11 and C Richter11 TZV as maintenance therapy after induction with NRTIs/PI in previously antiretroviral naïve patients shows an antiviral activity comparable to continuation of a PI-based regimen at 48 weeks interim analysis. Final analysis of the data at week 96 has to be awaited to further evaluate the efficacy of TZV maintenance ART. |
| P56 | SWITCHING TO NEVIRAPINE-BASED HAART IN VIROLOGICALLY-SUPPRESSED PATIENTS: INFLUENCE OF A LONGER TWICE-DAILY INDUCTION PERIOD ON ONCE-A-DAY DOSING J Int AIDS Soc 2008, 11(Suppl 1):P56 doi:10.1186/1758-2652-11-S1-P56 M Brandolini1, A Cattelan2, A Orani3, L Sighinolfi4, M Andreoni5, G Nardini6, G Sotgiu7 and R Maserati1 We are conducting a multicenter, randomized, controlled, prospective, open trial to evaluate both the efficacy and toxicity of nevirapine (NVP) (given twice [BID] or once daily [QD]) in virologically-suppressed patients on a PI-based HAART. NVP BID dosing is maintained for 2 months after the switch in both groups. |
| P57 | SUBSTITUTION OF NEVIRAPINE FOR EFAVIRENZ IN VIROLOGICALLY CONTROLLED PATIENTS INTOLERANT OF EFAVIRENZ J Int AIDS Soc 2008, 11(Suppl 1):P57 doi:10.1186/1758-2652-11-S1-P57 DJ Ward, JM Curtin and EJ Miller Efavirenz (EFV) is an important and frequently prescribed component of triple-combination antiretroviral therapy. However, many patients are unable to tolerate the neuropsychiatric side-effects of this medication. Nevirapine (NVP), another potent non-nucleoside RT inhibitor may be able to be substituted for EFV in patients who experience sideeffects. This study is a retrospective review of patients in a large HIV specialty private practice who were switched from EFV to NVP from 1998 through 2007. Earlier results from a portion of this cohort have previously been published [1]. |
| P58 | EFFICACY AND SAFETY OF SWITCHING ENFUVIRTIDE TO RALTEGRAVIR IN PATIENTS WITH VIRAL SUPPRESSION J Int AIDS Soc 2008, 11(Suppl 1):P58 doi:10.1186/1758-2652-11-S1-P58 JR Santos, JM Llibre, J Moltó, N Perez, MC García and B Clotet Switching ENF to RAL seems to be safe and effective in the short-term in patients with viral suppression despite a prior high antiretroviral experience. Its long-term impact on patient's adherence, quality of life, safety and efficacy should be evaluated in clinical trials. |
| P59 | ONCE-DAILY SAQUINAVIR (SAQ)/RITONAVIR (RTV) (2000/100 MG) WITH ABACAVIR/LAMIVUDINE (600/300 MG) OR TENOFOVIR/EMTRICITABINE (245/300 MG) IN NAÏVE PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P59 doi:10.1186/1758-2652-11-S1-P59 M Bickel1, A Bodtlaender2, G Knecht2, M Kurowski3, S Klauke2 and T Lutz2 In this ongoing study SAQ/RTV (2000/100 mg QD) waswell tolerated and demonstrated higher SAQand lower RTV drug levels as compared to the BID dosing schedule. (Table 1 and Figure 1). |
| P60 | CHANGES IN HEMATOLOGICAL PARAMETERS AFTER SWITCHING TREATMENT OF HIV-INFECTED PATIENTS FROM ZIDOVUDINE TO ABACAVIR OR TENOFOVIR DF J Int AIDS Soc 2008, 11(Suppl 1):P60 doi:10.1186/1758-2652-11-S1-P650 RF Viergever1, MJ ten Berg1, WW van Solinge1, AIM Hoepelman1 and EH Gisolf2 With this study we confirmed that switching antiretroviral medication from AZT to either ABC or TDF results in a significant increase in Hb and leukocyte count in HIV-infected patients. |
| P61 | SIMPLIFICATION OF THERAPY (ART) WITH EFAVIRENZ/EMTRICITABINE/TENOFOVIR DF SINGLE TABLET REGIMEN VS. CONTINUED ART IN SUPPRESSED, HIV-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P61 doi:10.1186/1758-2652-11-S1-P61 B Young1, E DeJesus2, JO Morales-Ramirez3, R Ebrahimi4, JF Maa5, D McColl4, A Farajallah5, D Seekins5 and JF Flaherty4 High and comparable rates of virologic suppression were maintained with EFV/FTC/TDF vs. SBR, regardless of type of prior ART. The grade/frequency of AEs reported for patients switched to EFV/FTC/TDF was consistent with previous studies. |
| P62 | DOES HIV-1 TROPISM CHANGE IN PATIENTS DURING VIROLOGICAL SUPPRESSIVE THERAPY? J Int AIDS Soc 2008, 11(Suppl 1):P62 doi:10.1186/1758-2652-11-S1-P62 O Degen1, C Noah2, K Colberg1, S Hertling1 and J van Lunzen1 The genotypic test in PBMC and plasma showed no changes of tropism during virological successful therapy in our patients. No shift from R5 to X4 usage was detected during suppressive therapy by standard phenotype testing which remains the gold standard at the moment. Thus historical samples might be used to screen selected aviremic patients for a switch to maraviroc. |
| P63 | PATIENT-REPORTED OUTCOMES AFTER SIMPLIFICATION TO A SINGLE TABLET REGIMEN OF EFAVIRENZ (EFV)/EMTRICITABINE (FTC)/TENOFOVIR DF (TDF) J Int AIDS Soc 2008, 11(Suppl 1):P63 doi:10.1186/1758-2652-11-S1-P63 S Hodder1, K Mounzer2, E DeJesus3, JF Maa4, R Ebrahimi5, K Grimm4, JF Flaherty5 and A Farajallah4 Simplification to EFV/FTC/TDF from a variety of ART maintained high levels of virologic suppression, adherence and quality of life through 48 weeks. Pts switched to EFV/FTC/TDF reported improvements in many HIV-related symptoms, found the new regimen easier to follow and preferred EFV/FTC/TDF over their previous ART regimen. |
| P64 | INDUCTION STRATEGY WITH ENFUVIRTIDE: RESULTS FROM THE FUZIONA STUDY, A MULTICENTER RETROSPECTIVE STUDY IN SPAIN J Int AIDS Soc 2008, 11(Suppl 1):P64 doi:10.1186/1758-2652-11-S1-P64 M Mora1, C Navarro1, A Gonzalez-Mena2, J Rodriguez-Baños3, B Clotet4, JL Blanco5, JR Blanco6, JC Lopez-Bernaldo de Quiros7, J Hernandez-Quero8, P Arazo9, J Flores10 and JR Arribas1 In contrast with prior studies, the majority of patients who achieved viral suppression after starting T20 maintained suppression after stopping it. This is probably related to the higher antiviral activity of the background regimen. (Table 1). |
| P65 | ABACAVIR/LAMIVUDINE HAS SHOWN SIMILAR EFFICACY TO OTHER NUCLEOSIDE CONVENTIONAL COMBINATIONS IN PREVIOUSLY HIV-INFECTED PATIENTS: RESULTS AT 48 WEEKS J Int AIDS Soc 2008, 11(Suppl 1):P65 doi:10.1186/1758-2652-11-S1-P65 P Echeverría1, J De la Torre2, J Pasquau3, E Casas4, T Puig5, E Ribera6, I Bravo1, R López1, B Clotet7, E Negredo1 and *. ELA Group8 ABC/3TC (Kivexa®), in combination with EFV, was a good alternative as a simplification regimen due to its virological and immunological effectiveness and good tolerability. Nowadays, the availability of a genetic test (HLA B*57) will reduce the incidence of discontinuation due to hypersensitivity reaction. |
| P66 | SIMPLIFICATION FROM TPV/RTV 500/200 BID TO TPV/RTV 500/100 BID GUIDED BY THERAPEUTIC DRUG MONITORING J Int AIDS Soc 2008, 11(Suppl 1):P66 doi:10.1186/1758-2652-11-S1-P66 J Morello, S Rodríguez-Nóvoa, F Blanco, I Jiménez-Nácher, G González-Pardo, AJ Rubio and V Soriano A subset of antiretroviral-experienced patients on successful TPV/r 500/200 BID based regimens could benefit from ritonavir dose reductions, which may be associated with improvements in liver enzymes and lipids. However, due to large inter-individual differences in TPV Ctrough, this strategy should only be performed using TDM. (Table 1). |
| P67 | SAQUINAVIR/RITONAVIR MONOTHERAPY AS A NEW NUCLEOSIDE-SPARING MAINTENANCE STRATEGY J Int AIDS Soc 2008, 11(Suppl 1):P67 doi:10.1186/1758-2652-11-S1-P67 P Echeverría1, P Domingo2, M Gutierrez2, G Mateo2, J Puig3, J Moltó3, N Pérez-Álvarez3, B Clotet3 and E Negredo3 SQV/r monotherapy, administered twice daily, may be a valid and economic option as a nucleoside-sparing strategy for virologically suppressed HIV-infected patients without prior history of virologic failure to protease inhibitorcontaining regimens, especially in those with intolerance or toxicities to nucleosides. |
| P68 | A PHASE IIIB PILOT STUDY SUBSTITUTING DARUNAVIR/RITONAVIR (DRV/R) AND ETRAVIRINE (ETR) FOR ENFUVIRTIDE (ENF) AND CURRENT PI IN A SUPPRESSIVE REGIMEN J Int AIDS Soc 2008, 11(Suppl 1):P68 doi:10.1186/1758-2652-11-S1-P68 P Ruane1, B Alas1, R Ryan2, S Fox3, A Perniciaro3 and J Witek3 In this study, following substitution of DRV/r and ETR for ENF, PI(s) and NNRTI(s), 9/9 previously suppressed pts who completed week 24 maintained VL < 50 copies/mL. DRV/r and ETR were generally safe and well tolerated. |
| P69 | EFFICACY AND TOLERABILITY OF LONG-TERM NEVIRAPINE PLUS NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS FOR HIV-1 INFECTION J Int AIDS Soc 2008, 11(Suppl 1):P69 doi:10.1186/1758-2652-11-S1-P69 CA Carocci1, MC Martinelli1, MV Mastronardi2, CP Corsi1 and LF Leoncini1 The follow-up results showed that prolonged treatment with NVP is a safe and potent antiretroviral regimen associated with viral suppression and increased CD4 cells count. In our patients the long-term exposure to NVP showed an increased total cholesterol (not requiring use of statins) and, in concordance with previous studies, an increased GGT level essentially in patients co-infected with HCV. |
| P70 | EVOLUTION OF CD4+ T-CELL COUNT IN HIV-1 INFECTED ADULTS RECEIVING ANTIRETROVIRAL THERAPY WITH SUSTAINED LONG-TERM VIROLOGICAL SUPPRESSION J Int AIDS Soc 2008, 11(Suppl 1):P70 doi:10.1186/1758-2652-11-S1-P70 H Byakwaga1, JM Murray2, K Petoumenos1, MA Boyd1, S Emery1, PW Mallon1 and DA Cooper1 These findings suggest that CD4+ T-cell count continues to increase in some patients after several years of cART. Our results point to an advantage to commencing cART at higher CD4+ T-cell strata. |
| P71 | VIROLOGICAL TREATMENT OUTCOME UNDER HAART: DOES SEX MATTER? J Int AIDS Soc 2008, 11(Suppl 1):P71 doi:10.1186/1758-2652-11-S1-P71 AE Haberl1, S Usadel2, N Hanhoff3 and S Holm4 We found that HIV-positive women depicted an inferior virological response to HAART compared to those previously published in German cohort analyses dominated by men (response rates >75%). Possible differences in adherence or drug resistance may have impacted these results and are currently being evaluated in ongoing sub-analyses. Of note, the lack of a study arm with male patients is a limitation of this investigation. However, this is partly off-set by the fact that there are good comparative data in the male population found in other cohorts. We conclude that our results are in discordance to the popular assumption that there are no gender specific differences in virological treatment outcome of HAART. |
| P72 | PATIENT CHARACTERISTICS AND TREATMENT OUTCOMES ASSOCIATED WITH PROTEASE INHIBITOR (PI) USE IN THE ASIA-PACIFIC REGION J Int AIDS Soc 2008, 11(Suppl 1):P72 doi:10.1186/1758-2652-11-S1-P72 SN Pujari1, S Sungkanuparph2, P Srasuebkul3, PL Lim4, N Kumarasamy5, J Chuah6, RN Kumar7 and P Phanuphak8 Newer PI-based regimens were prescribed more in high income countries than in other countries in Asia. Short-term virological outcomes following PI therapy in our cohort were good, and were related with CD4 count at time of initiation. |
| P73 | USE OF TRADITIONAL COMPLEMENTARY AND ALTERNATIVE MEDICINE (TCAM) BY HIV PATIENTS PRIOR TO INITIATING ART IN KWAZULU-NATAL, SOUTH AFRICA J Int AIDS Soc 2008, 11(Suppl 1):P73 doi:10.1186/1758-2652-11-S1-P73 K Peltzer1, N Friend-du Preez2, S Ramlagan1, H Fomundam3 and J Anderson2 Traditional herbal therapies and TCAM are commonly used by HIV treatment naïve outpatients of public health facilities in South Africa. Health care providers should routinely screen patients on TCAM use when initiating ART and also during follow-up and monitoring, keeping in mind that these patients may not fully disclose other therapies. Co-location of services, including voluntary organizations offering spiritual and/ or holistic health care advice, may help to address patients' needs where health care providers lack the time or knowledge to adequately address these issues. |
| P74 | LONG-TERM EFFICACY OF BOOSTED AND UNBOOSTED ATAZANAVIR-CONTAINING REGIMENS: RESULTS FROM THE SCOLTA PROJECT J Int AIDS Soc 2008, 11(Suppl 1):P74 doi:10.1186/1758-2652-11-S1-P74 T Quirino1, E Ricci2, R Giuntini3, C Martinelli3, F Vichi4, E Gianelli2, G Madeddu5, B Menzaghi6,14, G De Socio7, G Orofino8, L Palvarini9, G Penco10, E Rosella11, P Marconi12, S Carradori13, C Grosso11, G Pellicanò15 and P Bonfanti2 The study data show that, in clinical practice, both ATV-containing regimens have same efficacy and durability. |
| P75 | USE OF LOPINAVIR/RITONAVIR IN FIRST-LINE THERAPY OR SECOND-LINE THERAPY: 48-WEEK RESULTS FROM THE GERMAN PROSPECTIVE STAR COHORT J Int AIDS Soc 2008, 11(Suppl 1):P75 doi:10.1186/1758-2652-11-S1-P75 C Koegl1, A Trein2, W Schmidt3, A Baumgarten4, H Jaeger5 and HJ Stellbrink6 In this cohort study, virological outcomes of LPV/rbased regimens were comparable in ART-naïve and in pre-treated PI-naïve pts, reflecting good efficacy and durability also in second- or third-line use of LPV/r. The probability of remaining on treatment for 48 weeks was high in both groups (78 and 77%); VL was < 50 copies/ml in 79% of ART-naïve and in 75% of PI-naïve pts (OT) (ITT: 62% and 60%). In 34% of ART-naïve pts and in 48% of PI-naïve pts, CD4 cells increased to levels >500/ml, demonstrating an ongoing CD4 increase also in pre-treated PI-naïve pts. |
| P76 | 3OD – ONCE-DAILY (OD) TDF-CONTAINING HAART IN HIV-1-INFECTED FORMER IVDU-PATIENTS RECEIVING OPIATE SUBSTITUTION: EFFICACY, TOLERABILITY AND ADHERENCE J Int AIDS Soc 2008, 11(Suppl 1):P76 doi:10.1186/1758-2652-11-S1-P76 S Esser1, S Staszewski2, AE Haberl2, F Mulcahy3, J Gölz4, A Lazzarin5, E Teofilo6, J Vera7, A Körber1, B Ranneberg8 and L Gallo8 TDF in combination with other OD antiretrovirals in former IVDU patients showed comparable efficacy to that seen in the average HIV-1 infected population. However, measurement of adherence to self-administered HAART via pill count, MASRI or diary may be misleading in this population. |
| P77 | VIROLOGICAL FAILURE AND PREDICTORS IN PATIENTS WITH CLINICAL AND IMMUNOLOGICAL FAILURES TO FIRST-LINE ARV REGIMENS IN VIETNAM J Int AIDS Soc 2008, 11(Suppl 1):P77 doi:10.1186/1758-2652-11-S1-P77 VT Tuyet Nhung1, D Colby1, H Thu Thuy2, L Vinh Thuy2, DT Nhat Vinh1 and L Truong Giang2 Immunological and clinical failures predicted VF in only 57% and may lead to unnecessary ART change in 41.5% of patients. VL testing should be done to assess response of ARV treatment. Moreover, patients with virological suppression on first-line ARV also benefit by prolonging the use of first-line drugs and thereby preserving future treatment options. |
| P78 | EFFECTIVENESS AND SAFETY OF HAART REGIMENS CONTAINING TENOFOVIR DF + SAQUINAVIR OR FOSAMPRENAVIR IN HIV PATIENTS: SUB-ANALYSIS FROM PROTECTION STUDY J Int AIDS Soc 2008, 11(Suppl 1):P78 doi:10.1186/1758-2652-11-S1-P78 A Abdon1, J Cosín2, J Pasquau3, E Deig4, ML Álvarez5, P Ferrer5 and E Pedrol4 In this cohort, concomitant use of TDF with SQVor FPV was associated with good tolerability and an adequate rate of viral effectiveness, suggesting these combinations are suitable as rescue therapy in highly treatment-experienced patients. |
| P79 | EFFICACY AND SAFETY OF TENOFOVIR/EMTRICITABINE COMPARED TO ABACAVIR/LAMIVUDINE IN HIV-1 INFECTED PATIENTS IN CLINICAL SETTING. THE TEAL STUDY J Int AIDS Soc 2008, 11(Suppl 1):P79 doi:10.1186/1758-2652-11-S1-P79 KJ Eccleston1, A Bambumba1, CS Babu1, S Ahmed2 and V Lee1 Truvada was non-inferior to Kivexa in this cohort. However, virological failure was observed in three patients when Kivexa was used with an NNRTI. Median CD4 increase was greater in Truvada arm at 48 weeks but this was not statistically significant. Further data will be presented at the meeting. |
| P80 | KAPITAL2: A STUDY OF TREATMENT SATISFACTION REPORTED BY PATIENTS ON LOPINAVIR/R ANCHORED REGIMENS AND PHYSICIANS WHO PROVIDE HIV CARE J Int AIDS Soc 2008, 11(Suppl 1):P80 doi:10.1186/1758-2652-11-S1-P80 JL Casado1, L Griffa2, E Cabrero2, A Burgos2 and M Norton3 Overall, reported patient satisfaction level with LPV/r T was high. Not surprisingly, patients with the longest exposure duration reported the highest levels of satisfaction. Additional patient satisfaction studies conducted among patients on differing anchor antiretrovirals would provide further context, comparison, and interpretation for these LPV/r treatment satisfaction findings. |
| P81 | REAL-LIFE EFFECTIVENESS AND SAFETY OF LOPINAVIR/RITONAVIR IN HIV-INFECTED ADULTS WHO EXPERIENCED PRIOR DIFFERENT ANTIRETROVIRAL TREATMENTS J Int AIDS Soc 2008, 11(Suppl 1):P81 doi:10.1186/1758-2652-11-S1-P81 B Conway1, J DeWet2, A Tsang3, K Logue4, C Kovacs5, N Ackad6, J Vaillancourt7, N Longo7, D Haine7 and JS Sampalis7 After 48 weeks of treatment in a clinical setting, lopinavir/ritonavir is effective in achieving virologic control and immunologic improvement in ARV-naïve, PI-naïve or PI-experienced patients, with more significant immunologic benefit in ARV and PI-naïve patients. |
| P82 | GOOD EXPERIENCE OF ENFURVITIDE IN SEVERELY ILL PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P82 doi:10.1186/1758-2652-11-S1-P82 K Gyllensten1, H Granholm2 and A Blaxhult3 The indications for enfurvitide were in 28% of cases (7/25 cases) other than failure or intolerance and most commonly severely ill patients with co-morbidities in need for treatment interacting with conventional ARTs. The parenteral administration, lack of interaction and antiretroviral effect made it possible to maintain undetectable viral load in HIV-treated patients hospitalised for medical or surgical emergencies, and to rapidly reduce viral load in newly diagnosed patients during ICU care. This can improve the chances for survival for the patients and also reduce the risk for transmission to the staff. |
| P83 | SAFETY PERSONALISATION OF ART THERAPY: WHAT TREATMENTS DO PATIENTS RECEIVE WITH THE KNOWLEDGE OF THEIR HLA-B*5701 STATUS? J Int AIDS Soc 2008, 11(Suppl 1):P83 doi:10.1186/1758-2652-11-S1-P83 R Rubio1, MA Johnson2, BJ Haas3, EA Loeschel4, C Granier4, F Jackson4 and HC Pearce4 HLA-B*5701 positive patients and their clinicians chose treatment options that actively avoided exposure to abacavir. Mistakes can happen, highlighting the need for accurate reporting of screening results. Physicians and patients accept pharmacogenetic screening, and use the result to guide patient management, showing that pharmacogenetic screening allows for personalisation of therapy. |
| P84 | EFFECT OF AGE ON RESPONSE TO AND TOLERABILITY OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY: A CASE-CONTROL STUDY J Int AIDS Soc 2008, 11(Suppl 1):P84 doi:10.1186/1758-2652-11-S1-P84 D Francisci, G Masini, R Papili, B Belfiori and F Baldelli The main problem with older patients is treatment tolerability, which causes a more frequent change of antiretroviral drugs. However, viro-immunological results do not differ between the two age groups. Clinical trials admitting older HIV patients are needed. |
| P85 | RARITY OF MIXED CRYOGLOBULINEMIA (MC) IN HIV-1 (+) TREATMENT-NAÏVE PATIENTS (09/2006–5/07/2008) AND LONG-TERM FOLLOW-UP J Int AIDS Soc 2008, 11(Suppl 1):P85 doi:10.1186/1758-2652-11-S1-P85 S Mourtzoukos, T Kordossis, AN Kontos,AV Theofilopoulou and S Molangeli MC has been found to occur in 27% of HIV-1 (+) patients (1996–1997) [1], but its prevalence has declined during the HAART era (12/2003–07/2004) to 7.5% [2]. It is evident in the present study that MC is rare due possibly to earlier diagnosis and the use of HAART, but the long-term follow-up will clarify the phenomenon and give medical evidence as to whether the presence of MC is an indication for the initiation of treatment. |
| P86 | EFFICACY AND SAFETY OF RITONAVIR-BOOSTED FOSAMPRENAVIR (FPV/R) IN HIV-INFECTED PATIENTS: 48-WEEK RESULTS FROM AN OBSERVATIONAL STUDY J Int AIDS Soc 2008, 11(Suppl 1):P86 doi:10.1186/1758-2652-11-S1-P86 JF Hain, S Eberle and RK Walli Fosamprenavir/ritonavir demonstrated good efficacy and tolerability in ART-naïve patients as well as in HIV patients with any virological failure in a previous ART. |
| P87 | MANAGEMENT OF ANTIRETROVIRAL THERAPY (ART) IN ALBANIA J Int AIDS Soc 2008, 11(Suppl 1):P87 doi:10.1186/1758-2652-11-S1-P87 A Harxhi1, D Kraja1, E Shehu1, E Sharra2, S Bino2 and K Rjepaj2 Albania, as a country with low prevalence and limited resources, is using a public health ART strategy. We think that a better (if possible) strategy for ART management in Albania would be a combination of public health and individual approach. |
| P88 | ABACAVIR AND CARDIOVASCULAR RISK IN HIV-INFECTED PATIENTS: DOES T-LYMPHOCYTE HYPERACTIVATION EXERT A PATHOGENIC ROLE? J Int AIDS Soc 2008, 11(Suppl 1):P88 doi:10.1186/1758-2652-11-S1-P88 M Casana1, GM Bellistrì1, C Tincati1, FB Bai1, L Comi1, EM Merlini1, MC Cristina2, T Bini1, A d'Arminio Monforte1 and GM Marchetti1 While significantly reconstituting total CD4+, abacavir resulted in significant expansion of activated/senescent/proapoptotic T-cell subsets associated to vascular damage. Analogously to other drug-toxicity models, a specific interference of abacavir with purine signaling pathways might be speculated, leading to impairment of lymphocyte activation. By suggesting T-lymphocye hyperactivation as relevant in the pathogenesis of abacavir-related CVD, these data, albeit preliminary, advocate thorough assessment of possible immunologic biomarkers of abacavir-related cardiovascular damage.' |
| P89 | PROTEASE INHIBITOR ATAZANAVIR INDUCES LEUKOCYTE-ENDOTHELIAL CELL INTERACTIONS IN THE MICROVASCULATURE J Int AIDS Soc 2008, 11(Suppl 1):P89 doi:10.1186/1758-2652-11-S1-P89 MM Andrade1, C De Pablo-Bernal2, JV Esplugues3 and Á Álvarez3 These studies indicate that acute exposure to atazanavir induces leukocyte recruitment and suggest that atazanavir could be responsible of precipitating the cardiovascular diseases observed in HIV-infected patients treated with protease inhibitors as part of combined antiretroviral therapy. |
| P90 | ANTI-INFLAMMATORY EFFECT OF OMACOR DURING COMBINATION ANTIRETROVIRAL THERAPY: A 12-WEEKS RANDOMISED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL J Int AIDS Soc 2008, 11(Suppl 1):P90 doi:10.1186/1758-2652-11-S1-P90 M Thusgaard1, JH Christensen1, B Mørn1, TS Andersen1, R Vige2, H Arildsen3, EB Schmidt1 and H Nielsen1 In conclusion, treatment with Omacor significantly reduced the inflammatory activity of the leukotriene system in HIV patients receiving combination antiretroviral therapy which potentially might reduce their risk of atherosclerosis and cardiovascular events. |
| P91 | PROTEASE INHIBITOR-INDUCED CARDIOTOXICITY: DIRECT EFFECTS ON CELL VIABILITY AND INTRACELLULAR CALCIUM LEVELS J Int AIDS Soc 2008, 11(Suppl 1):P91 doi:10.1186/1758-2652-11-1-P91 JP Spiers1, C Edwards1, A Rietz1, E Jan2, F Mulcahy3, M Hennessy1, Y Volkov1 and AM Davies1 In conclusion, SQV, NFV EFV and RTV are cardiotoxic in this cell line. Only NFV altered intracellular calcium levels. The effects on cell survival and intracellular calcium levels are likely to have functional consequences with regard to cardiac contractility and intracellular signalling mechanisms. Furthermore, this assay is suitable for high content screening of new drugs. |
| P92 | CARDIOVASCULAR RISK ESTIMATION IN SPANISH HIV-INFECTED PATIENTS: A MULTICENTER COHORT STUDY J Int AIDS Soc 2008, 11(Suppl 1):P92 doi:10.1186/1758-2652-11-1-P92 E Ferrer1, C Minguez2, A Mariño3, P Geijo4, F Brun5, J Sanz6, M Velasco7, C Cortés8, A Castro9, A Ortí10, L Force11, P Barrufet11, C Villalonga12 and D Podzamczer1 Traditional cardiovascular risk factors are associated with increased eCVR in our HIV population, and seem to have a stronger role than HAART and HIV infection. Lower eCVR in pts with detectable viral loads is probably related to younger age, lower waist circumference and systolic blood pressure, and a better lipid profile. Pts with higher eCVR may benefit from lipid-friendly ARV therapy, but interventions on life habits are crucial. |
| P93 | COMPARATIVE ASSESSMENT OF CORONARY RISK IN HIV-INFECTED PATIENT COHORT USING FRAMINGHAM INDEX AND SPANISH VALIDATED CORONARY RISK INDEX: REGICOR J Int AIDS Soc 2008, 11(Suppl 1):P93 doi:10.1186/1758-2652-11-1-P93 M Cervero Jiménez, R Torres Perea, JL Agud Aparicio, JJ Jusdado Ruiz-Capillas, C García Lacalle, M Álamo del Rodríguez and E García Benaya REGICOR index seems more accurate for the assessment of CHD risk in primary prevention in Spain, and presumably so in HIV-infected patients as well. It should be validated in other Spanish regions and specifically in HIV-infected patients. This would have an impact on therapeutic decisions. |
| P94 | IMPAIRMENT OF FUNCTIONAL INTEGRITY OF THE VASCULATURE IS NOT CHANGED IN PATIENTS STARTING ABACAVIR J Int AIDS Soc 2008, 11(Suppl 1):P94 doi:10.1186/1758-2652-11-1-P94 S Zona, A Lattanzi, N Squillace, G Orlando, C Stentarelli, R Rossi, AC Nuzzo, MG Modena and G Guaraldi Change in impairment of functional integrity of the vasculature is not an associated factor related with ABC use. Cardiovascular disease risk among HIV-infected HAART-experienced persons is likely governed by complex pathophysiologic and treatment factors. |
| P95 | EVALUATION OF THE IMPACT OF LOPINAVIR/RITONAVIR (LPV/R) AND RITONAVIR (RTV) ON QTCF: RESULTS OF A THOROUGH QT STUDY J Int AIDS Soc 2008, 11(Suppl 1):P95 doi:10.1186/1758-2652-11-1-P95 CE Klein, YL Chiu, BA Da Silva, PA Noertersheuser, WM Awni, CM Holas, TT Doan and B Bernstein Based on exposure-QT response modeling, the maximum concentrations observed with recommended QD or BID doses of LPV/r are lower than exposures predicted to result in a 10 msec increase in QTcF. LPV/r and RTV administered at approved doses does not result in clinically significant changes in QTcF. |
| P96 | HIV AND ANTIOXIDANT LIPOPROTEIN-ASSOCIATED EFFECT. IS THERE A CORRELATION? J Int AIDS Soc 2008, 11(Suppl 1):P96 doi:10.1186/1758-2652-11-1-P96 SA Pereira1, J Batuca1, U Caixas2, T Branco3, I Germano2, F Lampreia2, J Delgado-Alves1 and EC Monteiro1 According to our results, HIV-infected patients with CD4+ lymphocyte >350 cells/mL revealed greater PON-1 activity, presumably associated with an antioxidant effect, less oxidative stress and less metabolic disturbance. There was no correlation with total-C, HDL-C and viral load. A possible inverse correlation was found with LDL-C levels. |
| P97 | CAROTID INTIMA MEDIA THICKNESS WITH NO CARDIOVASCULAR DISEASE IN HIV-INFECTED PATIENTS CORRELATES WITH A HYPERACTIVATED/PRO-APOPTOTIC T-CELL PHENOTYPE J Int AIDS Soc 2008, 11(Suppl 1):P97 doi:10.1186/1758-2652-11-1-P97 C Tincati1, GM Bellistrì1, M Casana1, EM Merlini1, L Comi1, M Olivetti1, F Bai1, B Teresa1, A Gori2, A d'Arminio Monforte1 and GM Marchetti1 Despite no overt sign of CVD, HIV-infected patients with pathologic IMT increases display a peripheral T-cell immune phenotype and activation similar to CVD patients characterised by a highly activated/senescent, pro-apoptotic T-cell pool. By showing specific T-cell patterns associated to IMT increases, our findings support a possible role of immunological parameters as early surrogate markers of CVD risk in HIV-infected patients. |
| P98 | IMPACT OF FASTING BLOODS ON HYPERTRIGLYCERIDEMIA J Int AIDS Soc 2008, 11(Suppl 1):P98 doi:10.1186/1758-2652-11-1-P98 NA Billing, GJ Moyle and M Nelson All individuals should routinely have their bloods taken in the fasting state. Failure to do so may result in the inappropriate initiation of lipid-lowering agents or potential treatment changes. |
| P99 | DO GENETIC POLYMORPHISMS ASSOCIATED WITH INFLAMMATION/LIPODYSTROPHY OR ENDOTHELIAL DAMAGE PREDICT CAROTID ALTERATIONS IN HIV+ SUBJECTS UNDER CART? J Int AIDS Soc 2008, 11(Suppl 1):P99 doi:10.1186/1758-2652-11-1-P99 K de Gaetano Donati1, M Rossi1, N Iannotti1, M Calbi1, A Marzocchetti2, A Pedicelli3, A Di Castelnuovo4, M Fantoni1, L Iacoviello4, R Cauda1 and A De Luca1 IMT mean value increases in HIV+ patients with age. The -308 promoter region TNF-alpha gene heterozygosis was associated with higher IMT. Studies are needed to confirm the hitherto undescribed association between TNF308 and IMT and the already known but still controversial association between plaque and exposure to d4T. |
| P100 | CONTRIBUTION OF ANTIRETROVIRAL THERAPY, CARDIOVASCULAR RISK FACTORS AND CONSTITUENTS OF METABOLIC SYNDROME TO INSULIN RESISTANCE(IR) IN HIV J Int AIDS Soc 2008, 11(Suppl 1):P100 doi:10.1186/1758-2652-11-S1-P100 M Cervero Jiménez, R Torres Perea, JL Agud Aparicio, JJ Jusdado Ruiz-Capillas, C García Lacalle, M del Álamo Rodríguez and E García Benaya H. Severo Ochoa, Leganés To assess the association between antiretroviral therapy, cardiovascular risk factors and constituents of metabolic syndrome to IR. |
| P101 | EVALUATION OF THE IMPACT OF LOPINAVIR/RITONAVIR (LPV/R) AND RITONAVIR (RTV) ON PR INTERVAL: RESULTS FROM A THOROUGH QT STUDY J Int AIDS Soc 2008, 11(Suppl 1):P101 doi:10.1186/1758-2652-11-1-P101 BA Da Silva, J Li, YL Lin, PA Noertersheuser, WM Awni, CE Klein, TT Doan and B Bernstein Based on the exposure-response model, it is estimated that the mean PR effect plateaus and has reached its maximum with the supratherapeutic 800/200 mg BID dose. At steady state, LPV/r is expected to produce clinically insignificant increases in PR interval of 18 to 20 msec and low dose ritonavir (100–400 mg daily) is expected to prolong PR by 4.8 to 11.6 msec. LPV/r and RTV do not result in clinically significant increases in PR interval. However, this effect should be considered when co-administering LPV/r or RTV with other drugs known to prolong PR interval or in patients with co-morbid conditions. |
| P102 | PREVALENCE OF CARDIOVASCULAR RISK FACTORS (CRF) AND METABOLIC SYNDROME (MS) IN A COHORT OF HIV-INFECTED PATIENTS IN SOUTHERN SPAIN. PREGO STUDY J Int AIDS Soc 2008, 11(Suppl 1):P102 doi:10.1186/1758-2652-11-1-P102 M Gallego1, F Oñate2, A del Arco3, J Roldan4, M Grana5, R Palacios1 and J Santos1 Tobacco use was the most frequent CRF. In this cohort, the prevalence of MS was lower than in others, and similar to that in general Spanish population, but with a different distribution of its components, predominating HTG and low HDL-C levels. Although the prevalence of MS and mean CVR were similar among patients on PI and those on NNRTI, lipid abnormalities were more frequent with PI, and HT and hyperglycaemia with NNRTI. MS was not associated with any HIV-specific factors, but only with age. |
| P103 | EXPERIENCE OF MYOCARDIAL INFARCTION IN A GLASGOW HIV COHORT J Int AIDS Soc 2008, 11(Suppl 1):P103 doi:10.1186/1758-2652-11-1-P103 S English1, A Winter2, R Nandwani2, A MacConnachie1, A Seaton1 and R Fox1 HIV-related cardiovascular morbidity is increasingly recognised. Myocardial infarction (MI) is common in the West of Scotland, thus cardiac events in patients with HIV are of particular interest. This study aimed to estimate the prevalence of MI in the Glasgow HIV cohort, comparing the characteristics of MI patients with an HIV-positive control group. |
| P104 | STICKY PLATELET SYNDROME (SPS) IN PATIENTS WITH AIDS: A CROSS-SECTIONAL STUDY J Int AIDS Soc 2008, 11(Suppl 1):P104 doi:10.1186/1758-2652-11-1-P104 H Castro Lopez, L Nieto Cisneros, S Trevino Perez, J Casillas Rodriguez and A Majluf Cruz SPS was recently described as a relatively frequent cause of either venous or arterial thrombotic events. To date, no single cause of thrombophilia can explain the growing incidence of vascular events associated to ARV in patients with AIDS. A few years ago, our group informed a large series of venous thromboembolic events in patients with AIDS in which none of the thrombophilic causes described in the general population was found significantly. Therefore, we attempted to investigate other causes of thrombophilia that may be affecting patients with AIDS. We have found that SPS is a very frequent condition in patients with AIDS receiving ARV therapy for at least 6 months. Moreover, we found that protease inhibitors are not associated with the appearance of the syndrome in this population. A controlled study about this association is warranted. |
| P105 | EFFECTS OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) ON PLATELET ACTIVATING FACTOR (PAF) METABOLISM IN HIV-INFECTED PATIENTS: IN VIVO RESULTS J Int AIDS Soc 2008, 11(Suppl 1):P105 doi:10.1186/1758-2652-11-1-P105 AB Tsoupras1, M Chini2, N Tsogas2, N Mangafas2, G Stamatakis1, S Antonopoulou3, CA Demopoulos1 and MC Lazanas2 Our preliminary in vivo results confirm the previous in vitro ones: group A's regimen retained its ability to reduce PAF production while group B's regimen seems to enhance it. Further studies are needed to confirm these results and to unveil any possible clinical implications of anti-PAF activity of HAART. |
| P106 | PERI-RENAL FAT DIAMETER IS RELATED TO INTIMA MEDIA THICKNESS AND RENAL ARTERIAL RESISTANCE INDEX IN HIV-1 INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P106 doi:10.1186/1758-2652-11-1-P106 PF Grima, R Chiavaroli and P Grima There is concern that human immunodeficiency virus (HIV) infection and the use of highly active antiretroviral therapy lead to accelerated atherosclerosis and increased risk of cardiovascular disease [1]. Primary objective of our study was to evaluate whether peri-renal fat diameter (PRFD), a parameter of visceral obesity, is related to renal arterial resistance index (RI) and carotid intima-media thickness (IMT), indices of atherosclerosis in HIV-infected patients [2]. |
| P107 | AN AUDIT OF CARDIOVASCULAR DISEASE RISK MANAGEMENT IN HIV-INFECTED PATIENTS ATTENDING A NORTHERN ENGLISH HOSPITAL J Int AIDS Soc 2008, 11(Suppl 1):P107 doi:10.1186/1758-2652-11-1-P107 GL Buxton and DR Chadwick Identification and management of cardiovascular risk factors did not meet BHIVA guidelines. Doctors need to improve identification of cardiovascular risk factors through annual checks comprising blood pressure, fasting glucose and lipids. Although current management through dietetic referral is efficient, alcohol and smoking management needs improving. |
| P108 | EFFECT OF ANTIRETROVIRAL THERAPY ON HOMOCYSTEINE PLASMA CONCENTRATIONS IN PATIENTS WITH AIDS J Int AIDS Soc 2008, 11(Suppl 1):P108 doi:10.1186/1758-2652-11-1-P108 H Castro Lopez, E Coria Ramirez, L Nieto Cisneros, S Trevino Perez, J Casillas Rodriguez and A Majluf Cruz Antiretroviral (ARV) therapy is currently associated with longer survival and improved quality of life in AIDS patients. Several complications related to these drugs have been recently published, specifically thrombotic events. Hyperhomocysteinemia is an independent risk factor for atherothrombosis and venous thrombosis. Therefore, we aimed to determine the effect of ARV therapy on homocysteine plasma levels in patients with AIDS. |
| P109 | TRADITIONAL RISK FACTORS DO NOT PREDICT OSTEOPOROSIS IN HIV PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P109 doi:10.1186/1758-2652-11-1-P109 NS Chew1, S McConkey2, J Lambert1, G Sheehan1 and WG Powderly1 Infection with HIV has changed from a fatal condition to a chronic process made manageable by effective antiretroviral therapy (ART). Thus much of the emphasis in managing patients with chronic HIV infection has changed from treating and preventing opportunistic infections to dealing with the consequences of life-long HIV treatment and associated toxicities including osteoporosis. We recently reported a prevalence of decreased BMD (both osteopenia and osteoporosis) of 54.7%, and actual osteoporosis (hip and/or spine) of 9.5% in a cohort of 148 patients attending two Dublin HIV clinics. This is in keeping with reported prevalence rates of osteopenia/osteoporosis at other HIV centres. We extended the aims of the above study to examine both HIV and non-HIV associated risk factors for osteopenia/osteoporosis in this cohort. |
| P110 | METABOLIC EVALUATION OF STUDY M05-730: LPV/R TABLETS QD VS. BID, CO-ADMINISTERED WITH TENOFOVIR DF + EMTRICITABINE IN ARV-NAÏVE HIV-1 INFECTED SUBJECTS J Int AIDS Soc 2008, 11(Suppl 1):P110 doi:10.1186/1758-2652-11-S1-P110 BA Da Silva, DE Cohen, TM Marsh, LM Fredrick, SE Gibbs, JM Hairrell, B Bernstein, D Grant and C Naylor Measures of lipid ratios and Framingham models are better assessments of cardiovascular risk than individual lipid parameters. Through 48 weeks, in subjects treated with a LPV/rbased regimen, these measures (TC:HDL and LDL-C:HDL ratios) and Framingham (TC-based and LDL-based) 10-year cardiovascular risk were minimally impacted. |
| P111 | METABOLIC SYNDROME AMONG PATIENTS INITIATING HAART AND OUTCOME IN SOUTHERN INDIA J Int AIDS Soc 2008, 11(Suppl 1):P111 doi:10.1186/1758-2652-11-1-P111 S Saghayam1, N Kumarasamy1, M Sundaram1, S Solomon1, G Shivaji2, K Mayer3 and C Wanke4 This study shows a high frequency of metabolic syndrome among HIV-positive patients due to low HDL and high insulin resistance. Efavirenz-based HAART, due to its beneficial effect on HDL, has been protective against metabolic syndrome in the first 12 months in this study but its long-term effects need to be studied. As HAART is available in large-scale government programs, routine monitoring of metabolic parameters is essential to minimize cardiovascular risk. |
| P112 | FACTORS RELATED TO LOW HDL-CHOLESTEROL IN HIV-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P112 doi:10.1186/1758-2652-11-1-P112 S Puerta1, R Palacios1, F Orihuela2, J De la Torre3, S Fernandez4, M Grana5, J Rodan6 and J Santos1 Immunological and virological situation, in addition to traditional cardiovascular risk factors such as tobacco and hypertriglyceridemia, affect HDL-C levels in HIV-infected patients. For patients on ART, the use of PI is associated with a higher probability of low levels of HDL-C. Although it is not clear if the higher HDL-C levels associated with ART use are surrogates for decreased CVD risk, this may be another reason to start ART earlier. |
| P113 | HIV INFECTION SIGNIFICANTLY REDUCES LIPOPROTEIN LIPASE WHICH REMAINS LOW AFTER 6 MONTHS OF ANTIRETROVIRAL THERAPY J Int AIDS Soc 2008, 11(Suppl 1):P113 doi:10.1186/1758-2652-11-1-P113 M Boothby1, AM Umpleby2, F Shojaee-Moradie2, JW Tomlinson3, LL Gathercole3, K McGee4, S Das5 and M Shahmanesh6 Post heparin lipoprotein lipase activity is reduced in HIV and does not return to control levels after 6 months of ARV therapy. AZT-containing regimens are associated with a greater increase in LPL, LPL gene expression and plasma adiponectin than TDF. |
| P114 | LONG-TERM SATISFACTION AND BENEFITS ON QUALITY OF LIFE IN HIV-INFECTED PEOPLE AFTER REPARATORY TREATMENT WITH AQUAMID® FOR FACIAL LIPOATROPHY J Int AIDS Soc 2008, 11(Suppl 1):P114 doi:10.1186/1758-2652-11-1-P114 JA Muñoz-Moreno1, J Puig1, CR Fumaz1, E Negredo1, MJ Ferrer1, N Pérez-Álvarez1, V González-Mestre2 and B Clotet1 HIV-associated facial lipoatrophy (HAFL) is known to produce disturbances on quality of life (QOL) and emotional status in people living with HIV. Reparatory treatment with facial infiltrations has been proposed as a safe and effective strategy [1], although long-term psychological benefits remain unknown [2]. |
| P115 | VIROLOGIC FAILURE AND METABOLIC SYNDROME IN PATIENTS WITH HIV INFECTION J Int AIDS Soc 2008, 11(Suppl 1):P115 doi:10.1186/1758-2652-11-1-P115 N Squillace, S Zona, G Orlando, C Stentarelli, B Beghetto, G Nardini and G Guaraldi Our study highlights that HIV-infected patients experiencing virological failure are more at risk to develop MS. It is necessary to obtain virologic suppression to prevent not only AIDS-related opportunistic infections, but also those cardiovascular events and diabetes related to MS presence. |
| P116 | VITAMIN D DEFICIENCY IN THE IN-PATIENT HIV POPULATION: CAUSE OR AFFECT? J Int AIDS Soc 2008, 11(Suppl 1):P116 doi:10.1186/1758-2652-11-1-P116 B Ancock, M Bower, BG Gazzard and M Nelson A significant number, 49 (66.2%), of our patients had either vitamin D deficiency or insufficiency. There also appears to be lower CD4 counts in the Vitamin D deficient group of patients. Whether specific antiretrovirals contribute to Vitamin D deficiency can not be confirmed from these figures, however, further investigation into the relationship between HIV, HAART and Vitamin D needs to be undertaken. |
| P117 | BODY PHYSICAL CHANGES IN HIV PATIENTS UNDER ANTIRETROVIRAL TREATMENT IN SPAIN J Int AIDS Soc 2008, 11(Suppl 1):P117 doi:10.1186/1758-2652-11-1-P117 L Griffa, E Cabrero and A Burgos A high proportion of patients under ART in Spain refer changes in their physical appearance. The prevention of the potential negative impact of BPC on patients' self-esteem should be considered among the antiretroviral treatment end-points. |
| P118 | BIOCHEMICAL MARKERS OF BONE TURNOVER AND CALCIUM DIETARY INTAKE EVALUATION IN HIV-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P118 doi:10.1186/1758-2652-11-1-P118 G Camanni1, G Toraldo2, D Rosignoli1, R Pippi2, E Schiaroli1, G Angeletti2, F Baldelli1 and D Francisci1 This study shows that the majority of our patients have a deficit of calcium intake associated with low level of vitamin D, elevation of PTH and increase in markers of bone turnover (serum crosslaps and BALP). Because hypovitaminosis D was present in almost all the patients (naïve or treated), we believe that levels of vitamin D should be assessed and routinely corrected in all HIV patients, not only for the well-known action of this hormone on bone metabolism and bone fractures, but also because of its immunomodulatory properties and effects on adipocyte differentiation. |
| P119 | ASSESSMENT FOR SONOGRAPHIC GRADING SCALES OF THE BODY FAT CHANGES RELATED TO THE LIPOATROPHIC FINDINGS OF HIV PATIENTS IN TREATMENT WITH HAART J Int AIDS Soc 2008, 11(Suppl 1):P119 doi:10.1186/1758-2652-11-1-P119 R Gulizia1, C Gervasoni2, M Ortu2, M Galli2 and C Filice1 US shows significant correlation with the HOPS based assessments. Significant areas under the ROC curves, distinct diagnostic thresholds with high sensitivity, specificity and likelihood ratios suggest that US is reliable for the diagnosis of LA. Compared to the HOPS, the US-GS shows high percentages of correctly classified cases of LA. Serial assessments could identify early BFCs related to HAART or be used to prevent advanced stages. It could suggest the need for proactive switching therapies or identify the SFT recovery in response to reactive switching therapies. |
| P120 | EFAVIRENZ INDUCES ALTERATIONS IN LIPID METABOLISM THROUGH AMPK ACTIVATION J Int AIDS Soc 2008, 11(Suppl 1):P120 doi:10.1186/1758-2652-11-S1-P120 A Blas-García1, D Ballesteros2, D Monleón1, JM Morales1, M Rocha1, VM Víctor1, N Apostolova3 and JV Esplugues3 Recent evidence suggests that the NNRTI efavirenz (EFV) contributes to changes in lipid and body fat composition that are implicated in lipoatrophy. As the liver is an important organ in lipid metabolism, we have evaluated the effects of clinically-used concentrations of EFV on mitochondrial function and cellular lipid metabolism in vitro, and the implication of AMP-activated protein kinase (AMPk), the master switch for regulation of cellular bioenergetics, in these processes. |
| P121 | LIPID CHANGES IN PATIENTS RECEIVING NEVIRAPINE (NVP) IN COMBINATION WITH TENOFOVIR/EMTRICITABINE: RESULTS FROM THE CCIAT TRIAL J Int AIDS Soc 2008, 11(Suppl 1):P121 doi:10.1186/1758-2652-11-1-P121 C Davis1, R Talwani1, B Gilliam1, A Amoroso1, C Boyce2, P Piliero3, C Conner3 and R Redfield1 The combination of NVP plus TDF/FTC resulted in apparent positive effects on serum lipids, with an increase in HDL-C, decrease in TGs and little change in LDL-C and TC. This regimen might improve the cardiovascular risk profile of pts taking ARV therapy. |
| P122 | LIPOMETABOLIC SIDE-EFFECTS OF THREE RITONAVIR-BOOSTED DOUBLE PROTEASE INHIBITOR REGIMENS WITHOUT REVERSE TRANSCRIPTASE INHIBITORS J Int AIDS Soc 2008, 11(Suppl 1):P122 doi:10.1186/1758-2652-11-1-P122 A Wendig1, C Stephan1, P Khaykin1, M Bickel1, T Lennemann1, G Knecht2, T Lutz2, N von Hentig1 and S Staszewski1 After 48 weeks on a double-boosted PI regimen, all three patient groups showed significant increases in total cholesterol. The increase in triglyceride levels was only significant for LOPSAQ, but not for ATSAQ or FOSAQ. Overall, <5% required a new LLA-therapy during the first 48 weeks. HDL- and LDL-cholesterol increases were not significant. The cardiovascular impact of these lipometabolic interferences requires further investigations. |
| P123 | PI AND OPG/RANKL LEVELS IN HUMAN OSTEOBLAST CELLS J Int AIDS Soc 2008, 11(Suppl 1):P123 doi:10.1186/1758-2652-11-1-P123 M Borderi1, D Gibellini2, L Tampellini1, C Biagetti1, F Vescini3, MC Re2 and F Chiodo1 The association between loss of bone mineral density (BMD) and PI use is evidenced on several in vitro models and seems to have different etiology depending on specific molecule. Although an HAART regimen always contains one or more transcriptase inhibitors, there are no specific data available regarding specific PI action on BMD. However, some in vitro experiments showed that these compounds might induce the differentiation of osteoclast cells. In order to analyse the specific effect of each PI on human osteoblast we analysed OPG and RANKL levels after exposing the cells to each PI. |
| P124 | A 24-MONTH FOLLOW-UP OF THE METABOLIC PROFILE OF GREEK HIV (+) POPULATION ON LOPINAVIR/RITONAVIR-BASED REGIMEN: THE ACA GREC TRIAL J Int AIDS Soc 2008, 11(Suppl 1):P124 doi:10.1186/1758-2652-11-1-P124 SM Metallidis1, ML Lazanas2, PG Gargalianos3, H Sambatakou4, NM Magafas2, GX Xilomenos3, PP Panagopoulos5, MG Giannaris4, GB Bakoyiannis6, KX Xynos7, HG Gogos8, HB Bassaris8, HG Giamarellou5, PN Nikolaidis1, SK Kourkoudi9 and KL Loyo9 Minimal differences were observed in fasting glucose and lipid profile between HAART naïve and experienced subjects receiving LPV/r in a 2-year study period. The TC and TG increase observed never reached toxicity levels. TC/HDL, an important predictor of cardiovascular event occurrence, remained below the critical value 5 for the whole period. Severity of condition as defined by the baseline CD4+ count affects TG levels. |
| P125 | STATISTICAL AGREEMENT BETWEEN ATPIII, IDF, EGIR, AACE METABOLIC SYNDROME CLASSIFICATIONS IN HIV-INFECTED PATIENTS AND ASSOCIATION WITH LIPODYSTROPHY J Int AIDS Soc 2008, 11(Suppl 1):P125 doi:10.1186/1758-2652-11-1-P125 G Guaraldi, S Zona, R D'Amico, N Squillace, G Orlando, C Stentarelli and R Esposito Concordance between MS classification is less than ideal. After adjusting for BMI strata, lipodystrophy phenotypes and central fat accumulation are associated with for MS diagnosis. |
| P126 | HYPERTENSION IS THE MOST COMMON COMPONENT OF THE METABOLIC SYNDROME IN A COHORT OF NRTI-BASED HAART TREATED PATIENTS – A PRELIMINARY REPORT J Int AIDS Soc 2008, 11(Suppl 1):P126 doi:10.1186/1758-2652-11-1-P126 SO Iwuala The association between hypertension and HAART has been frequently documented. Hypertension as a cardiovascular risk factor was prevalent in these young NRTIbased HAART treated patients and was the most common feature of the metabolic syndrome. There is a need for larger studies in this aspect of the adverse effect of HAART to be done especially countries with a huge burden of young HIV-infected patients. |
| P127 | LIPID ELEVATIONS IN THE ARTEMIS AND TITAN TRIALS: EFFECTS OF DEMOGRAPHICS, HIV DISEASE STAGE, TREATMENT ARM AND LIPID-LOWERING DRUGS J Int AIDS Soc 2008, 11(Suppl 1):P127 doi:10.1186/1758-2652-11-1-P127 M Nelson1 and AM Hill2 The ARTEMIS trial (TMC114-C211) evaluated LPV/r vs. DRV/r 800/100 mg OD in treatment-naïve patients, in combination with TDF/FTC. The TITAN trial (TMC114-C214) evaluated LPV/r vs. darunavir/ritonavir 600/100 mg BID in LPV-naïve, treatment-experienced patients with HIV-1 RNA > 1000 copies/mL, in combination with optimised NRTI/NNRTI combinations. |
| P128 | KIDNEY TUBULAR ABNORMALITIES IN HIV PATIENTS TREATED WITH TENOFOVIR WITH NORMAL GLOMERULAR FUNCTION – RESULTS OF A PROSPECTIVE STUDY ON 284 PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P128 doi:10.1186/1758-2652-11-1-P128 P Labarga1, P Barreiro1, L Martin-Carbonero1, S Rodríguez-Nóvoa1, C Solera1, J Medrano1, P Rivas1, M Albalate2, F Blanco1, V Moreno1, E Vispo1, E Valencia1, J González-Lahoz1 and V Soriano1 Treatment with TDF is associated with an increased risk over time of kidney tubular damage in the absence of significant glomerular impairment. The long-term consequences of abnormal tubular dysfunction in patients on TDF warrant close examination. |
| P129 | A CROSS-SECTIONAL COMPARISON OF RENAL FUNCTION IN PATIENTS ON STABLE ABACAVIR (ABC) OR TENOFOVIR (TDF) CONTAINING THERAPY J Int AIDS Soc 2008, 11(Suppl 1):P129 doi:10.1186/1758-2652-11-1-P129 LJ Waters, P Randell, AGA Jackson, J Taylor, S Mandalia, BG Gazzard and GJ Moyle Significant renal abnormalities were infrequent. For renal end-points we did not detect a statistically significant or clinically relevant safety difference between the ABC and TDF in our cohort. |
| P130 | SUBCLINICAL KIDNEY DISEASE IN HIV-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P130 doi:10.1186/1758-2652-11-S1-P130 ML Sorlí, M Velat, AM Guelar, M Montero, J Villar, G Vallecillo, A Gonzalez and H Knobel Early stages of kidney disease were detected in a high proportion of HIV-infected patients. Simple and cheap laboratory analysis (dipsticks and estimated glomerular filtration rate) appears to be useful as screening method to detect subclinical kidney disease; at this stage the measures of control and prevention can be more effective. |
| P131 | A CENTRAL BODY FAT DISTRIBUTION IS RELATED TO INCREASED RENAL ARTERIAL RESISTANCE INDEX AND RENAL FUNCTION IMPAIRMENT IN HIV-1 INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P131 doi:10.1186/1758-2652-11-1-P131 PF Grima, P Grima and R Chiavaroli HIV-1 infected lipodystrophic patients with central fat distribution are at risk of diminished renal filtration, with positive correlation between intrarenal arterial resistive index and thickness of omental and peri-renal adipose tissue. This might indicate that fat distribution is important for renal function abnormalities and resistive index may be one of the markers for renal outcome. |
| P132 | INTRODUCTION OF A SYSTEM TO SCREEN FOR CHRONIC KIDNEY DISEASE AND MONITOR FOR NEPHROTOXICITY OF ANTIRETROVIRALS AT AN OUTPATIENT HIV CLINIC J Int AIDS Soc 2008, 11(Suppl 1):P132 doi:10.1186/1758-2652-11-1-P132 S Kelly1, C Bergin1, V Treacy1, L Sahm2 and E de Barra1 Improved screening will allow identification of patients who require interventions to reduce cardiovascular risk and progression of CKD, timely referral and planning for renal replacement therapy, and early identification of nephrotoxicity due to antiretrovirals. |
| P133 | EVALUATION OF KIDNEY TOXICITY IN HIV PATIENTS WITH TENOFOVIR-BASED REGIMEN: THE ROLE OF BOOSTED PROTEASE INHIBITOR IN REAL CLINICAL SETTING J Int AIDS Soc 2008, 11(Suppl 1):P133 doi:10.1186/1758-2652-11-1-P133 F Ortu, P Piano, P Serra, R Meleddu, N Corso and PE Manconi In conclusion, our study demonstrated that also in real-life conditions, patients receiving TDF in combination with PI/r-based regimens had greater declines in renal function than did TDF NNRTI. |
| P134 | RISK FACTORS FOR END-STAGE LIVER DISEASE AMONG HIV AND HEPATITIS C VIRUS CO-INFECTED PATIENTS IN THE SPANISH VACH COHORT J Int AIDS Soc 2008, 11(Suppl 1):P134 doi:10.1186/1758-2652-11-1-P134 R Teira1, P Geijo2, J Cosín3, A Muñoz-Sanz4, P Viciana5, I Suarez-Lozano6, J López-Aldeguer7, E Pedrol8, F Vidal9, T Sanchez10, F Lozano11, A Terron12, A Vergara13, MJ Galindo14, P Domingo15, E Ribera16, B Roca17, ML Garcia-Alcalde18, M Garrido19 and P Muñoz-Sanchez20 In conclusion, we found no evidence to support the hypothesis of a different effect of PI's and NAN's on the occurrence of ESLD among HIV and HCV co-infected individuals. Hepatitis B co-infection, more profound immunosupression and older age were associated with this outcome. |
| P135 | SCREENING FOR LIVER FIBROSIS IN HIV-MONO-INFECTED PATIENTS WITH INCREASED ALT COMPARING FIBROSCAN WITH FIB-4 J Int AIDS Soc 2008, 11(Suppl 1):P135 doi:10.1186/1758-2652-11-1-P135 S Mauss, J Henke, F Berger, P Hegener and G Schmutz Elevated ALT values are frequently observed in HIV-mono-infected patients. Recent studies have reported cases of cryptogenic liver cirrhosis in HIV+ individuals. Other possible explanations are non-alcoholic/alcoholic steatohepatitis and drug toxicity. We have used two non-invasive methods, liver elastometry (FibroScan) and a serologic fibrosis index (FIB-4), for liver fibrosis screening in a single centre. |
| P136 | ATAZANAVIR IS SAFE AND EFFICACIOUS IN HBV AND HCV CO-INFECTED PATIENTS: RESULTS OF AI424138 (CASTLE) J Int AIDS Soc 2008, 11(Suppl 1):P136 doi:10.1186/1758-2652-11-1-P136 J Absalon1, G Thal2, A Thiry1, R Yang1, MD Mancini1 and D McGrath1 Virologic and immunologic response was comparable in Hep+ treated with ATV/r or LPV/r. ATV/r had a more favorable lipid profile (TC, non-HDL, LDL, TG) and fewer gastrointestinal adverse events among Hep+ subjects than LPV/r. While the overall rates of transaminitis in Hep+ were low in this study compared to those observed in other clinical trials, a small number of subjects in the ATV/r and none on LPV/r had grade 3–4 AST elevations. The cause of this higher proportion in the ATV/r treatment arm among this limited number of subjects is unclear. With close monitoring of liver function tests, ATV/r can be considered as part of HAART among treatment-naïve Hep+ patients. |
| P137 | RISK FACTORS FOR ADVANCED LIVER FIBROSIS IN HIV-INFECTED INDIVIDUALS: ROLE OF THE METABOLIC SYNDROME J Int AIDS Soc 2008, 11(Suppl 1):P137 doi:10.1186/1758-2652-11-1-P137 F Blanco, P Barreiro, P Ryan, E Vispo, LMartin-Carbonero, P Tuma, P Labarga, J González-Lahoz and V Soriano Former alcohol abuse and non-alcoholic steatohepatitis as a result of insulin resistance and/or exposure to dideoxy-nucleosides represent an emerging cause of ALF in HIV patients. |
| P138 | UNEXPLAINED SEVERE PORTAL HYPERTENSION IN HIV-INFECTED PATIENTS: A NEW CLINICAL ENTITY? J Int AIDS Soc 2008, 11(Suppl 1):P138 doi:10.1186/1758-2652-11-1-P138 I Maida1, E Vispo2, G Sotgiu3, P Barreiro2, L Martin-Carbonero2, MJ Ríos3 and V Soriano2 A small subset of HIV patients may develop SPH in the absence of known predisposing conditions and advanced hepatic fibrosis. These patients may eventually experience potentially fatal GI bleeding. Exposure to didanosine seems to be involved in most cases. A primary injury of the portal vessels by this adenosine analog may play a central pathogenic role in this condition. |
| P139 | STATISTICAL AGREEMENT BETWEEN ULTRASOUND (US) AND COMPUTERIZED TOMOGRAPHY (CT) FOR NON-ALCOHOLIC LIVER DISEASE (NAFLD) DIAGNOSIS J Int AIDS Soc 2008, 11(Suppl 1):P139 doi:10.1186/1758-2652-11-1-P139 S Zona, S Ballestri, A Lonardo, R D'Amico, N Squillace, G Orlando, C Stentarelli, P Loria and G Guaraldi To assess K statistic of non-invasive imaging evaluations to diagnose NAFLD by means of US fatty liver indicator (FLI) score and liver to spleen attenuation ratio by CT. |
| P140 | "ENDOCRINE NAFLD": A HORMONOCENTRIC PERSPECTIVE OF NON-ALCOHOLIC LIVER DISEASE (NAFLD) PATHOGENESIS IN HIV-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P140 doi:10.1186/1758-2652-11-S1-P140 C Stentarelli, S Zona, V Rochira, G Caffagni, L Zirilli, S Ballestri, A Lonardo, R D'Amico, N Squillace, G Orlando, P Loria and G Guaraldi We assessed endocrine system involvement in a multifactorial pathogenesis hypothesis of NAFLD in HIV-infected patients. |
| P141 | HEPATIC SAFETY OF TIPRANAVIR/RITONAVIR (TPV/R)-BASED ANTIRETROVIRAL THERAPY: EFFECT OF HEPATITIS VIRUS CO-INFECTION AND BASELINE LIVER FIBROSIS J Int AIDS Soc 2008, 11(Suppl 1):P141 doi:10.1186/1758-2652-11-1-P141 J Macias1, F Orihuela2, A Rivero3, P Viciana4, M Márquez5, J Portilla6, MJ Ríos7, L Muñoz8, J Pasquau9, M Castaño2, L Abdel-Kader1 and JA Pineda1 Liver tolerability of TPV/r was generally good in a cohort of patients with a high proportion of HCV co-infection, including subjectswith advanced fibrosis. Monitoring of liver enzymes was not different for co-infected patients. Thus, more frequent blood testing does not seem warranted for these patients. |
| P142 | MITOCHONDRIAL EFFECTS OF 3 YEARS OF CD4-GUIDED HIV TREATMENT INTERRUPTION J Int AIDS Soc 2008, 11(Suppl 1):P142 doi:10.1186/1758-2652-11-1-P142 G Garrabou1, E Negredo2, C Morén1, J Romeu2, B Rodríguez-Santiago3, M Nicolàs1, Ò Miró1, F Cardellach1, J Puig2, N Pérez-Álvarez2, R López-Blánquez2, L Ruiz4, R Bellido4, C Miranda2 and B Clotet5 PBMCs' mitochondrial function improved during a prolonged ARVT interruption in spite of mtDNA content decrease. The absence of correlation between mitochondrial parameters suggests the existence of a mitochondrial transcriptional or translational upregulation mechanism which could be increasing mitochondrial protein expression in the absence of mtDNA content improvement, or also could be the reversion of an ARV-mediated mitochondrial toxicity mechanism that was previously disturbing mitochondrial function through a DNA polymerase gamma-independent way. |
| P143 | HIGHLY ACTIVE ANTIRETROVIRAL TREATMENT (HAART) INTERRUPTION LEADS TO AN INCREASE IN MITOCHONDRIAL DNA CONTENT IN HIV-INFECTED CHILDREN J Int AIDS Soc 2008, 11(Suppl 1):P143 doi:10.1186/1758-2652-11-1-P143 C Morén1, G Garrabou1, N Rovira2, A Noguera2, M Nicolàs1, F Cardellach1, Ò Miró1 and C Fortuny2 MtDNA content restoration was found in a group of perinatally HIV-infected pediatric patients after 12 months of HAART interruption. Our results suggest that mitochondrial damage is rather due to the use of nucleoside analogues than to HIV infection itself. In this setting, it is important to investigate new therapeutic treatment-sparing strategies in HIV-infected pediatric patients. |
| P144 | MITOCHONDRIAL IMPAIRMENT IN HIV-INFECTED CHILDREN J Int AIDS Soc 2008, 11(Suppl 1):P144 doi:10.1186/1758-2652-11-1-P144 C Morén1, G Garrabou1, E Molina2, A Noguera2, M Nicolàs1, F Cardellach1, C Fortuny2 and Ò Miró1 We found a reduction in mtDNA amount in HIVinfected children with respect to healthy controls. However, this depletion was not reflected in MRC CIV activity dysfunction. HAART does not seem to interfere with mitochondrial parameters. Future studies will be performed in order to determine whether this is caused by upregulatory mechanisms or longer time is required to detect alterations in MRC. |
| P145 | QUANTITATIVE AND QUALITATIVE MTDNA-LESIONS WITH MITOCHONDRIAL DYSFUNCTION IN MULTIPLE ORGANS AFTER HAART-ASSOCIATED FATAL LACTACIDOSIS J Int AIDS Soc 2008, 11(Suppl 1):P145 doi:10.1186/1758-2652-11-1-P145 J Thoden1, D Lebrecht1, N Venhoff1, JH Neumann2, K Müller3 and UA Walker1 We describe a 62 year-old HIV-infected male, being treated with didanosine (ddI), stavudine (d4T) and efavirenz, who died with lactacidosis. Co-morbidities were ethanol-induced liver cirrhosis (Child B) and unclear renal insufficiency (GFR 20 ml/min). |
| P146 | MITOCHONDRIAL TOXICITY OF ANTIRETROVIRALS IN NON-HIV-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P146 doi:10.1186/1758-2652-11-1-P146 G Garrabou1, E Pedrol2, E Deig2, C Morén1, M Nicolàs1, P García2, I Vidal2, F Cardellach1 and Ò Miró1 In non-HIV-infected patients, one month of ARV treatment induced mitochondrial damage, even when considering the HAART consisting of FTC+TDF+SQV/r with theoretical low mitochondrial toxic profile. Mitochondrial changes consisted of slight mtDNA depletion and moderated mtDNA-encoded-MRC complex IV dysfunction, although none of these changes were statistically significant. These findings validate HAART-induced mitochondrial toxicity, even in the absence of HIV infection. Further studies should be performed to assess mitochondrial toxicity of different HAART schedules in non-infected individuals to elucidate toxic effects of antiretrovirals without HIV or previous ARV interference. |
| P147 | URIDINE SUPPLEMENTATION WITH MITOCNOL ATTENUATES MITOCHONDRIAL CARDIOMYOPATHY INDUCED BY ZIDOVUDINE AND ZALCITABINE J Int AIDS Soc 2008, 11(Suppl 1):P147 doi:10.1186/1758-2652-11-1-P147 K Balcarek1, D Lebrecht1, C Deveaud2, B Beauvoit2, J Bonnet2, J Kirschner3, N Venhoff1 and UA Walker1 Both zidovudine and zalcitabine induced a mitochondrial cardiomyopathy, which is antagonized by uridine supplementation. The results provide proof of the importance of pyrimidine pools in the pathogenesis of zidovudine cardiomyopathy. As uridine supplementation is tolerated well by humans, this strategy should be investigated in clinical trials. |
| P148 | URIDINE SUPPLEMENTATION WITH MITOCNOL ANTAGONIZES ANTIRETROVIRAL NUCLEOSIDE ANALOGUE-INDUCED MITOCHONDRIAL PERIPHERAL AND CEREBRAL NEUROPATHY IN VIVO J Int AIDS Soc 2008, 11(Suppl 1):P148 doi:10.1186/1758-2652-11-1-P148 D Lebrecht1, C Deveaud2, B Beauvoit2, J Bonnet2, J Kirschner3, K Mueller4, N Venhoff1 and UA Walker1 Zidovudine and zalcitabine induce a mitochondrial peripheral and cerebral neuropathology, both of which are antagonized by Mitocnol. |
| P149 | SENSORY NEUROPATHY NOT ASSOCIATED WITH INTERRUPTION OF ARV THERAPY IN TAKING STAVUDINE-LAMIVUDINE-NEVIRAPINE COMBINATION HAART IN ABUJA, NIGERIA J Int AIDS Soc 2008, 11(Suppl 1):P149 doi:10.1186/1758-2652-11-1-P149 O Salami, N Ghaji and C Awunor Sensory neuropathy is a common and frequently unrecognised complication of antiretroviral therapy which clinicians must constantly be on the look out for. However, it was not associated with interruption of ARV therapy in our patients. Symptomatic treatment and use of ARVs with less neurotoxicity can help improve the quality of life of patients who experience it. |
| P150 | FREQUENCY OF BONE ABNORMALITIES AND ASSOCIATED FACTORS IN A SPANISH COHORT OF HIV-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P150 doi:10.1186/1758-2652-11-S1-P150 A Bonjoch1, C Estany1, J Puig1, P Echeverría1, C Caum2, B Clotet1 and E Negredo1 Sensory neuropathy is a common and frequently unrecognised complication of antiretroviral therapy which clinicians must constantly be on the look out for. However, it was not associated with interruption of ARV therapy in our patients. Symptomatic treatment and use of ARVs with less neurotoxicity can help improve the quality of life of patients who experience it. |
| P151 | A CROSS-SECTIONAL COMPARISON OF SERUM BONE MARKERS IN PATIENTS ON STABLE ABACAVIR (ABC) OR TENOFOVIR (TDF) CONTAINING THERAPY J Int AIDS Soc 2008, 11(Suppl 1):P151 doi:10.1186/1758-2652-11-1-P151 LJ Waters, P Randell, AGA Jackson, J Taylor, S Mandalia, BG Gazzard and GJ Moyle Abnormalities in markers of bone turnover were infrequent but more common on TDF than ABC. There was no association between altered bone markers and duration of TDF use but the clinical impact of these changes should be assessed longitudinally. |
| P152 | WITH HAART: A CASE CONTROL STUDY OF PREDICTORS J Int AIDS Soc 2008, 11(Suppl 1):P152 doi:10.1186/1758-2652-11-1-P152 E Mazzotta, A Agostinone, F Sozio, A Pieri, E Polilli, R Zicolella, F Di Masi, L Alterio, G Parruti and L Di Matteo Our investigation confirms that ON is not rare during long-term treatment of HIV infection. Better knowledge of the condition, furthermore, may help prompt diagnosis of incident cases in the future. Patients at higher risk have concomitant advanced HIV infection at diagnosis, presence of multiple co-morbidities and treatment with other drugs in addition to HAART, long-term exposure to steroids and high levels of serum IgE immunoglobulins. Cigarette smoking was very frequent both among cases and controls and its contributory role to disruption of bone microvasculature cannot therefore be excluded by our experimental design. |
| P153 | HIV-POSITIVE PATIENTS NAÏVE AND ON TREATMENT J Int AIDS Soc 2008, 11(Suppl 1):P153 doi:10.1186/1758-2652-11-1-P153 M Casana, T Bini, P Cicconi, G Cuko, A Magenta, L Tagliabue, L Comi, L Pietrogrande and A d'Arminio Monforte Patients with abnormal bone mineral density score at DEXA are at higher risk of vertebral deformity, as detected by SDI. These results should be taken into account in the clinical management of HIV-infected patients. |
| P154 | INCIDENCE OF INFECTIONS IN TREATMENT-EXPERIENCED (TE) PATIENTS IN THE MOTIVATE STUDIES OF MARAVIROC (MVC) PLUS OPTIMIZED BACKGROUND THERAPY (OBT) J Int AIDS Soc 2008, 11(Suppl 1):P154 doi:10.1186/1758-2652-11-1-P154 A Ayoub1, J Goodrich2, R Tressler3, E Van Der Ryst1, N Rajicic3, K Tomaszewski1 and HB Mayer4 To date, clinical data do not indicate that MVC is associated with clinically relevant increased rates of infections. Data from Phase III TE studies do not indicate a difference in the spectrum or severity of infections reported among patients receiving MVC and those receiving PBO, except a slightly increased rate of URTI and lower rate of pneumonia on MVC vs. PBO. Longer duration of MVC therapy (48 vs. 24 weeks) did not show any effect on the incidence of infections and no significant difference in the time of onset of these events was seen. |
| P155 | CNA110329: A PROSPECTIVE EPIDEMIOLOGICAL STUDY TO DETERMINE THE PREVALENCE OF HLA-B*5701 IN HIV-1 INFECTED INDIVIDUALS IN FIVE EUROPEAN COUNTRIES J Int AIDS Soc 2008, 11(Suppl 1):P155 doi:10.1186/1758-2652-11-1-P155 JM Prins1, A Rauch2, C Bergin3, M Ristola4, T Branco5 and HC Pearce6 This study adds to the available data on HLAB* 5701 prevalence in European populations, and shows further variation in the prevalence of HLA-B*5701 in different countries. It is important to understand the prevalence of the allele in specific populations to inform cost-effectiveness models with regard to genetic screening for ABC HSR. |
| P156 | GENDER DIFFERENCES IN DEPRESSION EVOLUTION IN A COHORT OF PATIENTS ATTENDING A METABOLIC CLINIC FOR LIPODYSTROPHY MANAGEMENT J Int AIDS Soc 2008, 11(Suppl 1):P156 doi:10.1186/1758-2652-11-1-P156 G Orlando, N Squillace, I Mazeu, B Beghetto, G Nardini and G Guaraldi As demonstrated in the general population, women with HIV infection seem to be more vulnerable than men to experience more severe depression symptoms that still remain even after face lipoatrophy treatment. This issue underlines the need for new studies analyzing the gender peculiarity of depression among patients with HIV infection. |
| P157 | SAFETY ANALYSIS OF DARUNAVIR/R (DRV/R): COMBINED DATA FROM RANDOMISED PHASE II AND PHASE III STUDIES J Int AIDS Soc 2008, 11(Suppl 1):P157 doi:10.1186/1758-2652-11-1-P157 G Fätkenheuer1, B Clotet2, G Pialoux3, K Ruxrungtham4, C Cohen5, J Flamm6, T Vangeneugden7, E Lefebvre8 and S Spinosa-Guzman7 In conclusion, DRV/r was consistently well tolerated and caused significantly less grade 2–4 diarrhoea than LPV/r. In ARTEMIS, the incidence of grade 2–4 diarrhoea and nausea with DRV/r 800/100 mg QD was half that reported with DRV/r 600/100 mg BID in TITAN; this could be related to population, background regimen and/or dosing differences. |
| P158 | STUDY OF HIV-POSITIVE PATIENTS WITH ASYMPTOMATIC RETROPERITONEAL LYMPHADENOPATHY ON ANTIRETROVIRAL THERAPY FOR THE DEVELOPMENT OF IRIS J Int AIDS Soc 2008, 11(Suppl 1):P158 doi:10.1186/1758-2652-11-1-P158 AK Tripathi, N Gupta and M Khanna We conclude that IRIS is common in Indian HIVpositive patients on ART, particularly those who have low CD4 count. The problem of IRIS may be more significant in Indian patients as they often present late in the course of the disease for ARTand the incidence of opportunistic infections is high. There is a need for larger study with longer follow-up on IRIS in Indian HIV patients. |
| P159 | QUALITY OF LIFE OF HIV-INFECTED INDIVIDUALS IN A COMMUNITY-BASED ANTIRETROVIRAL PROGRAMME J Int AIDS Soc 2008, 11(Suppl 1):P159 doi:10.1186/1758-2652-11-1-P159 J Pitt1, L Myer2 and R Wood1 This study confirmed the HRQoL benefits of HAART in a community ARV clinic in South Africa. While the majority of patients experienced a significant improvement in HRQoL on HAART, up to a third of patients reported declines in HRQoL. HAART-related drug toxicities (including those secondary to the use of stavudine) did not have a significant negative impact on HRQoL during the first 48 weeks of HAART supporting the ongoing use of stavudine in the national ARV roll-out programme. |
| P160 | HEALTH-RELATED QUALITY OF LIFE IN HIV-INFECTED PATIENTS IN A PRIVATE PRACTICE IN GERMANY J Int AIDS Soc 2008, 11(Suppl 1):P160 doi:10.1186/1758-2652-11-S1-P160 S Mauss, J Henke, F Berger, P Hegener and G Schmutz HIV+ patients rate their QoL worse than healthy controls but better than HIV+ individuals from mid-1990s. Compared to HIV-negative individuals, QoL is impaired in the cognitive-emotional domain independent of health status. This suggests that being HIV-infected represents an emotional stress despite improved physical well-being. Effects of different drug classes should be interpreted carefully due to a potential selection bias. |
| P161 | CLINICAL CONCENTRATIONS OF EFAVIRENZ (EFV) REDUCE CELLULAR PROLIFERATION AND VIABILITY IN SEVERAL HUMAN CELL LINES J Int AIDS Soc 2008, 11(Suppl 1):P161 doi:10.1186/1758-2652-11-1-P161 N Apostolova1, A Blas-García2, D Ballesteros3, Y González2, A Morán2, LJ Gómez-Sucerquia3 and JV Esplugues1 In conclusion, clinical concentrations of EFV can be cytotoxic and lead to activation of apoptotic programmes in common cellular models. This suggests that the therapeutic range of EFV is rather narrow and also that prolonged administration of this drug may result in HAART-related mitochondrial dysfunction. |
| P162 | HIV PATIENTS' GASTROINTESTINAL TOLERABILITY AND TREATMENT SATISFACTION AFTER SWITCHING FROM LOPINAVIR/RITONAVIR (LPV/R) SGC TO CO-FORMULATED LPV/R TABLETS J Int AIDS Soc 2008, 11(Suppl 1):P162 doi:10.1186/1758-2652-11-1-P162 J Borras-Blasco1, JD Rosique-Robles1, A Belda2, FJ Abad1 and MDE Castera1 New co-formulated LPV/r formulation (tablets) has been well appreciated and tolerated by our patients, with a considerable decrease in GI effects, especially in the drug-related diarrhea severity. |
| P163 | NEUROTOXIC EFFECT OF ANTIRETROVIRAL AGENTS ON CNS J Int AIDS Soc 2008, 11(Suppl 1):P163 doi:10.1186/1758-2652-11-1-P163 IW Husstedt1, D Reichelt2, U Oelker-Grueneberg2 and S Evers1 In concordance with earlier publications, these results show using clinical and neurophysiological methods that ddI, ddC and d4T cause additionally, besides HIV infection itself, cognitive impairment in HIV-infected patients. It is assumed that these alterations are induced by the toxic impact of ddI, ddC, and d4T on b-polymerase in mitochondriae of the CNS. As shown in newborns, this effect may last up to 2 years after finishing HAART. Neurotoxic effects of ddI, ddC, and d4T represent an additional factor in the development of newer forms of HIV-associated neurocognitive disorders. |
| P164 | EVALUATION OF ADHERENCE AND TOXICITIES TO HAART IN A COHORT OF HIV+ IMMIGRANT PATIENTS IN SOUTHEASTERN SPAIN DURING THE PERIOD 1998–2007 J Int AIDS Soc 2008, 11(Suppl 1):P164 doi:10.1186/1758-2652-11-1-P164 FJ Vera-Méndez1, J Trujillo-Santos1, A Cano-Sánchez2, JA García-Henarejos1, J García-García1, OJ Martínez-Madrid1, R Vilaplana-García1, C Pérez-Pagán1, N Cobos-Trigueros1, M Alcalde-Encinas1 and V Herrero-Segastume1 In our cohort, most HIV+ immigrant patients were under HAART therapy. The antiretroviral drugs most frequently used in combination in immigrants were the NRTI and NNRTI. Adherence was good in most of the immigrant patients, without differences in relation to the native population. Toxicity was the second most common cause that prompted the change in therapy after HAART therapy simplification. The PI were the antiretroviral agents that occurred more frequently in terms of toxicity of class or family. |
| P165 | RISK FACTORS AND CLINICAL AND THERAPEUTIC ISSUES OF PANCREATIC ABNORMALITIES DURING HIV INFECTION J Int AIDS Soc 2008, 11(Suppl 1):P165 doi:10.1186/1758-2652-11-1-P165 R Manfredi and L Calza Epidemiological-pathogenetic studies are needed to assess the trend of pancreatic abnormalities in the cART era, and their relationship with continued antiretroviral-antimicrobial chemotherapy. This research field appears somewhat neglected, so that observational studies and controlled trials are lacking. The indications to gabexate-octreotide during HIV disease deserve investigation. |
| P166 | RELATIONSHIP BETWEEN DIFFERENT TYPES OF NONADHERENCE BEHAVIOUR AND VIROLOGICAL RESPONSE IN UNSELECTED HIV-POSITIVE COHORT J Int AIDS Soc 2008, 11(Suppl 1):P166 doi:10.1186/1758-2652-11-1-P166 A Ammassari, MP Trotta, P Marconi, M Zaccarelli, P Sette, ML Giancola, P Pierro, S Mosti, RA Acinapura and A Antinori Although there is the availability of more convenient cART, non-adherence remains a major challenge. Types of deviation from cART prescription are heterogeneous and strongly impact virological response. To optimize treatment adherence and virological response, a comprehensive investigation of all non-adherence behaviours is needed in clinical practice. |
| P167 | EFFECT OF A FIXED-DOSE COMBINATION OF EMTRICITABINE, TENOFOVIR AND EFAVIRENZ ON ADHERENCE AND TREATMENT ACCEPTABILITY (ADONE STUDY) J Int AIDS Soc 2008, 11(Suppl 1):P167 doi:10.1186/1758-2652-11-1-P167 F Maggiolo1, M Airoldi1, MP Trotta2, P Sette2, L Bisi3, C Mussini3, F Bai4, T Bini4, G Orofino5 and A Gori6 The ADONE study is the first clinical experience exploring the effect on adherence of a simplification strategy based on the reduction of pills without a substantial change of the drugs included into the therapeutic regimen. Its primary endpoints are adherence, acceptability of HAART and quality of life of patients. By simply using a FDC, one pill once-a-day, we obtained an improvement of self-reported adherence. Furthermore, the patients' judgement about simplicity, convenience, tolerability and efficacy of the FDC was significantly more positive if compared with the use of the same drugs as single pills. The simplicity of the therapeutic regimen is an added value of HAART that increments adherence and may improve long-term success. |
| P168 | ONCE-DAILY REGIMENS WERE ASSOCIATED WITH A HIGHER RATE OF SELF-CHOSEN DISCONTINUATIONS J Int AIDS Soc 2008, 11(Suppl 1):P168 doi:10.1186/1758-2652-11-1-P168 R Murri, A Cingolani, A De Luca, S Di Giambenedetto, G Marasca, A Muscatello, V Mazzocato, L Bracciale and E Tamburrini Being female, IDU, taking a QD regimen and symptom score were correlated to self-chosen discontinuations of HAART. It is possible that people taking a QD regimen perceive therapy as a very easy task and are more prone to forgetful events. |
| P169 | FACTORS CORRELATED TO NON-ADHERENCE TO ANTIRETROVIRAL THERAPY AMONG IMMIGRANTS FROM POOR RESOURCE COUNTRIES, ATTENDING A REFERENCE CENTER IN ROME J Int AIDS Soc 2008, 11(Suppl 1):P169 doi:10.1186/1758-2652-11-1-P169 P Pierro, P Lorenzini, MP Trotta, P Sette, ML Giancola, N Orchi, M Giulianelli, P De Longis, U Visco-Comandini, A Antinori and M Zaccarelli In this specific setting of immigrant population, worst sexual behavior and less knowledge are associated with non-adherence. Conversely, non-adherence failed to be associated with substance abuse. Thus our program is ongoing and enhancing. We plan to evaluate changes in behavior and adherence after repeated counseling, to target intervention to specific subgroups, also using cultural opinion-leaders, following information collected. |
| P170 | ADHERENCE WITH LOPINAVIR/RITONAVIR (LPV/R) TABLET AND SOFTGEL (SGC) CAPSULE BASED ANTIRETROVIRAL REGIMENS AND PREDICTORS OF EARLY TREATMENT COMPLIANCE J Int AIDS Soc 2008, 11(Suppl 1):P170 doi:10.1186/1758-2652-11-S1-P170 TJ Podsadecki, RA Rode, C Naylor, DE Cohen and TM Marsh In this large study of LPV/r, QD dosing resulted in higher levels of adherence than BID dosing. Adherence to LPV/r tablets and SGC were similar. Sex, age and race were predictors of early adherence. Differences in early adherence did not predict clinical outcomes in this study. |
| P171 | DISPOSITIONAL OPTIMISM, PERCEIVED HEALTH COMPETENCE AND ADHERENCE IN HIGHLY ANTIRETROVIRAL-EXPERIENCED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P171 doi:10.1186/1758-2652-11-1-P171 CR Fumaz1, JA Muñoz-Moreno2, MJ Ferrer1, N PérezÁlvarez3, J Moltó1 and B Clotet4 After more than 10 years on treatment, a high percentage of patients had adequate levels of adherence to antiretroviral therapy. Dispositional optimism was relatively high but perceived health competence remained moderate. In a highly antiretroviral-experienced population, the differences observed between adherent and non-adherent patients cannot be explained by dispositional optimism or perceived health competence. |
| P172 | CHALLENGES TO ADHERENCE AMONG HIV-POSITIVE PATIENTS ON ANTIRETROVIRAL THERAPY IN LAGOS, NIGERIA J Int AIDS Soc 2008, 11(Suppl 1):P172 doi:10.1186/1758-2652-11-1-P172 AO Adeyemi1, OO Olaogun1 and OA Adesola2 Adherence support, motivation and skills are needed to sustain our treatment program against virologic and immunologic failures. Proactive ways of supporting adherence programs are needed. Additionally, reminder tools may be needed. It is important to re-enforce partner/family notification and reduce stigma towards better adherence. Emphasis should be on the use of combined HIV drug formulation to reduce daily number of pills taken. |
| P173 | LOSS TO FOLLOW-UP IN HIV IMMIGRANT PATIENTS. IS IT A RELEVANT PROBLEM? RESULTS OF THE SPANISH COMESEM COHORT J Int AIDS Soc 2008, 11(Suppl 1):P173 doi:10.1186/1758-2652-11-1-P173 M Cervero1, R Torres1, JL Agud Aparicio1, C Barros2, G Gaspar3, E Casas4, R Hervás5 and A Barrios6 To assess epidemiological characteristics and loss to follow-up in immigrant patients, and compare them with Spanish-born patients, in two periods: 1983–1999 and 2000–2008. |
| P174 | DEPRESSION IN HIV PATIENTS IS ASSOCIATED WITH LOW ADHERENCE: A CROSS-SECTIONAL STUDY AMONG HIV PATIENTS IN DENMARK J Int AIDS Soc 2008, 11(Suppl 1):P174 doi:10.1186/1758-2652-11-1-P174 LO Rodkjaer1, T Laursen1, N Balle2 and M Sodemann3 Depression is a common co-morbidity to HIV. International studies suggest that between 20–37% of HIV-positives may have a diagnosable depression. The current estimates may be underestimated as there is evidence that depression may be underdiagnosed. There are no studies on the number of Danish HIV-positives who have or have had a diagnosable depression. Our aim was to investigate the prevalence of depression among HIV-patients in an outpatient clinic in Denmark. |
| P175 | ADHERENCE TO ANTIRETROVIRAL THERAPY AMONG CHILDREN RECEIVING THERAPY IN A RESOURCE-POOR SETTING J Int AIDS Soc 2008, 11(Suppl 1):P175 doi:10.1186/1758-2652-11-1-P175 JE Bisimba, JP Naubutu and E Swai The levels of adherence in children receiving ART are comparable to levels in resource-rich settings. It is possible for patients to achieve near perfect levels of adherence with formulations of fixed dose combinations for pediatrics, thorough counseling, use of reminders, tailoring the regime to the child's life style, and addressing key issues related to side-effects. |
| P176 | ADHERENCE, COPING STRATEGIES AND DEPRESSION IN HIGHLY ANTIRETROVIRAL-EXPERIENCED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P176 doi:10.1186/1758-2652-11-1-P176 CR Fumaz1, JA Muñoz-Moreno2, MJ Ferrer1, N PérezÁlvarez3, J Moltó1 and B Clotet4 A high percentage of patients had adequate adherence after more than 10 years on treatment. The majority of coping strategies used to face the illness were active, except for denial/self-blame, which was associated with depression. In this study, adequate adherence was not related either to the use of active coping strategies or to the absence of depressive symptoms. |
| P177 | ADHERENCE TO ANTIRETROVIRAL THERAPIES IN PEOPLE WITH HIV INFECTION: A QUALITATIVE APPROACH FROM A NARRATIVE-BASED MEDICINE STUDY J Int AIDS Soc 2008, 11(Suppl 1):P177 doi:10.1186/1758-2652-11-1-P177 A Tomasini1, R Murri2, G Guaraldi3, N Squillace3, G Orlando3, S Zona3, I Mazeu3, MS Aloisi1 and M Bossola2 Information obtained through a narrative-based medicine approach is a useful instrument to identify strategies for the improvement of adherence to drugs, and ultimately for the efficacy of treatment in people with HIV. The content of interview also offered complementary information that can positively support an empathic patient-physician communication. |
| P178 | RE-EVALUATION OF RESISTANCE ALGORITHMS FOR LOPINAVIR/RITONAVIR IN THE TITAN TRIAL J Int AIDS Soc 2008, 11(Suppl 1):P178 doi:10.1186/1758-2652-11-1-P178 V Calvez1, AM Hill2 and AG Marcelin1 The analysis identified more sensitive cut-off levels for several lopinavir genotypic algorithms, below those currently used, at which there is significant efficacy advantage for treatment with darunavir/ritonavir versus lopinavir/ritonavir in the TITAN trial. These new cut-off levels also detect a higher percentage of patients with virological failure than previous cutoff levels. |
| P179 | USING THE LATEST RESISTANCE SCORE TO PREDICT ETRAVIRINE (ETV) RESISTANCE IN NAÏVE AND NNRTI-FAILING PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P179 doi:10.1186/1758-2652-11-1-P179 M Zaccarelli1, P Lorenzini1, CSF Ceccherini-Silberstein2, V Tozzi1, F Forbici3, MP Trotta1, R D'Arrigo4, P Marconi1, P Narciso1, CF Perno3 and A Antinori1 The presence of mutations predictive of full or intermediate ETV resistance is uncommon among naïve patients, thus, in almost all cases, ETV use may be allowed. The detection of ETV-resistance is also infrequent in patients failing a NNRTI regimen because usually they develop the K103N mutation, that alone or in combination does not affect ETV sensitivity. Our data also suggest that a quick withdrawal of a failing NNRTI regimen, possibly in the first 3 months of failure, can maintain ETV sensitivity, thus preserving a treatment option. |
| P180 | IMPACT OF HIV VIRAL DIVERSITY AND BASELINE RESISTANCE ON TREATMENT OUTCOMES AND THE EMERGENCE OF RESISTANCE: THE CASTLE STUDY 48-WEEK RESULTS J Int AIDS Soc 2008, 11(Suppl 1):P180 doi:10.1186/1758-2652-11-S1-P180 M Lataillade, R Yang, MD Mancini and D McGrath Both regimens (ATV/r and LPV/r) achieved consistently high response rates regardless of HIV subtype or BL substitutions. Both regimens had infrequent emergence of non-polymorphic PI substitutions with virologic failure, and similar rates of selection of antiretroviral resistance mutations. |
| P181 | ETRAVIRINE PROTECTS THE ACTIVITY OF DARUNAVIR IN THE DUET TRIALS J Int AIDS Soc 2008, 11(Suppl 1):P181 doi:10.1186/1758-2652-11-1-P181 M Peeters1, J Vingerhoets1, L Tambuyzer1, H Azijn1, AM Hill2, S De Meyer1 and G Picchio3 In the DUET studies, ETR-treated patients experienced less virologic rebound and loss of DRV susceptibility than those in the placebo arm. Among those with virologic failure, ETR-treated patients showed less emergence of resistance to DRV. |
| P182 | HIV LAMIVUDINE RESISTANCE MUTATIONS IN HBV COINFECTED ROMANIAN PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P182 doi:10.1186/1758-2652-11-1-P182 L Manolescu1, P Marinescu2, C Sultana1, A Temereanca1, C Vagu1, C Grancea1 and S Ruta1 We suggest that association of HIV F subtype and genotype A of HBV may generate a less severe evolution of HBV infection irrespective of the LAM treatment with less frequent mutations in pol HIV gene. The absence of type 1 TAMs opens the possibility to treat these patients with tenofovir-containing regimens with a good virological response. Further studies are needed to clarify the kinetics and significance of different mutation patterns observed in naïve vs. LAM treated HIV/HBV co-infected patients. |
| P183 | ARE NON-B SUBTYPES LESS SUSCEPTIBLE TO ANTIRETROVIRAL DRUGS? A BIOINFORMATICAL APPROACH TO PREDICTION OF NON-B SUBTYPE SUSCEPTIBILITY J Int AIDS Soc 2008, 11(Suppl 1):P183 doi:10.1186/1758-2652-11-1-P183 J Kjær1, L Høj1, A Cozzi-Lepri2, Z Fox3 and JD Lundgren4 redictions showed significant difference between the predicted mean IC50 FC values for the both A and G HIV-1 subtypes compared to IC50 FC for subtype B. This is in large driven by reduced susceptibility to amprenavir, atazanavir, nelfinavir, and zidovudine and does also affect susceptibility for C and CRF_AG subtypes. With the majority of the drugs we did not find any reduced susceptibility for the subtypes. |
| P184 | CONTINUOUS DECLINE IN PREVALENCE OF DRUG RESISTANCE MUTATIONS AMONG NAÏVE AND CART EXPERIENCED HIV-POSITIVE PATIENTS IN POLAND OVER TIME J Int AIDS Soc 2008, 11(Suppl 1):P184 doi:10.1186/1758-2652-11-1-P184 GP Stanczak1, KJ Przybylska-Stengiel1, E Firlag-Burkacka1, A Wiercinska-Drapalo2, A Horban1 and JJ Stanczak1 The prevalence of DR mutations in both analyzed groups decreased when compared to previous studies from 2006 and 2002–2005. It may be the effect of more effective antiretroviral drugs, incorporation of GT results into clinical practice, and/or growing awareness of the role of adherence. Transmission of DR mutations in Poland is limited to single classes which is concordant with the results of a study conducted by the SPREAD programme in Europe [2]. The publication of standardized lists of HIV-1 protease and reverse transcriptase mutations for DR surveillance [1] facilitates the comparison of results obtained in different countries. |
| P185 | IMPACT OF THE HIV-1 PROTEASE N88S SUBSTITUTION ON PROTEASE INHIBITOR SUSCEPTIBILITY AND CLINICAL RESPONSE J Int AIDS Soc 2008, 11(Suppl 1):P185 doi:10.1186/1758-2652-11-1-P185 J Uy1, M Lataillade2, A Thiry2, D McGrath2, D Seekins1 and G Hanna1 Emergence of the N88S substitution in HIV-1 protease is rare in antiretroviral-naive patients treated with an atazanavir-containing regimen. Virus with N88S often remained susceptible to ATV/RTV and was consistently susceptible to other commonly-used protease inhibitors. |
| P186 | CORRELATION BETWEEN PATTERNS OF HIV-1 DRUG RESISTANCE AND DRUG ADMINISTRATION IN ANTIRETROVIRAL EXPERIENCED PATIENTS IN GREECE DURING 1999–2006 J Int AIDS Soc 2008, 11(Suppl 1):P186 doi:10.1186/1758-2652-11-1-P186 D Paraskevis1, G Magiorkinis2, E Magiorkinis2, V Sypsa2, PG Gargalianos3, MC Lazanas4, V Paparizos5, A Karafoulidou6, T Kordossis6, A Antoniadou7, H Sambatakou8, GL Daikos6 and A Hatzakis2 Patterns of resistance over time are correlated in a different way with the administration of particular drugs. Importantly, ABC, TDF and boosted PIs (bLPV, bATV and bTPV) are associated with decreasing resistance to N(t)RTIs and PIs during 1999–2006. |
| P187 | REDUCED SUSCEPTIBILITY TO LAMIVUDINE AND EMTRICITABINE ASSOCIATED WITH THE NOVEL K66N MUTATION IN HIV-1 REVERSE TRANSCRIPTASE J Int AIDS Soc 2008, 11(Suppl 1):P187 doi:10.1186/1758-2652-11-1-P187 Y Verlinden1, G Muyldermans1, M Van Houtte1, K Van Der Borght1, L Rimsky2 and T Pattery1 The mutation K66N in HIV-1 RT is associated with reduced phenotypic susceptibility to 3TC and FTC. Further research is required to investigate the clinical impact of this finding, how the mutation evolves and whether it is selected during a specific therapy. |
| P188 | INCIDENCE OF THE RESISTANCE MUTATION K65R ON REVERSE TRANSCRIPTASE IN DIFFERENT HIV-1 SUBTYPES J Int AIDS Soc 2008, 11(Suppl 1):P188 doi:10.1186/1758-2652-11-1-P188 D Turner1, S Pollack2, E Kachman1, E Kedem2, E Shahar2, M Burk1, N Matos1, G Hassoun2, G Grisaru1 and B Avidor1 Non subtype B selects for the K65R mutation with a higher incidence than for subtype B viruses. Effective strategies must be developed to handle non-B infections, with particular emphasis on subtype C, especially in countries where non B subtypes are highly represented. |
| P189 | ACTIVITY OF ETRAVIRINE ON DIFFERENT HIV-1 SUBTYPES: WEEK 48 DATA OF THE POOLED DUET TRIALS AND IN VITRO SUSCEPTIBILITY IN TREATMENT-NAÏVE PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P189 doi:10.1186/1758-2652-11-1-P189 J Vingerhoets1, H Azijn1, L Tambuyzer1, I Dierynck1, S De Meyer1, L Rimsky1, M Peeters1, G De Smedt1, MP de Béthune1 and G Picchio2 In the DUET studies, ETR was equally effective in suppressing viral replication in patients infected with HIV-1 subtype B or non-B. Furthermore, both subtype B and non-B HIV-1 recombinant clinical isolates from treatment-naïve patients exhibited comparable levels of in vitro phenotypic susceptibility to ETR. These results confirmed the broad activity of ETR against HIV-1. |
| P190 | GENOTYPIC SUSCEPTIBILITY TO TIPRANAVIR OF HIV-1 ISOLATES IN TREATMENT-EXPERIENCED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P190 doi:10.1186/1758-2652-11-S1-P190 P Piliero1, L Bhatti2, E Coakley3, J Scherer1, M McDonough1 and J Baxter4 In this cohort of TEPs failing a PI-based regimen, a majority of patient isolates showed full or partial susceptibility to TPV. Even in the most PI-experienced patients, one-third to onehalf had virus that remained fully or partially susceptible to TPV. An advantage of phenotypic testing is that it reports both full and partial drug susceptibility which may help guide clinician choice of TPV. When constructing a new regimen in PI-experienced patients, resistance testing should guide the use of TPV as a potential therapeutic option. |
| P191 | MUTATIONS IN THE PROTEASE GENE ASSOCIATED WITH VIROLOGICAL FAILURE TO LOPINAVIR-CONTAINING REGIMENS IN CLINICAL SAMPLES J Int AIDS Soc 2008, 11(Suppl 1):P191 doi:10.1186/1758-2652-11-1-P191 JR Santos1, JM Llibre1, N Pérez-Álvarez2, P Domingo3, C Miralles4, J Schapiro5 and B Clotet1 In multi-treated patients, L33F, M36I, M46I, I47V, G48V, A71V, G73S, I84V, L90M, but not L10R/V, K20M, V32I, I47A, I50V, I54L/A/M/T/S, L63P, A71T, I76V, and V82F/T/S may be over-represented in LPV/r failure. Enrichment of these mutations should be expected in populations receiving widespread salvage with LPV/r. This may assist in considering future options, together with previous use of other PI and subtype prevalence. |
| P192 | GENOTYPIC SUSCEPTIBILITY TO TIPRANAVIR (TPV) AND DARUNAVIR (DRV) IN A COHORT OF TREATMENT-EXPERIENCED PATIENTS (TEP) J Int AIDS Soc 2008, 11(Suppl 1):P192 doi:10.1186/1758-2652-11-1-P192 J Baxter1, L Bhatti2, J Scherer3, M McDonough3 and P Piliero3 In this cohort of TEPs failing a PI-based regimen, 59% of HIV-1 isolates demonstrated PI resistance. Of these isolates, over 50% remained sensitive to either TPV or DRV, with 27.3% sensitive to only one of the two drugs. In PI-experienced patients, TPV and DRV remain the most likely available PIs to use in constructing a new regimen. |
| P193 | PATTERNS OF DRUG RESISTANCE MUTATIONS AFTER FAILURE OF FIRST-LINE NNRTI-BASED ANTIRETROVIRAL THERAPY IN WESTERN INDIA J Int AIDS Soc 2008, 11(Suppl 1):P193 doi:10.1186/1758-2652-11-1-P193 SN Pujari1, AN Dravid1, N Gupte2, AMakne1, S Gaikwad1, P Mukhopadhaya3, B Aich3 and V Bele1 Patterns of resistance mutations after failure of NNRTI-based first-line regimens amongst subtype C viruses is similar to that documented in other subtypes in literature. After failure of first-line therapy most patients have NNRTI and/or 3TC resistance. The frequency of TAMs is high and is associated with high viral loads and low CD4 counts at the time of GRT. |
| P194 | IS HAART BASED ON NEWEST ACTIVE ANTIRETROVIRAL DRUGS INFLUENCED BY GSS? J Int AIDS Soc 2008, 11(Suppl 1):P194 doi:10.1186/1758-2652-11-1-P194 MO Ortu, PV Vitiello, FA Adorni, RR Rossotti, PDV Di Vincenzo, OV Viganò, M Galli and SR Rusconi Starting an antiretroviral regimen with drugs from the newest active classes can offer viro-immunologic success either with GSS1, 2 or 3. Lack of statistical difference can be explained with a low number of enrolled patients and different viro-immunologic conditions at baseline (higher viral loads and lower CD4 for GSS2 and 3). High frequency for specific mutations confirms the key role of some mutations acquired following the exposure to certain drugs and their persistence through multiple changes of drug regimen. The association between GSS2 and mutation frequency (time weighted) could be linked to patients with better compliance and long persistence of key mutations, which appeared after a long drug exposure. |
| P195 | HIV TREATMENT DECISION MAKING: HIGH RATE OF REVISED TREATMENT CHOICES BASED UPON DIFFERENT GENOTYPIC INTERPRETATION SYSTEMS J Int AIDS Soc 2008, 11(Suppl 1):P195 doi:10.1186/1758-2652-11-1-P195 E Wolf1, E Gersbacher1, M Vogel2, A Eberhard3, J Goelz4, Y Yazdanpanah5, J Rockstroh2, G Fätkenheuer6, S Mauss7, C Mayr8, H Knechten9, I Van Walle10, E Jaegel-Guedes3 and H Jaeger3 The use of calculated phenotypic information (VT) derived from genotypic mutation patterns led to revised treatment decisions in more than 50% of HIV pts. New treatment choices mostly consisted in different use ofNRTI and PI. There was a trend to higher activity scores in the revised treatment choices. |
| P196 | HIV-1 POL GENE DIVERSITY AND ANTIRETROVIRAL DRUG RESISTANCE MUTATIONS IN ITANHAÉM CITY, BRAZIL J Int AIDS Soc 2008, 11(Suppl 1):P196 doi:10.1186/1758-2652-11-1-P196 RB Rodrigues-Matias, KCP Guatelli, RF Ambar, NB Duarte, LH Gagliani, S Komninakis, V Candido, MM Caseiro and DJ Sa-Filho Itanhaém city has shown a pivotal role in the epidemiology of HIV-1 due to its geographic location near the city of Sao Paulo, the epicenter of Brazilian AIDS epidemic, and between the southern region where there is a high level of Brazilian subtype C and Santos city where were identified two HIV-1 circulating recombinants forms classified as CRF28_BF and CRF29_BF. In this work, we describe the viral genetic diversity and drug resistance mutations in different subtypes of random samples. |
| P197 | VALIDATION OF AN ENHANCED SENSITIVITY TROFILE™ HIV-1 CO-RECEPTOR TROPISM ASSAY FOR SELECTING PATIENTS FOR THERAPY WITH ENTRY INHIBITORS TARGETING CCR5 J Int AIDS Soc 2008, 11(Suppl 1):P197 doi:10.1186/1758-2652-11-1-P197 L Trinh, D Han, W Huang, T Wrin, J Larson, L Kiss, E Coakley, CJ Petropoulos, N Parkin, JM Whitcomb and JD Reeves In conclusion, these validation experiments demonstrate that the enhanced Trofile assay has improved sensitivity to detect CXCR4-use in env clone mixtures and patient env populations compared to the original Trofile assay, while assay accuracy, precision and reproducibility are maintained. This increases the utility of the Trofile assay for selecting patients for CCR5 antagonist therapy. |
| P198 | PREVALENCE OF CCR5-TROPIC HIV-1 AMONG TREATMENT-EXPERIENCED INDIVIDUALS IN SOUTH AFRICA INFECTED WITH CLADE C VIRUS J Int AIDS Soc 2008, 11(Suppl 1):P198 doi:10.1186/1758-2652-11-1-P198 S Eng1, I Sanne2, S Badal-Faesen2, R Wood3, N Rajicic1 and R Tressler1 R5-tropic HIV-1 was the predominant variant detected in this TE South African population infected with Clade C HIV-1. In a multivariate model, older age, higher CD4 cell count, and higher VL were all associated with the presence of R5 co-receptor usage. |
| P199 | THERAPEUTIC DRUG MONITORING OF NEW FORMULATION KALETRA IN PREGNANCY J Int AIDS Soc 2008, 11(Suppl 1):P199 doi:10.1186/1758-2652-11-1-P199 V Jackson1, LJ Else2, SH Khoo2, SE Gibbons2, M Brennan1, EO Connor3, N Boyle4, C Fleming4, S Coulter-Smith1 and J Lambert5 Standard dosage of LPV/r during pregnancy resulted in adequate therapeutic drug levels in the majority women examined. In addition, the similarities in the percentage of unbound LPV in the third trimester versus post-partum suggest that the standard dose of LPV/r is appropriate during pregnancy. Further research into this is required. |
| P200 | ELITE CONTROLLERS OR MISQUANTIFICATION OF VIRUS LOAD BY COBAS TAQMAN? J Int AIDS Soc 2008, 11(Suppl 1):P200 doi:10.1186/1758-2652-11-S1-P200 N Taylor1, M Jauer2, K Bijuklic1, A Egle1, R Greil1, W Patsch3, M Obermeier2 and J Eberle2 In the face of the severe consequences for therapeutic decisions and patient counseling, the observed rate of misquantifications in our patient cohort by Cobas TaqMan HIV-1 is unacceptable. Misquantifications can not be assigned to a rare subtype but occur with different virus strains. There is an urgent need for refinement of the Cobas TaqMan. In addition, these findings shed a different light concerning the definition of so-called elite controllers in clinical practice. |
| P201 | DETERMINATION OF HIV-1 CO-RECEPTOR USAGE IN GERMAN PATIENTS – COMPARISON OF GENOTYPIC METHODS WITH THE TROFILE® PHENOTYPIC ASSAY J Int AIDS Soc 2008, 11(Suppl 1):P201 doi:10.1186/1758-2652-11-1-P201 MJ Obermeier1, T Berg1, N Sichtig2, P Braun3, MP Däumer4, H Walter5, C Noah6, E Wolf7, H Müller8, M Stürmer9, A Thielen10 and R Kaiser2 The results of the genotypic classification approaches show similar results as comparison of phenotypic approaches. Due to our experiences, a differentiated approach using the geno2pheno system provides the best results in CXCR4 usage prediction. For patients with severely limited therapeutic options we suggest the use of CCR5 blockers only if the geno2pheno system, using a FPR of 5%, does not predict CXCR4 usage. The other side of the patient spectrum with many antiretroviral therapy options requires a more stringent setting with a FPR of 20%. For this highly personalized approach, close co-operation between the clinicians and virologists is essential. Sequencing of proviral DNA is leading to similar results as sequencing viral plasma RNA, with a slightly higher rate of X4 detection, thus offering an possibility for tropism testing at a plasma viral load below detection limit. |
| P202 | INFLUENCE OF GENDER IN PREDICTING CCR5 CORECEPTOR USAGE J Int AIDS Soc 2008, 11(Suppl 1):P202 doi:10.1186/1758-2652-11-1-P202 S Nozza, A Soria, F Visco, C Vinci, F Cossarini, V Spagnuolo, B Barda, L Della Torre, A Castagna, A Lazzarin, L Galli and G Tambussi Factors associated with CCR5 coreceptor usage are not yet extensively evaluated; in some studies high CD4 and low viremia have been considered predictive [1, 2]. We evaluated factors predicting the viral tropism in failing patients with long exposure to HIV, screened for Maraviroc Expanded Access Program (A4001050) at San Raffaele Hospital. |
| P203 | EVALUATION OF ROCHE COBAS TAQMAN QUANTITATIVE HIV-1 RNA PCR AGAINST OTHER HIV-1 COMMERCIAL VIRAL LOAD TESTS TO EXAMINE POTENTIAL UNDER-QUANTIFICATION J Int AIDS Soc 2008, 11(Suppl 1):P203 doi:10.1186/1758-2652-11-1-P203 X Couto-Parada1, A Lee1, I Ushiro-Lumb1, J Anderson2, G Baily3, S Limb4, H Noble4, C Orkin3, I Reeves2, A Oliver1 and D Clark1 Our extended evaluation did not find the significant levels of under-quantification reported previously [2], although we did identify a further individual where the present CAP/CTM test is unsuitable for virological monitoring. This frequency of significant under-quantification is consistent with our findings in routine diagnostic service and clinicians should remain alert to the possibility of under-quantification with this test. |
| P204 | ESTIMATING RENAL IMPAIRMENT AND EVALUATING ANTIRETROVIRAL DOSE ADJUSTMENTS AMONG HIV-POSITIVE PATIENTS: A COMPARISON OF THREE HOSPITALS J Int AIDS Soc 2008, 11(Suppl 1):P204 doi:10.1186/1758-2652-11-1-P204 K Mackie1, RWeston2, S Sonecha3, A Murungi3 and A Duncan4 Although eGFR is now clinically regarded as the new standard for measuring renal impairment, dose adjustment recommendations for ARV drugs are based on CG estimates. With the introduction of fixed dose combinations, pharmacists should be aware that drug dose adjustment may require use of individual drugs and liquid formulations. Further work needs to be undertaken in individual units to develop a system for identifying patients who require careful renal monitoring and subsequent dosage adjustment. The result of not adjusting doses when required needs to be studied. |
| P205 | REPRODUCIBILITY OF A HIGH-THROUGHPUT HIV-1 GENOTYPIC RESISTANCE ASSAY OVER TIME (2001-2007) J Int AIDS Soc 2008, 11(Suppl 1):P205 doi:10.1186/1758-2652-11-1-P205 A Deloof, G Muyldermans, T Pattery, P Mc Kenna, A Van Cauwenberge, H De Wolf and M Van Houtte Since both BLAST values did not differ, it can be concluded that re-culturing of viruses did not lead to a significant decrease in similarity. Furthermore, despite the presence of high levels of nucleotide sequence mixtures of the original clinical isolates, the high reproducibility of the genotyping assay (more than 99% sequence identity) was demonstrated. A combination of optimal assay design, rigorous personnel training, the testing of the internal QC panel at regular intervals and participation in a CLIA-approved 6-monthly external proficiency testing program (Accutest) ensures that quality standards are consistently met for the genotyping assay performed at Virco. |
| P206 | IMMUNE AND VIROLOGIC RESPONSES TO TRUVADA OR COMBIVIR AS A FIRST-LINE THERAPY OF HIV-INFECTED, TREATMENT-NAÏVE PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P206 doi:10.1186/1758-2652-11-1-P206 R Maserati1, M Clerici2, M Lauriola1, M Pacei2, M De Gennaro3, E Chiesa4, M Coen5, R Terzi5, DH Bray6 and S Lo Caputo7 Although the four therapeutic regimens considered do not differ significantly in the ability to suppress HIV viremia, the TVD-EFV combination is associated with a significant down-modulation of immune activation. In the light of the increasing importance of immune activation in the pathogenesis of HIV infection, the ability of this combination to reduce this parameter seems potentially important. |
| P207 | RALTEGRAVIR CLINICAL EFFICACY AGAINST B SUBTYPE AND NON-B SUBTYPE HIV-1 IS SIMILAR J Int AIDS Soc 2008, 11(Suppl 1):P207 doi:10.1186/1758-2652-11-1-P207 H Teppler1, J Rockstroh2, R Isaacs1, H Wan1, C Hervey1, M Miller1 and BY Nguyen1 Raltegravir (RAL) is the first approved HIV integrase inhibitor and has demonstrated potent efficacy in both treatment-experienced and -naïve HIV-infected patients (pts). This analysis reports long-term efficacy data from one Phase II and two Phase III studies in pts infected with non-B subtype virus. |
| P208 | EFFECT OF HEMOLYSIS ON HIV-1 PROTEASE AND REVERSE TRANSCRIPTASE GENOTYPING AND PHENOTYPING SUCCESS: A 2-YEAR ANALYSIS J Int AIDS Soc 2008, 11(Suppl 1):P208 doi:10.1186/1758-2652-11-1-P208 T Pattery, I Bovee, E Rousseau, N Hartmans and P Mc Kenna The success rate for hemolyzed samples with VL >1000 cp/ml was >97% for both years and is similar to the success rate for non-hemolyzed samples with VL > 1000 cp/ml (>98% for 2006 and >97% for 2007), indicating that hemolyzed samples can be processed for resistance testing under circumstances where re-sampling is difficult. The sensitivity to phenotyping clearly demonstrates the integrity of the amplified product that can be used to generate viable recombinant virus stocks. Further investigation is required on the severity of hemolysis and detection of well-defined mixtures within hemolyzed samples. |
| P209 | ANALYSIS OF VIRAL LOAD, CD4+ AND CD8+ T-CELL FROM HIV-1 INFECTED PATIENTS ENROLLED IN THE AIDS PROGRAMS FROM THE CITY OF SANTOS, BRAZIL J Int AIDS Soc 2008, 11(Suppl 1):P209 doi:10.1186/1758-2652-11-1-P209 AC Zetehaku1, AFP Lins-Filho1, JT Rabelato1, JC Tobara1, NC Nahon1, NT Santos1, RBR Matias1, RG Comparini1, RF Ambar1, LH Gagliani1, S Komninakis1, RS Diaz2, AAC Golegã1, MM Caseiro1 and DJ Sa-Filho1 Although there have been descriptions of a continuous immunologic benefit among individuals under antiretroviral treatment in spite of virologic failure, it is clear that moderate to high levels of viremia will lead to a decrease in the average CD4 counts in a relatively short period of time in this population. Interestingly, both groups showed an equally high level of CD8+T cells in spite of the degree of viral suppression. Only 9.4% under treatment in the public system in this key location in Brazil present long-term viral suppression, which may be the characteristic of developing countries with widespread access to all FDA licensed antiretrovirals for all patients free of cost. |
| P210 | MEASUREMENT OF 3-METHYLHISTIDINE IN SPOT URINE FROM HIV-INFECTED PERSONS: AN ALTERNATIVE SCREENING METHOD FOR MUSCLE PROTEIN DEGRADATION TO SERUM CK J Int AIDS Soc 2008, 11(Suppl 1):P210 doi:10.1186/1758-2652-11-S1-P210 AC Venhoff1, E Bissé2, T Epting2, J Thoden1, UAWalker1 and N Venhoff1 In conclusion, measurement of 3-MH on spot urine samples is not useful for assessing changes in muscular protein degradation. A meat-free diet, 24-hour urine collection and refraining from physical activity might reduce confounding factors of 3-MH secretion. |
| P211 | ANALYSIS OF HIV VARIANTS IN BLOOD AND SEMEN IN SERODISCORDANTS BY HETERODUPLEX MOBILITY ASSAY J Int AIDS Soc 2008, 11(Suppl 1):P211 doi:10.1186/1758-2652-11-1-P211 SK Jadhav1, SM Velhal1, A Deshpande2 and AH Bandivdekar1 Presence of distinct viral variants in blood and semen play an important role in escape of the HIV in different components and showing the shedding pattern to escape from the effective antiretrovirals, Presence of virus in the sperm shows that the spermatozoa are also another factor responsible for sexual transmission of HIV. |
| P212 | ACTIVATION OF HIV-SPECIFIC CD8+ T LYMPHOCYTES BY HISTAMINE DEPENDS ALSO ON THE TOTAL NK CELLS J Int AIDS Soc 2008, 11(Suppl 1):P212 doi:10.1186/1758-2652-11-1-P212 D Sedláèek, J Hanzlíková, M Liska, J Gorèíková, S Amiramini and P Panzner HIV-specific CTLs production of IFN-gamma was statistically significantly higher after stimulation by HIV peptides and histamine in HIV-positive subjects compared to the production after stimulation by HIV peptides alone and this production depended also on the number of total NK cells. |
| P213 | D-DIMER AND ANTI-COAGULATION ACTIVITY MARKERS IN CHILDREN AND ADOLESCENTS WITH HIV INFECTION J Int AIDS Soc 2008, 11(Suppl 1):P213 doi:10.1186/1758-2652-11-1-P213 G Pontrelli, H Tchidjou, R Citton, N Mora, P Palma, A Martino, P Rossi and S Bernardi The higher anticoagulant activity present in symptomatic patients (CDC classification B and C) could be explained by the treatment, and its related viral suppression, more frequent in these subjects. No relation has been observed regarding C reactive protein levels. These preliminary data seem to confirm the same observation done in adult cohorts, but further studies are necessary to correlate such alterations with clinical events and to investigate the protective role of therapy in this particular population. |
| P214 | TENOFOVIR TOXICITY IN CHILDREN: TWO CLINICAL CASES J Int AIDS Soc 2008, 11(Suppl 1):P214 doi:10.1186/1758-2652-11-1-P214 AS Bengleil, M Kambraki, O Al Fituri, I El Ammari, A Idris Elteer and AM Martino TDF-related tubular damage is well described in adults and few cases have been described in children. Despite the benefits of this drug, after initiation of TDF a vigilant screening of renal function should be recommended especially in pre-pubertal children. |
| P215 | IMPACT ON BONE MINERAL DENSITY OF TENOFOVIR-CONTAINING HAART IN HIV-1 INFECTED CHILDREN AND ADOLESCENTS: A REPORT FROM 5 YEARS OF CLINICAL EXPERIENCE J Int AIDS Soc 2008, 11(Suppl 1):P215 doi:10.1186/1758-2652-11-1-P215 R Rosso1, A Di Biagio1, A Parodi2, C Torrisi2, F Ginocchio1, F De Terlizzi3, M Vignolo2 and C Viscoli1 Our young patients do not seem to be at greater risk for bone toxicity. And a non-invasive technique, such as QUS technology, opens up new interesting perspectives, allowing following of bone mass changes in vertically infected patients and better multiple evaluation of the role of disease-related conditions or treatments able to interfere with bone mass acquisition during growth. |
| P216 | PROGRESSION TO AIDS IN HIV VERTICALLY INFECTED CHILDREN DIAGNOSED AND ARV TREATED FROM FIRST YEAR OF LIFE J Int AIDS Soc 2008, 11(Suppl 1):P216 doi:10.1186/1758-2652-11-1-P216 S Dobosz, M Marczyñska, A Oldakowska and M Szczepañska-Putz The risk of progression to AIDS in HIV vertically infected children is high. We aim to evaluate the incidence of progression to AIDS in children on ARV treatment from the first years of life. |
| P217 | CART IN VERTICALLY HIV-INFECTED CHILDREN TREATED SINCE INFANCY J Int AIDS Soc 2008, 11(Suppl 1):P217 doi:10.1186/1758-2652-11-1-P217 M Marczyñska, A Oldakowska, S Dobosz, M Szczepasñka-Putz and J Popielska cART in vertically HIV-infected children treated since infancy is effective. Most of the patients had to change their regimens because of treatment failure or adverse events. Multidrug resistance (double or triple class) appeared in 15% of patients. |
| P218 | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV IN THE HAART ERA: PATTERNS IN USE OF NEONATAL PROPHYLAXIS J Int AIDS Soc 2008, 11(Suppl 1):P218 doi:10.1186/1758-2652-11-1-P218 K England In the absence of evidence from clinical trials, practices for prescribing neonatal prophylaxis vary in the HAART era, with evidence of shorter durations in recent years. Prevalence of severe anaemia among infants exposed to ART in utero and early life remains low overall. |
| P219 | REGULAR AUDIT CAN LEAD TO CHANGES IN PRACTICE AND BETTER OUTCOMES FOR PREGNANT WOMEN WITH HIV J Int AIDS Soc 2008, 11(Suppl 1):P219 doi:10.1186/1758-2652-11-1-P219 V Patton1, R Fox1, R Nandwani1, A Seaton1, A MacConnachie1, M Hepburn2, E Ellis2, H Mactier2 and A Winter1 Annual audit of all pregnant patients was beneficial in highlighting areas where improvements could be made to the care pathway. Antiretroviral treatment for PMTCT is now initiated at an earlier gestation to ensure undetectable viral load in case of pre-term labour. TDM has enabled doses of PIs to be increased if necessary to ensure viral load is undetectable at delivery. It has also confirmed suspected non-adherence with medication enabling other action to be taken prior to delivery to reduce risk of MTCT. |
| P220 | J Int AIDS Soc 2008, 11(Suppl 1):P220 doi:10.1186/1758-2652-11-S1-P220 Abstract withdrawn |
| P221 | SAFETY AND EFFICACY OF LOPINAVIR/RITONAVIR COMPARED TO NELFINAVIR-BASED HAART DURING PREGNANCY J Int AIDS Soc 2008, 11(Suppl 1):P221 doi:10.1186/1758-2652-11-1-P221 JM Peña1, MI González2, JF Pascual-Pareja3, J López-Aldeguer4, JA Iribarren5, M Leyes6, P Miralles7, J Sanz8, A Ocampo9, JL Gómez-Sirvent10 and JT Ramos11 In our cohort lopinavir/ritonavir and nelfinavirbased regimens during pregnancy were safe, effective and well tolerated. |
| P222 | EFFICACY AND SAFETY OF TRUVADA® IN HIV-1 PREGNANT WOMEN: REPORT OF 23 CASES J Int AIDS Soc 2008, 11(Suppl 1):P222 doi:10.1186/1758-2652-11-1-P222 N Ciraru-Vigneron1, MC Mazeron1, V Lefevre1, N Chernai2, H Trout1, JF Bergman1 and E Barranger1 Most of the pregnancies under Truvada® were discovered after the first trimester. In this cohort, use of Truvad® is effective and safe; the data are in line with the guidelines which allow the continuation of this association in pregnant women. |
| P223 | OUTCOME OF PREGNANCIES IN HIV-POSITIVE WOMEN FOLLOWED UP AT THE INSTITUTE OF TROPICAL MEDICINE (ITM) IN ANTWERP, BELGIUM, BETWEEN 1997 AND 2007 J Int AIDS Soc 2008, 11(Suppl 1):P223 doi:10.1186/1758-2652-11-1-P223 I Kint1, J Pelgrom2, P Maes3, K Wouters1, S Caluwaerts1 and A Buvé1 HIV transmission from mothers to their babies is very rare in industrialized countries, but other adverse pregnancy outcomes remain a problem. Rates of prematurity and low birthweight are substantially higher in HIV-infected women. |
| P224 | PARTICULAR ASPECTS OF MOTHER-TO-CHILD TRANSMISSION OF HIV INFECTION: SINGLE CENTER'S 7-YEAR EXPERIENCE IN ROMANIA J Int AIDS Soc 2008, 11(Suppl 1):P224 doi:10.1186/1758-2652-11-1-P224 C Oprea, E Ungureanu, R Radoi, S Tetradov, G Tardei and D Duiculescu There was no perinatal HIV transmission in the mother-child pairs with complete prophylaxis. The lack of HIV diagnosis in pregnant women was the major risk of MTCT especially in the first years of the study period. Breastfeeding and vaginal delivery increased the risk of perinatal HIV transmission in the group of untreated mothers.The number of pregnancies in women who acquired HIV infection in the early childhood by parenteral route is increasing in the last years and this will be a major concern for us in the future. |
| P225 | MANAGING HIV IN PREGNANCY IN GLASGOW J Int AIDS Soc 2008, 11(Suppl 1):P225 doi:10.1186/1758-2652-11-1-P225 V Patton1, R Fox1, R Nandwani1, A Seaton1, A MacConnachie1, M Hepburn2, E Ellis2, H Mactier2 and A Winter1 A significant proportion of pregnancies occurred within our existing HIV cohort, most of these women conceiving on HAART. In centres without sufficient numbers to run dedicated antenatal/HIV clinics, it is possible to obtain good results through close team working. There was no increased rate of pre-term delivery and no increased risk of low birth-weight. Non-adherence was the most important factor in failing to achieve undetectable viral load at delivery. |
| P226 | MATERNO-FETAL TRANSMISSION OF HIV INFECTION IN CONSTANTA COUNTY IN THE LAST 8 YEARS J Int AIDS Soc 2008, 11(Suppl 1):P226 doi:10.1186/1758-2652-11-1-P226 SC Cambrea1, MM Ilie2, C Marcas2, S Rugina1 and CN Rugina3 After January 2000, the mother-to-child transmission rate decreased gradually to 15.62%. The mother-to-child transmission rate decreased more obviously during the last 3 years. It is absolutely necessary to make the diagnosis of HIV in pregnant women. We should administrate ARVT both in the pregnant woman and in the newborn according to the current recommendations of the national and international guidelines. The majority of HIV+ mothers (66%) who had children were unmarried and of poor socio-economic status. |
| P227 | HIV MATERNAL-FETAL TRANSMISSION IN A LOW RESOURCES SETTING IN THE OUTSKIRTS OF BUENOS AIRES, ARGENTINA J Int AIDS Soc 2008, 11(Suppl 1):P227 doi:10.1186/1758-2652-11-1-P227 M Hojman1, F Murano2, G Manonelles3, M Maldonado1, N Ahmed1, M Sanchez Vera2 and M Prieto2 Beginning of HIV follow-up post-partum, availability of VL result at the moment of delivery, AZT intra-partum, higher gestational age, lack of administration of ART to the newborn, and breastfeeding were significant for HIV-MFT. It is mandatory to re-affirm the importance of the fulfillment of measures destined to diminish the probability of HIV-MFT. |
| P228 | PREVALENCE AND RISK FACTORS ASSOCIATED WITH LOSS TO FOLLOW-UP IN A COHORT OF HIV-INFECTED PATIENTS TREATED WITH HIGHLY ACTIVE ANTIRETROVIRAL TREATMENT J Int AIDS Soc 2008, 11(Suppl 1):P228 doi:10.1186/1758-2652-11-1-P228 S Morreel1, T Schepens1, E Florence2, I Kint2, O Koole2 and R Colebunders2 Patients without health insurance, having to travel longer distance to reach the clinic, and IVDU users are at risk for LTFU. Such patients should be the target of reinforced counseling and follow-up. The LTFU patients frequently disappeared from care with a detectable viral load with the risk of further spread of potentially resistant virus. |
| P229 | CLINICAL MENTORING: A SUSTAINABLE STRATEGY FOR SCALING UP HIV/AIDS CLINICAL EXPERTISE IN DEVELOPING COUNTRIES J Int AIDS Soc 2008, 11(Suppl 1):P229 doi:10.1186/1758-2652-11-1-P229 S Aggett, K Shantz, R Mair and M Charles Clinical mentoring is an effective method to rapidly develop local expertise to provide the best HIV care possible within developing countries' available resources. Existing programs have shown that clinical mentoring as part of a national healthcare strategy has a profound and lasting impact. This impact is felt immediately on the community level and, ultimately, on a national level as the health and welfare of citizens improve. |
| P230 | PATIENT SATISFACTION SURVEY FOR THE HOME DELIVERY OF MEDICATION SCHEME J Int AIDS Soc 2008, 11(Suppl 1):P230 doi:10.1186/1758-2652-11-S1-P230 B Smith, S Sonecha, A Murungi and M Nelson This patient survey showed a positive attitude towards the home delivery scheme and that it provides a useful service in their journey through clinics. A further survey looking at the possible benefits to the Trust such as reduction in pharmacy waiting times, potential reduction in pharmacy stock holding and savings on the HIV drug budget is warranted. Extension of the service to drugs other than antiretrovirals should also be considered. |
| P231 | TEN YEARS OF NON-OCCUPATIONAL HIV POST-EXPOSURE PROPHYLAXIS: WHAT HAVE WE LEARNED? J Int AIDS Soc 2008, 11(Suppl 1):P231 doi:10.1186/1758-2652-11-1-P231 F Tissot1, V Fardel2 and M Cavassini1 nPEP requests increased over time. Testing the source person for HIV allowed to avoid nPEP in 29% of cases, and is therefore paramount in the management of potential HIV exposure. Furthermore, it allows active screening of high-risk behaviour population for undiagnosed HIV infection, as shown by our prevalence of 3.5%. This number may justify nPEP prescription in cases where HIV status of the source cannot be determined. |
| P232 | OCCUPATIONAL HIV EXPOSURE AMONG THAI HEALTHCARE WORKERS: AN ANALYSIS OF 558 EXPOSURES DURING 1998–2007 J Int AIDS Soc 2008, 11(Suppl 1):P232 doi:10.1186/1758-2652-11-1-P232 P Wangpatharawanit, W Padiwongpaisarn, N Phanuphak and P Phanuphak Occupational HIV exposure is still common in healthcare facilities of TRCS. The patterns of exposure have not changed over time in spite of active prevention efforts. Newer strategies are needed to ensure adherence to workplace safety measures and to raise level of carefulness at work. |
| P233 | PLASMA CONCENTRATIONS OF BOOSTED AND UNBOOSTED ATAZANAVIR ARE PREDICTED BY 63396C>T SNP IN THE PXR GENE J Int AIDS Soc 2008, 11(Suppl 1):P233 doi:10.1186/1758-2652-11-1-P233 M Siccardi1, A D'Avolio1, L Baietto1, A Calcagno1, SE Gibbons2, M Sciandra1, S Bonora1, SH Khoo2, DJ Back2, G Di Perri1 and A Owen2 Homozygosity for PXR 63396 T was strongly correlated with ATV Ctrough, which suggests that PXR is important in the regulation of disposition of this drug. The impact of 63396 C>Twas more marked for unboosted ATV, presumably due to inhibition of CYP3A4 and ABCB1 by RTV in the boosted regimen. Further studies are now required to confirm this association, prior to prospective studies to define its clinical value for individualisation of ATV therapy. |
| P234 | IMPROVEMENT OF ATAZANAVIR-INDUCED HYPERBILIRUBINAEMIA FOLLOWING TDM-GUIDED ATAZANAVIR DOSE REDUCTION J Int AIDS Soc 2008, 11(Suppl 1):P234 doi:10.1186/1758-2652-11-1-P234 M Giola1, M Cusato2, P Villani2, C Basilico1, D Bernasconi De Luca1, L Lazzaroni1, L Rizzi1 and PA Grossi1 Our data confirm a strong correlation between ATV Ctrough and hyperbilirubinaemia, and more interestingly, support a reduction in the ATV dosage from 300 mg to 200 mg (both plus RTV 100 mg) once daily in hyperbilirubinaemic patients with an ATV Ctrough >750 ng/mL. By this approach, we were able to reduce significantly the bilirubin levels, maintaining an optimal HIV suppression and a satisfactory immunologic competence. |
| P235 | PREDICTORS OF SEVERE HYPERBILIRUNIAEMIA IN HIV-INFECTED PATIENTS TREATED WITH ATAZANAVIR (ATV) J Int AIDS Soc 2008, 11(Suppl 1):P235 doi:10.1186/1758-2652-11-1-P235 M Casana1, A Barassi1, P Cicconi1, T Bini1, L Comi1, O Turri2, F Pateri1, ML Biondi2, GL Melza d'Eril1 and A d'Arminio Monforte1 Hyperbilirubinemia is the most common laboratory abnormality in patients treated with ATV; bilirubin plasma levels have been correlated with ATV plasma concentration [1]. In this study we analysed the relationships between hyperbilirubinemia, Gilbert's syndrome and ATV plasma concentration. |
| P236 | ANTIVIRALS AND NUCLEAR RECEPTOR ACTIVATION OF CYP3A4 AND 2B6 J Int AIDS Soc 2008, 11(Suppl 1):P236 doi:10.1186/1758-2652-11-1-P236 J Svard1, JP Spiers1, F Mulcahy2 and M Hennessy1 In conclusion, the results indicate that inductive effects of PIs and NNRTIs on the CYP-P450 superfamily are due to PXR rather than CAR regulatory mechanisms. Newer PIs such as LPV and FOS are as likely to induce CYP3A4 and 2B6 expression by this pathway as older ARV agents and may affect plasma levels of co-administered through altered metabolism. Clinically relevant combinations and all new drugs should be screened for PXR and CAR activation. |
| P237 | FREQUENCY OF FUNCTIONAL DRUG DISPOSITION GENE POLYMORPHISM IN THAI POPULATION: RELEVANCE TO ANTIRETROVIRAL DRUGS J Int AIDS Soc 2008, 11(Suppl 1):P237 doi:10.1186/1758-2652-11-1-P237 A Chaikan1, N Chierakul2, N Saguenwong3, C Chuchuttaworn4, A Owen1, L Dickinson1, SH Khoo1, DJ Back1 and GR Davies1 Although the different allele frequencies for ABCB1 and ABCG2 could have a modest impact on the bioavailability, the over-representation of CYP3A5 6986 G would be expected to result in lower drug concentrations of PIs. However, we have previously shown an association of PXR SNPs with atazanavir plasma concentrations and so genotypephenotype studies for these SNPs in Thai populations are now warranted. |
| P238 | LOPINAVIR IS A SUBSTRATE FOR SLCO1A2 BUT 516A > C AND 38T > C POLYMORPHISMS DO NOT INFLUENCE LOPINAVIR PLASMA CONCENTRATIONS J Int AIDS Soc 2008, 11(Suppl 1):P238 doi:10.1186/1758-2652-11-1-P238 V Shallcross, WS Kwan, R Hartkoorn, T Mahungu, SH Khoo, DJ Back and A Owen These data indicate that LPV is a substrate for SLCO1A2. However, SLCO1A2 516A > C and 38T > C did not influence plasma concentrations of LPV and does not therefore appear to be a major determinant of intersubject variability. These data must be interpreted with caution due to the limitations associated with a TDM cohort (i.e. selection bias and lack of ethnicity data). As with all pharmacogenetic data, the findings warrant confirmation in other cohorts. |
| P239 | THE PHARMACOKINETIC (PK) INTERACTION BETWEEN OMEPRAZOLE AND TMC278, AN INVESTIGATIONAL NONNUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR (NNRTI) J Int AIDS Soc 2008, 11(Suppl 1):P239 doi:10.1186/1758-2652-11-1-P239 HM Crauwels1, RPG van Heeswijk1, D Kestens1, M Stevens1, A Buelens1, K Boven2 and RMW Hoetelmans1 These results confirm the pH-dependent bioavailability of TMC278 and indicate that proton pump inhibitors and TMC278 25 mg QD (selected dose for Phase III) should not be co-administered. As an alternative, H2-antagonists can be used, if taken 12 hours before or 4 hours after TMC278 [2]. |
| P240 | PHARMACOKINETIC INTERACTIONS BETWEEN BUPRENORPHINE/NALOXONE AND TIPRANAVIR/RITONAVIR IN HIV-NEGATIVE SUBJECTS CHRONICALLY RECEIVING BUPRENORPHINE/NALOXONE J Int AIDS Soc 2008, 11(Suppl 1):P240 doi:10.1186/1758-2652-11-S1-P240 RD Bruce1, FL Altice1, DE Moody2, S Lin2, WB Fang2, JP Sabo3, JM Wruck3, C Conner3, P Piliero3, L Andrews1 and GH Friedland1 The results of this study indicate that no dosage modification of buprenorphine/naloxone is required when it is co-administered with TPV/r. The mechanism by which BUP/NAL affected the pharmacokinetic parameters of TPV is unclear; however, it is likely that the effect of lower plasma RTV exposure contributed substantially to the effect on tipranavir. Caution should be used when combining BUP/NAL with TPV/r as tipranavir may be less effective due to decreased tipranavir plasma concentrations in patients taking these agents concomitantly. |
| P241 | MODELLING THE CHANGE IN LOPINAVIR APPARENT ORAL CLEARANCE OVER TIME FOLLOWING CESSATION OF LOPINAVIR/RITONAVIR: DATA FROM THE TAIL STUDY J Int AIDS Soc 2008, 11(Suppl 1):P241 doi:10.1186/1758-2652-11-1-P231 L Dickinson1, M Boffito2, LJ Else3, GJ Moyle2, SH Kho3, A Pozniak2 and L Aarons4 A model assuming competitive inhibition of LPV by RTV combined with zero-order kinetics best described the time-dependent changes in LPV CL/F following drug cessation. Given the complexity of the LPV-RTV interaction, potentially more complex models should be explored. |
| P242 | QUANTITATION OF RALTEGRAVIR IN HUMAN PLASMA, DRIED BLOOD SPOTS AND PERIPHERAL BLOOD MONONUCLEAR CELL LYSATE BY MEANS OF LC-MS/MS J Int AIDS Soc 2008, 11(Suppl 1):P242 doi:10.1186/1758-2652-11-1-P232 R ter Heine, H Rosing, ECM van Gorp, JW Mulder, JH Beijnen and ADR Huitema The described method has been applied in a clinical study in patients on a raltegravir-containing salvage regimen. DBS sampling proved to be easily implemented and DBS samples were succesfully obtained from all included patients. |
| P243 | ATAZANAVIR (ATV) PLASMA CONCENTRATIONS AT DIFFERENT TIMES AFTER DRUG UPTAKE: ASSOCIATIONS WITH VIROLOGIC RESPONSE AND HYPERBILIRUBINEMIA J Int AIDS Soc 2008, 11(Suppl 1):P243 doi:10.1186/1758-2652-11-1-P233 M Fabbiani1, S Di Giambenedetto1, E Ragazzoni2, M Colafigli1, M Prosperi1, R Cauda1, P Navarra2 and A De Luca1 Identification of an ATV C12 h efficacy threshold can be useful for the clinical application of morning TDM in patients receiving ATV at night. |
| P244 | IMPACT OF AGE ON PHARMACOKINETICS OF BOOSTED ATAZANAVIR 300/100 IN THAI HIV-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P244 doi:10.1186/1758-2652-11-1-P234 A Avihingsanon1, J van der Lugt1, S Kerr1, M Gorowara1, S Chanmano1, DA Cooper2, P Phanuphak1, D Burger3 and K Ruxrungtham4 Aging may have an effect on the pharmacokinetics (PK) of antiretroviral drugs and hence contribute to differences in efficacy and toxicity. We evaluated the impact of age on the pharmacokinetics of boosted atazanavir in a Thai HIV-1 infected population. |
| P245 | POPULATION PHARMACOKINETIC/PHARMACODYNAMIC ANALYSIS OF LOPINAVIR AND RITONAVIR IN SUBJECTS RECEIVING THE TABLET FORMULATION J Int AIDS Soc 2008, 11(Suppl 1):P245 doi:10.1186/1758-2652-11-1-P235 J Ng, CE Klein, P Diderichsen, BA Da Silva, B Bernstein, WM Awni and YL Chui In summary, only weight had a small, statistically significant but not clinically relevant, effect on LPV CL/F. A priori adjustment in LPV/r dose based on subject characteristics (race, sex, weight, renal function, etc.) is not warranted. The virologic response did not correlate with LPV levels indicating that, even at the lowest levels measured in this trial, the virologic response was maintained. |
| P246 | THERAPEUTIC DRUG MONITORING OF ATAZANAVIR IN PREGNANCY J Int AIDS Soc 2008, 11(Suppl 1):P246 doi:10.1186/1758-2652-11-1-P236 J Lambert1, LJ Else2, V Jackson3, SE Gibbons2, M Brennan3, J Kieran1, J Breiden1, S Coulter-Smith3 and SH Khoo2 ATV/r concentrations showed a considerable degree of inter-patient variability in our sample. However, the standard dose did achieve therapeutic levels both ante-partum and post-partum in the majority of cases, suggesting the current regimen is appropriate in pregnancy. |
| P247 | THE EFFECT OF FOOD ON RITONAVIR BIOAVAILABILITY FOLLOWING ADMINISTRATION OF RITONAVIR 100 MG FILM-COATED TABLET IN HEALTHY ADULT SUBJECTS J Int AIDS Soc 2008, 11(Suppl 1):P247 doi:10.1186/1758-2652-11-1-P237 J Ng, CE Klein, YL Chui, WM Awni, JB Morris, TJ Podsadecki, Y Cui, B Bernstein and D Kim Overall, ritonavir pharmacokinetics after administration of the tablet are slightly affected by meal content (with moderate or high fat). |
| P248 | EZETIMIBE AS LIPID-LOWERING THERAPY FOR PATIENTS RECEIVING HAART J Int AIDS Soc 2008, 11(Suppl 1):P248 doi:10.1186/1758-2652-11-1-P238 AK Asghar1, M Bower2, P Holmes2, BG Gazzard2, H Isenman2 and M Nelson2 Dyslipidaemia in HIV has been linked with both a cytokine-driven lipid metabolism re-arrangement in significant viraemia, and with the use of highly-active antiretroviral therapy (HAART), especially protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs). |
| P249 | ONCE-DAILY DARUNAVIR (DRV) USED IN ROUTINE CLINICAL CARE PRODUCES TROUGH DRV DRUG CONCENTRATIONS IN EXCESS OF 30× THE PROTEIN-CORRECTED (PC) EC50 FOR WILD-TYPE HIV J Int AIDS Soc 2008, 11(Suppl 1):P249 doi:10.1186/1758-2652-11-1-P239 CM Robertson1, AN Jayasuriya2, CJ Smith3, S Taylor2, NE Dufty2, A Berry2 and C Stradling2 Once-daily darunavir used in routine clinical care produces trough DRV drug concentrations in excess of 30× the PCEC50 for WT HIV. This is in keeping with data from randomised controlled trials. |
| P250 | AN OPEN-LABEL MULTICENTRE PILOT STUDY EVALUATING THE PHARMACOKINETICS (PK) OF CO-ADMINISTERED LOPINAVIR (LPV) AND NEVIRAPINE (NVP) IN HIV+ ADULTS J Int AIDS Soc 2008, 11(Suppl 1):P250 doi:10.1186/1758-2652-11-S1-P250 LJ Else1, TW Mahungu2, Z Cuthbertson2, CJ Smith3, D Podlekareva4, P Hay5, UB Dragsted4, SH Khoo1, MA Johnson2, DJ Back1 and M Youle2 This study explored an NRTI sparing strategy. We recognise that one limitation is that some patients were switched to the LPV/r tablet formulation. The issue of whether, if starting with this strategy, a dose of 400/100 mg or 600/150 mg tablet would be used, has not been addressed here. PK parameters at wk 4 and 48 did not differ significantly in patients receiving co-administered LPV/r and NVP. However, there was a trend towards lower LPV C in patients who switched to LPV/r tablet. Therefore, there is a need for caution and a consideration for TDM-guided dose adjustment depending on the population. |
| P251 | IS PROGNOSIS AFTER FIRST AIDS-DEFINING PATHOLOGY INCIDENCE BECOMING BETTER IN RECENT YEARS OF HAART ERA? J Int AIDS Soc 2008, 11(Suppl 1):P251 doi:10.1186/1758-2652-11-1-P251 G Gaspar1, JA Melero1, E Contés2, J Sanz3, JJ Jusdado4, V Castilla5, A Barrios6 and MT de Guzmán1 Prognosis of HIV-infected patients after incidence of first AIDS-defining condition is becoming increasingly better in recent years, probably reflecting improvements in HIV infection treatment protocols. |
| P252 | PERIPHERAL BLOOD CD4+ T-LYMPHOCYTE COUNT INFLUENCES CEREBROSPINAL FLUID CELLULAR RESPONSE IN PATIENTS WITH HIV-RELATED CRYPTOCOCCAL MENINGITIS J Int AIDS Soc 2008, 11(Suppl 1):P252 doi:10.1186/1758-2652-11-1-P252 DM Cecchini1, AM Cañizal2, H Rojas2, A Arechavala2, R Negroni2, MB Bouzas2 and J Benetucci2 This result suggests that, despite the advanced level of immunodeficiency observed in these patients, the peripheral blood CD4+ T-lymphocyte count has a major influence on the development of an inflammatory response in the CSF in patients with meningitis by Cryptococcus neoformans. |
| P253 | EARLY PREDICTORS OF OUTCOME AND MANAGEMENT OF PCP IN GLASGOW: 11 YEARS EXPERIENCE IN THE POST-ANTIRETROVIRAL ERA J Int AIDS Soc 2008, 11(Suppl 1):P253 doi:10.1186/1758-2652-11-1-P253 CL Mackintosh, A MacConnachie, R Nandwani, A Seaton, A Winter and R Fox The majority of cases of PCP occur in the context of a new HIV diagnosis. Risk factors for poor outcome can be identified at admission and treatment decisions are influenced by severity of illness and prior treatment. |
| P254 | CLINICAL AND IMMUNO-VIROLOGIC OUTCOME IN A COHORT OF IMMIGRANT AND NATIVE SUBJECTS WITH HIV INFECTION IN SOUTH-EASTERN SPAIN DURING THE PERIOD 1998–2007 J Int AIDS Soc 2008, 11(Suppl 1):P254 doi:10.1186/1758-2652-11-1-P254 FJ Vera-Méndez1, J Trujillo-Santos1, A Cano-Sánchez2, JA García-Henarejos1, N Cobos-Trigueros1, J García-García1, OJ Martínez-Madrid1, R Vilaplana-García1, C Pérez-Pagán1, M Alcalde-Encinas1 and V Herrero-Segastume1 In our cohort, there was no difference in immuno-virological outcome in the HIV-positive native and immigrant population. There was a greater loss of follow-up in immigrant patients with HIV infection. We found no differences in the frequency of AIDS defining illnesses, tuberculosis and chronic diarrhoea due to Cryptosporidium the diseases being most prevalent in both groups. A larger number of native patients died from causes unrelated to AIDS. |
| P255 | IMPACT OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY ON CYTOMEGALOVIRUS VIRAEMIA, IN THE ABSENCE OF SPECIFIC ANTI-CYTOMEGALOVIRUS THERAPY J Int AIDS Soc 2008, 11(Suppl 1):P255 doi:10.1186/1758-2652-11-1-P255 R Mihailescu, S Paraschiv, V Arama, A Streinu-Cercel, D Otelea, OE Benea, M Iosipenco, M Mardarescu, M Luminos, D Munteanu, M Radulescu, C Chiotan, A Hristea and R Ungurianu In conclusion, HAART effected the reduction of CMV viral load, without any specific anti-CMV therapy. As in the case of other opportunistic infections, history of CMV infection seemed to have been improved by controlling HIV infection. CMV viremia detection was useful in early diagnosis of asymptomatic CMV infection. |
| P256 | 23% OF NEWLY DIAGNOSED HIV CASES IN 2007 AT KAROLINSKA UNIVERSITY HOSPITAL HAD OPPORTUNISTIC INFECTIONS J Int AIDS Soc 2008, 11(Suppl 1):P256 doi:10.1186/1758-2652-11-1-P256 K Egnell1 and V Svedhem2 Identifying these symptoms, which were not recognised as HIV-related by health workers, will help us to find these patients earlier. Identifying the pathways that these patients used to get into the health care system, will tell us where to intensify HIV testing. |
| P257 | IMPACT OF CMV INFECTION ON HORIZONTALLY TRANSMITTED HIV-1 DISEASE PROGRESSION J Int AIDS Soc 2008, 11(Suppl 1):P257 doi:10.1186/1758-2652-11-1-P257 A Cupsa1, F Dumitrescu1, L Giubelan1, T Kalath2, A Romanescu2, I Niculescu1 and N Anghel2 In comparison with pts non-infected with CMV, those with dual infection (HIV+, CMV+) had a sizeable number of HIV/AIDS associated clinical conditions and a faster progression probably due to immunological suppression added by the herpetic infection. |
| P258 | RETROSPECTIVE EVALUATION OF CASES OF CNS TOXOPLASMOSIS IN PATIENTS WITH AIDS HOSPITALIZED IN THE DEPARTMENT OF HOSPITAL FOR INFECTIOUS DISEASES, WARSAW J Int AIDS Soc 2008, 11(Suppl 1):P258 doi:10.1186/1758-2652-11-1-P258 MA Miarka, J Gizinska, D Latarska-Smuga and RB Podlasin e disease. Neuro-imaging of CNS toxoplasmosis revealed mainly single in CT but multiple in MRI focal lesions. Therapy with sulfadiazine was often associated with side-effects. The prophylaxis of CNS toxoplasmosis can be insufficient in some cases. |
| P259 | FACTORS ASSOCIATED WITH POSITIVE TUBERCULIN SKIN TEST RESULTS IN HIV-1 INFECTED THAI PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P259 doi:10.1186/1758-2652-11-1-P259 NT Teeratakulpisarn1, SP Phositlimakul1, PS Suwanmala1, CW Wongsuthipol1, TP Pankam1, NP Phanuphak1, CB Burapat2, TT Tasaneeyapan2, WK Kittikraisak2, KDM McCarthy3, KPC Cain3, JKV Varma3 and P Phanuphak4 LTBI was common in HIV-infected Thai patients, particularly those with a history of injection drug use. HIVinfected Thai patients found to have a positive TST require culture of sputum and possibly other sources, not just sputum smear microscopy, to exclude active TB disease. |
| P260 | HIGH RATES OF VIRAL SUPPRESSION IN HIV/TB PATIENTS TREATED WITH NNRTI-BASED ANTIRETROVIRAL THERAPY J Int AIDS Soc 2008, 11(Suppl 1):P260 doi:10.1186/1758-2652-11-S1-P260 LJ Campbell1, A Samarawickrama2, AC Bailey2, E Hamlyn3, J Ashby3, AWinston3 and FA Post4 We reviewed all HIV/TB patients who received NNRTI-based antiretroviral therapy (ART) together with TB therapy at two London HIV clinics from 2000 to 2007. Baseline characteristics, TB outcome, trends in CD4 T-cell count and HIVRNA level, and liver enzymes were examined. |
| P261 | CLINICAL EPIDEMIOLOGY OF HIV AND TUBERCULOSIS CO-INFECTION IN GALATI, ROMANIA J Int AIDS Soc 2008, 11(Suppl 1):P261 doi:10.1186/1758-2652-11-1-P261 M Arbune1, C Scorpan2 and OE Benea3 A peculiar HIV epidemic has evolved in Romania since 1990. HIV screening of TB patients is usual practice starting from 1998. In comparison to national statistics, Galati county has similar prevalence for HIV/AIDS (50/100,000 vs. 60/100,000) but higher for TB (163.7/100,000 vs. 110.1/ 100,000). The purpose of the study is to assess the epidemiology and clinical characteristics of HIV tuberculosis co-infection (HIV/ TB) in Galati, Romania. |
| P262 | CHARACTERISTICS DISTINGUISHING DISSEMINATED MYCOBACTERIUM TUBERCULOSIS (MTB) AND NONTUBERCULOUS MYCOBACTERIAL (NTM) INFECTION IN HIV PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P262 doi:10.1186/1758-2652-11-1-P262 AC Bailey1, A Samarawickrama1, F Ibrahim2, RD Barker1 and FA Post2 Clinical and laboratory characteristics of patients with MTB and NTM overlap. In patients with suspected disseminated mycobacterial infection, prior or concurrent AIDS defining illnesses and recent HAART initiation favour NTM, while >100 CD4 T-cells/mm3 and parenchymal lung disease are suggestive of MTB. |
| P263 | INCIDENCE OF IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME AMONG HIV PATIENTS INFECTED WITH TUBERCULOSIS IN A DUBLIN COHORT J Int AIDS Soc 2008, 11(Suppl 1):P263 doi:10.1186/1758-2652-11-1-P263 EG Muldoon, M Mokoka, P Kok and C McNally HIV/TB co-infection is more prevalent in the immigrant population. Our rate of IRIS is 13% in patients co-infected with HIV/TB, which is lower than previous series. The development of IRIS depends on the population studied, but extrapulmonary tuberculosis and low CD4 counts appear to be risk factors for IRIS. |
| P264 | CROSS-SECTIONAL STUDY TO DETERMINE PREVALENCE OF SIGNIFICANT LIVER FIBROSIS (F2–F4) IN HIV/HCV CO-INFECTED PATIENTS: GRAFIHCO STUDY J Int AIDS Soc 2008, 11(Suppl 1):P264 doi:10.1186/1758-2652-11-1-P264 C Tural1, E Ortega2, JA Pineda3, J Gonzalez-García4, L Griffa5, E Cabrero5 and A Burgos5 An algorithm of biomarkers, including APRI and Forns index, identifies a significant proportion of HIV/HCV coinfected patients with F2–F4 liver fibrosis in daily clinical practice, although its performance is slightly lower than that reported in prior validation studies. Immunodepression and male sex are the main factors associated with significant fibrosis assessed by this procedure. |
| P265 | A 4-YEAR FOLLOW-UP OF A COHORT OF HIV-POSITIVE CIRRHOTIC PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P265 doi:10.1186/1758-2652-11-1-P265 P Tuma, E Vispo, J Medrano, P Barreiro, L Martin-Carbonero, P Labarga and V Soriano Liver cirrhosis in HIV+ patients under HAART does not seem to progress as fast as expected without antiretroviral therapy. This observation may be due to multiple factors, such as appropriate prevention of variceal bleeding and liver cancer following diagnosis of compensated cirrhosis using FibroScan, successful treatment of chronic hepatitis C, and selection of less hepatotoxic drugs in this population. |
| P266 | RAPID VIROLOGICAL RESPONSE IS THE BEST PREDICTOR FOR ACHIEVING SVR UNDER PEG-IFN/RIBAVIRIN HEPATITIS C THERAPY IN HIV/HCV CO-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P266 doi:10.1186/1758-2652-11-1-P266 M Janke1, G Luechters1, M Vogel1, E Voigt1, JC Wasmuth1, C Schwarze-Zander1, J Emmelkamp1, G Fätkenheuer2 and J Rockstroh1 The most reliable predictive factor for achieving sustained virological response in HIV/HCV co-infected patients treated with peg-IFN plus RBV is to obtain rapid virological response. Further positive predictives for obtaining SVR are infection with HCV-GT 2 or 3 and early virological response (EVR). Positive predictive factors for obtaining EVR are again HCV infection with GT 2 or 3, RVR and, interestingly, also stable HIV infection without a need for HAART therapy. |
| P267 | SWITCHING FROM ZIDOVUDINE/LAMIVUDINE (ZDV/LMV) TO TENOFOVIR/EMTRICITABINE (TDF/FTC) OR ABACAVIR/LAMIVUDINE (ABC/LMV) IN HIV/HCV CO-INFECTION (COTKI STUDY) J Int AIDS Soc 2008, 11(Suppl 1):P267 doi:10.1186/1758-2652-11-1-P267 P Nasta, F Gatti, A Matti and G Carosi Switching from ZDV/LMV to TDF/FTC or ABC/ LMV in HIV/HCV persons treated with ATV/rtv provides a simplified QD regimen which maintains virological control and improves both lipid and glucose parameters without increase in hepatic toxicities. |
| P268 | HCV RELAPSE AFTER PEG-INTERFERON (IFN) PLUS RIBAVIRIN (RBV) THERAPY: IS 12-WEEK FOLLOW-UP ENOUGH TO DETERMINE SUSTAINED HCV CLEARANCE? J Int AIDS Soc 2008, 11(Suppl 1):P268 doi:10.1186/1758-2652-11-1-P268 J Medrano1, S Resino2, E Vispo1, P Tuma1, J García-Samaniego1 L Martin-Carbonero1, P Labarga1, I Jimenez1, M Romero1, P Barreiro1 and V Soriano1 Sustained HCV clearance after pegIFN-RBV is less frequent in HIV-positive (-pos) than in HIV-negative (-neg) individuals. Less information exists about the rate of HCV relapses and timing for recurrence of HCV viremia upon completion of therapy in these two populations. |
| P269 | FREQUENCY OF HEPATIC STEATOSIS IN HIV AND HEPATITIS C CO-INFECTED PATIENTS TREATED BY ANTIRETROVIRAL THERAPY DURING 1995 TO 2008 J Int AIDS Soc 2008, 11(Suppl 1):P269 doi:10.1186/1758-2652-11-1-P269 V Martinez1, N Thi Dieu TA2, M Guiget3, Z Mokhtari4, MA Valantin5, F Charlotte6, P Bertheau7, JM Molina8, C Katlama5 and E Caumes5 In our population of HIV/HCV co-infected patients receiving ART, half of them presented liver steatosis. Steatosis was associated with genotype 3, RNA HCV, and hepatic fibrosis. No association was observed between steatosis and antiretroviral therapy, as well as HIV markers (i.e. CD4 and HIV-RNA). |
| P270 | ACUTE HEPATITIS C INFECTION IN A COHORT OF HIV-INFECTED PATIENTS IN BELGIUM J Int AIDS Soc 2008, 11(Suppl 1):P270 doi:10.1186/1758-2652-11-S1-P270 E Florence1, E Bottieau1, M Van Den Boer1, M Vekemans1, S Francque2, E Vlieghe1, P Soentjens1 and R Colebunders1 Acute HCV infection is increasingly diagnosed among MSM in our cohort and interfered frequently with HAART. Evolution to liver fibrosis was rapid in a substantial proportion of the study population. HCV treatment rate and treatment success were low. MSM need more counseling about the risk of (re-) acquiring HCV infection and HCV screening should be reinforced in the 6 months after STD diagnosis. |
| P271 | RAPID REBOUND IN HEPATITIS B DNA IN PREVIOUSLY UNDETECTABLE HEPATITIS B/HIV CO-INFECTED PATIENTS SWITCHING FROM TENOFOVIR TO ENTECAVIR THERAPY J Int AIDS Soc 2008, 11(Suppl 1):P271 doi:10.1186/1758-2652-11-1-P271 M Hull1, J Toy2, V Montessori1, M Harris3, G Ritchie4, C Sherlock4 and JSG Montaner1 Entecavir has been shown to successfully suppress lamivudine-refractory HBV in mono-infected patients. Entecavir may be less potent than tenofovir at maintaining HBV suppression in HBV/HIV co-infected patients. The |
| P272 | SAFETY AND TOLERABILITY OF ETRAVIRINE (ETR; TMC125) IN HEPATITIS B AND/OR C CO-INFECTED PATIENTS IN DUET-1 AND DUET-2: POOLED 48-WEEK RESULTS J Int AIDS Soc 2008, 11(Suppl 1):P272 doi:10.1186/1758-2652-11-1-P272 B Clotet1, C Katlama2, A Lazzarin3, K Jansen4, TN Kakuda5 and G De Smedt4 In general, the incidence and severity of AEs with ETR was similar to placebo, irrespective of co-infection status. The incidence of hepatic AEs and grade 3 or 4 AST/ALT elevations was higher in co-infected patients than in non-coinfected patients in both treatment groups, consistent with the underlying chronic hepatitis condition. ETR did not increase hepatic toxicity in patients with hepatitis co-infection and was generally well tolerated in all patients. |
| P273 | ABSENCE OF LIVER STEATOSIS IN HIV-INFECTED PATIENTS RECEIVING TENOFOVIR-CONTAINING REGIMEN J Int AIDS Soc 2008, 11(Suppl 1):P273 doi:10.1186/1758-2652-11-1-P273 V Borghi, C Mussini, L Manzini, L Bisi and R Esposito As previously described, the risk of steatosis is mainly associated to HCV genotype 3 in patients infected by HCV. HIV co-infected patients with genotype other than 3 are at risk of developing steatosis with stavudine but not with tenofovir. |
| P274 | IMPACT OF HYPERGLYCEMIA AND CHOLESTEROL LEVELS ON THE OUTCOME OF HEPATITIS C TREATMENT IN HIV/HCV CO-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P274 doi:10.1186/1758-2652-11-1-P274 M Cesari, I Caramma, S Antinori, OV Viganò, M Galli and L Milazzo In conclusion, our study identified in a HIV/HCV co-infected population, hyperglycemia, serum cholesterol and, at a lesser extent, LDL as predictors of response to peg-IFN plus ribavirin therapy as previously reported in HCV-infected subjects. A possible explanation is that the entry of HCV into the cell is mediated by LDL-receptor that could be downregulated by high levels of total and LDL-cholesterol, resulting in reduced HCV infectivity. HIV/HCV co-infected patients display a complex pattern of metabolic alterations in which viral features, host characteristics and drug toxicity interact and influence each other; prospective studies will better address this important issue and the underlying mechanisms. |
| P275 | PRESENCE OF HEPATITIS B VIRUS IN CEREBROSPINAL FLUID OF HIV-1 CO-INFECTED ADOLESCENTS J Int AIDS Soc 2008, 11(Suppl 1):P275 doi:10.1186/1758-2652-11-1-P275 D Duiculescu1, L Ene1, G Tardei1, C Ionescu1 and S Ruta2 We report for the first time the presence of HBVDNA in CSF of HIV co-infected patients. HBV was detected in the CSF of more than half of the patients with positive plasma HBV-DNA. CSF HBV-DNA levels were positively correlated with plasma DNA. The clinical significance of the presence of HBV in CSF is a very interesting aspect to be investigated in the future. |
| P276 | CONTINUING EVIDENCE TO SUPPORT THE ROLE OF EARLY KINETIC MONITORING IN PREDICTING SUSTAINED VIRAL RESPONSE FOR HIV/HCV CO-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P276 doi:10.1186/1758-2652-11-1-P276 J Kieran, A Jackson, DO Shea, G Farrell, J Thornhill, C McNally, F Mulcahy and C Bergin Monitoring of early viral kinetics can be used to accurately predict those patients who will achieve SVR, especially those for whom only 24 weeks of therapy is required. |
| P277 | SUBSTITUTION OF TENOFOVIR FOR NUCLEOSIDE ANALOGUES IN VIROLOGICALLY CONTROLLED HIV-INFECTED PATIENTS CO-INFECTED WITH HEPATITIS C VIRUS: TEN-SWITCH J Int AIDS Soc 2008, 11(Suppl 1):P277 doi:10.1186/1758-2652-11-1-P277 J Grebely1, L Gallagher2, E Knight2, K Genoway2, M Storms3, HK Tossonian3, M Hosseina3, G Showler4, JD Raffa5, C Fraser4, F Duncan6 and B Conway3 Switching nucleosides in an effective HAART regimen to TDF in preparation for HCV treatment to address potential ribavirin/nucleoside interactions is a safe intervention not associated with loss of virologic or immunologic efficacy of the regimen. |
| P278 | EFFICACY OF SHORTER DURATION HCV TREATMENT IN INJECTION DRUG USERS (IDUS) J Int AIDS Soc 2008, 11(Suppl 1):P278 doi:10.1186/1758-2652-11-1-P278 A Barrieshee and B Conway Shorter duration of treatment of HCV can be successful in IDUs, particularly if the infection is with HCV genotype 2/3 and an RVR can be documented. Although the shorter duration of therapy cannot yet be recommended as a standard of care, these data may help inform therapeutic decisions in the face of inevitable premature discontinuation of therapy. |
| P279 | HEPATITIS B VIRUS (HBV) GENOTYPE DISTRIBUTION AND LAMIVUDINE-RESISTANT MUTATIONS IN HIV/HBV CO-INFECTED PATIENTS ATTENDING A PARISIAN HOSPITAL J Int AIDS Soc 2008, 11(Suppl 1):P279 doi:10.1186/1758-2652-11-1-P279 N Schnepf1, C Lafuente-Lafuente2, I Jarrin2, G Simoneau2, JD Magnier2, A Trylesinski3, P Sellier2 and MC Mazeron2 The two groups of co-infected patients differed in the ratio of males to females, the route of transmission and the predominant HBV genotype. Patients in Group 2 had lower HBV viral load and were more often HBeAg-negative. Neither HBV genotype nor geographical origin were statistically associated with advanced liver disease. |
| P280 | J Int AIDS Soc 2008, 11(Suppl 1):P280 doi:10.1186/1758-2652-11-S1-P280 Abstract withdrawn |
| P281 | J Int AIDS Soc 2008, 11(Suppl 1):P281 doi:10.1186/1758-2652-11-1-P281 Abstract withdrawn |
| P282 | HEPATIC TOLERABILITY OF FOSAMPRENAVIR/RITONAVIR (FPV/RTV) IN HIV/HEPATITIS C CO-INFECTED SUBJECTS WITH SEVERE HEPATIC FIBROSIS J Int AIDS Soc 2008, 11(Suppl 1):P282 doi:10.1186/1758-2652-11-1-P282 P Nasta, F Gatti, G Cologni, A Matti, M Monia and G Carosi In HIV/HCV co-infected patients, LEE is frequent and it is related with liver disease progression and death. In co-infected subjects FPV/rtv at standard dose represents a safe opportunity also in cirrhotic patients. |
| P283 | TREATMENT OUTCOME OF CHRONIC HEPATITIS C IN HIV-INFECTED PATIENTS AT THE INSTITUTE OF TROPICAL MEDICINE, ANTWERP, BELGIUM, FROM 2000 TO 2008 J Int AIDS Soc 2008, 11(Suppl 1):P283 doi:10.1186/1758-2652-11-1-P283 E Bottieau, E Florence, M De Boer, E Vlieghe, R Demeester, M Vekemans, F Moerman, L Lynen, S Francque and P Michielsen Management of HCV/HIV co-infection was extremely complex even in our highly specialized setting. In addition, the response rate to HCV therapy was disappointingly low in comparison with published trials. Better therapies are urgently needed, especially for HCV genotypes 1 and 4. |
| P284 | OUTCOME OF CHRONIC HEPATITIS DELTA IN PATIENTS WITH AND WITHOUT HIV INFECTION IN THE HAART ERA J Int AIDS Soc 2008, 11(Suppl 1):P284 doi:10.1186/1758-2652-11-1-P284 P Tuma, E Vispo, P Barreiro, A Madejon, J Medrano, R Romero, M Bottecchia, J García-Samaniego and V Soriano The prognosis of chronic hepatitis delta seems to be worst in HIV-negative individuals than in HIV co-infected patients on antiretroviral therapy. Inhibition of HBV replication by using tenofovir might indirectly ameliorate delta pathogenicity. |
| P285 | HCV GENOTYPES DISTRIBUTION IN THE NIZHNY NOVGOROD AREA HIV-POSITIVE POPULATION J Int AIDS Soc 2008, 11(Suppl 1):P285 doi:10.1186/1758-2652-11-1-P285 S Minaeva, G Moshkovich, E Tikhonova and O Sandova In the Nizhny Novgorod area, a distribution of HCV genotypes among HIV-infected individuals was observed with a higher prevalence of genotype 3a (43.9%) by comparison with the population of Russia (10.5%). As has been shown in previous research, HCV genotype 3a is a favorable prognostic factor for achieving in most cases a sustained virologic response. Our findings have potential implications for appropriate patient selection for HCV treatment, as individuals carrying this genotype are more likely to respond to therapy. |
| P286 | THROMBOPENIA AND/OR SPLENOMEGALY IN HIV/HCV CO-INFECTED PATIENTS WITH MILD LIVER FIBROSIS ALERTS FOR THE RISK OF PORTAL HEPATOPATHY J Int AIDS Soc 2008, 11(Suppl 1):P286 doi:10.1186/1758-2652-11-1-P286 E Vispo, I Maida, P Barreiro, V Moreno and V Soriano Primary hepatic vascular damage induced by didanosine might result in non-cirrhotic portal hypertension. This condition may appear in HIV patients without any known cause of liver disease, as well as superimposed to other hepatic illnesses, as chronic hepatitis C. The recognition of clinical classical signs of portal hypertension (e.g. thrombopenia, splenomegaly) in the absence of a significant liver fibrosis or synthetic function compromise may alert to the possibility of this condition. |
| P287 | INCREASED RIBAVIRIN DOSE IN HIV/HCV CO-INFECTED PATIENTS LEADS TO INCREASED SERUM CONCENTRATION OF RIBAVIRIN J Int AIDS Soc 2008, 11(Suppl 1):P287 doi:10.1186/1758-2652-11-1-P287 F Almasi, G Spiridon, V Jullien, JF Merritet, P Sogni and D Salmon Ribavirin in combination with pegylated interfreon alpha 2a is the standard treatment for chronic HCV hepatitis. Body weight and/or HCV genotype are factors which determine ribavirin dosage. Ribavirin's side-effects, especially anemia, are negatively related to its serum concentration and its efficacy is positively related to serum concentration, respectively. |
| P288 | PREDICTORS OF IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME ASSOCIATED WITH KAPOSI SARCOMA (IRIS-KS) IN A RURAL AREA OF MOZAMBIQUE J Int AIDS Soc 2008, 11(Suppl 1):P288 doi:10.1186/1758-2652-11-1-P288 E Letang1, J Almeida2, E Ayala1, JM Miro3, C Carrilho4, R Bastos5, D Nhassone6, J Gascon1, C Menendez1, PL Alonso1 and D Naniche1 In this cohort of antiretroviral-naïve HIV and HHV-8 co-infected African patients, IRIS-KS was observed in 11.6% of patients. A plasma HIV-1 RNA viral load > 5 log10 copies/mL, a BMI < 18.5, and the presence of KS at baseline were independent predictors of IRIS-KS. Close clinical supervision is warranted for these patients. |
| P289 | IMPACT OF HIV TREATMENT ON CLEARANCE OF HUMAN PAPILLOMAVIRUS (HPV) INFECTION IN HIV-INFECTED WOMEN J Int AIDS Soc 2008, 11(Suppl 1):P289 doi:10.1186/1758-2652-11-1-P289 D Konopnicki, Y Manigart, R Scheen, M Delforge, P Barlow, S De Wit and N Clumeck Cervical infection with oncogenic HPV remains a significant problem in HIV-infected women in the HAART era. Whether this will induce an increase of cervical cancer incidence in aging cohorts of HIV+ women remains unknown. As previously described, CD4 level is significantly associated with the risk of presence of oncogenic HPV. Long-term impact of HAART on the natural history of oncogenic HPV deserves further evaluation. |
| P290 | RITUXIMAB AND CASTLEMAN DISEASE AND KAPOSI'S SARCOMA J Int AIDS Soc 2008, 11(Suppl 1):P290 doi:10.1186/1758-2652-11-S1-P290 J Lobo, C Gallo, M R-Junquera, V Carcaba, J A-Megido, S Santos, A G-Franco and I Suarez Castleman disease was initially described as benign localized lymph nodes found primarily in the mediastinum of asymptomatic patients; additional types were recognized that extend the spectrum of this heterogeneous group of diseases. Optimal standard therapies have not been established. Rituximab is an anti-CD20 monoclonal antibody that has demonstrated efficacy in patients with various lymphoid malignancies. It is an unusual complication in patients with HIV-1 and HHV-8 infection, but it should be included in the differential diagnosis of patients who exhibit a relapsing systemic inflammatory syndrome and lymphoadenopathy. |
| P291 | THE USE OF ENFUVIRTIDE-BASED HAART REGIMENS IN HIV PATIENTS UNDERGOING CHEMOTHERAPY FOR LYMPHOMA J Int AIDS Soc 2008, 11(Suppl 1):P291 doi:10.1186/1758-2652-11-S1-1-P291 BA White1, R Fox1, J Laird2, A Seaton1 and A MacConnachie1 To evaluate the use of enfuvirtidebased HAART regimens in patients receiving chemotherapy for lymphoma, where the concomitant use of antineoplastic agents with PI- or NNRTI-based regimens is difficult due to P450 enzyme and p-glycoprotein induction and inhibition. |
| P292 | FACTORS ASSOCIATED WITH ANXIETY, DEPRESSION AND COGNITIVE IMPAIRMENT IN ELDERLY PATIENTS RECEIVING HAART J Int AIDS Soc 2008, 11(Suppl 1):P292 doi:10.1186/1758-2652-11-S1-1-P292 G Liuzzi, S Menichetti, R Libertone, MF Salvatori, P Balestra, R Bellagamba, A Antinori and V Tozzi Anxiety and depression were reported in nearly two-thirds of patients aged >50 years. Anxiety was associated with low CD4 cell count. Cognitive impairment was present in almost 50% of patients aged >50 years. Cognitive decline increased with increasing age. By contrast, anxiety and depression did not influence cognitive performance. Anxiety and depression were less common in EFV-treated patients, suggesting a prescription bias. Physicians must be aware of the high prevalence of psychiatric and cognitive disturbances in HIV patients aged >50 years. |
| P293 | VARICELLA VACCINATION IN HIV-POSITIVE INDIVIDUALS - A TIME TO ACT J Int AIDS Soc 2008, 11(Suppl 1):P293 doi:10.1186/1758-2652-11-S1-1-P293 E de Barra, C Rock, B Kiely, C McNally, F Lyons and C Bergin Primary varicella infection in the HIV-positive population poses a credible threat. Our review of VZV immune status in a cohort of HIV-positive patients identifies the SSA population is a particular "at risk" group. Current guidelines advise that non-immune patients with CD4 counts >200 can be vaccinated, whereas those with CD4 counts <200 should have their household contacts vaccinated. The non-immune patients who had CD4>200 were offered vaccination. Educating patients re household contact vaccination is difficult in this population. Inclusion of VZV in the universal childhood vaccination schedule would help in this regard. We are presently assessing all patients with regard to requirement for VZV vaccination, with particular focus on those who migrated from SSA prior to 2002. |
| P294 | HPV INFECTION IN HIV-POSITIVE SUBJECTS AND MOLECULAR EPIDEMIOLOGY J Int AIDS Soc 2008, 11(Suppl 1):P294 doi:10.1186/1758-2652-11-S1-1-P294 K Protopas1, S Tsiodras2, K Chranioti2, A Papadopoulos2, P Panagopoulos2, J Georgoulakis2, A Antoniadou2, V Sakka2, L Galani2, D Kavatha2, G Poulakou2, A Spathis2, I Katsarolis2, I Karaiskos2, J Panagiotidis2, P Karakitsos2 and HG Giamarellou2 HPV infection was prevalent in this patient cohort and was associated with the number of sexual partners, lower CD4 counts and the development of cytopathological changes. HPV infection may be better controlled in HIV pts at a better immunological state. Prospective follow-up of HIV pts with HPV is necessary for the prevention of peri-anal malignancies. |
| P295 | GBV-C/HIV CO-INFECTED PATIENTS FROM AIDS CENTER PRAGUE HAVE HIGHER CD4 CELL COUNTS AND PROBABLY BETTER QUALITY OF LIFE J Int AIDS Soc 2008, 11(Suppl 1):P295 doi:10.1186/1758-2652-11-S1-1-P295 V Aster1, J Konig2, H Rozsypal1, L Machala3, O Urbankova4 and M Stankova1 No relationship between HGV infection and HIV viral load was observed. Patients with present or past HGV infection had higher CD4 count. This relation was more apparent in patients without HAART therapy. Our results are comparable with results of other studies, showing beneficial effect of HGV infection on CD4 count in HIV-infected patients. On QoL, there is a trend showing that HGV co-infected patients tend to experience better quality of life measured by SEIQoL and LSQ than those without HGV co-infection. |
| P296 | HOSPITAL ADMISSIONS AND ASSOCIATED DIAGNOSIS OF HIV PATIENTS IN THE HAART ERA J Int AIDS Soc 2008, 11(Suppl 1):P296 doi:10.1186/1758-2652-11-S1-1-P296 A Prisca, C Caldas, S Xerinda, D Ferreira, R Coelho, S Cardoso, S Rocha, A Ferreira, R Marques and A Sarmento The majority (75%) of the patients who needed hospitalization had no/poor adherence to their HAART regimen and/or outpatient clinic appointments. The finding that 6.7% of the admissions were new HIV-diagnosed patients, most of them presenting with an AIDS-defining disease, is evidence of the significant proportion of late presenters in our clinic. |
| P297 | CHANGES IN CCR5+ CELLS AND ANTIGEN-SPECIFIC CD4+ T-CELLS DURING MONOTHERAPY WITH A CCR5 ANTAGONIST SCH532706 COMPARED WITH COMBINATION THERAPY J Int AIDS Soc 2008, 11(Suppl 1):P297 doi:10.1186/1758-2652-11-S1-1-P297 SL Pett1, J Zaunders2, M Bailey2, DA Cooper3, K MacRae4, S Emery5 and A Kelleher1 CD4+ T-cell increases were modest on SCH532706/r and cART. CCR5+CD8+ T-cells and PDC increased substantially during receipt of the CCR5-antagonist, but not cART, suggesting alterations in trafficking due to CCR5 blockade. Declines in CMV, HSV and HIV Gag responses were equivalent during receipt of SCH523706/r and subsequent cART. |
| P298 | RESULTS OF A PHASE I STUDY TO EVALUATE THE SAFETY, TOLERABILITY, PHARMACOKINETICS (WITH AND WITHOUT RITONAVIR) AND FOOD-EFFECT OF VCH-286 J Int AIDS Soc 2008, 11(Suppl 1):P298 doi:10.1186/1758-2652-11-S1-1-P298 L Proulx, N Chauret, P Clermont, J Laterreur and R Thibert VCH-286 was safe and well tolerated up to 800 mg as a single oral dose. Food did not influence the PK profile at a 400 mg dose. These results supported the initiation of a multiple-dose 14-day study in HIV-1 infected subjects. |
| P299 | WHAT ABOUT PRIMARY PULMONARY HYPERTENSION IN HIV INFECTION IN THE ERA OF COMBINATION ANTIRETROVIRAL THERAPY? J Int AIDS Soc 2008, 11(Suppl 1):P299 doi:10.1186/1758-2652-11-S1-1-P299 M Mary-Krause1, C Lascoux-Combe2, A Simon3, E Teicher4, D Costagliola1 and the FHDH-ANRS 04 Our results are consistent with the assumption that the HIV is a risk factor of PPH occurrence, and that PPH is related to a high degree of immunosupression. Nevertheless, even among patients with more than 500 CD4/mm3, the risk of PPH is higher than in the general population. Although PPH may be under-reported in the database, there is no reason to believe that the rate of under-notification varied over time or with risk factors of PPH, therefore, the increased risk we observed could be under estimated in our study, while we are confident in the risk factors evidenced. Active surveillance for PPH should be considered for patients with low CD4 cell count and clinical symptoms such as cough. |
| P300 | AGE-RELATED CO-MORBIDITIES IN PEOPLE LIVING WITH HIV J Int AIDS Soc 2008, 11(Suppl 1):P300 doi:10.1186/1758-2652-11-S1-S1-P300 G Guaraldi1, S Zona1, G Orlando1, N Squillace1, C Stentarelli1, G Nardini1, B Beghetto1, R Esposito1 and FJ Palella2 Metabolic, cardiovascular, endocrine, hepatic and kidney disease are age-associated conditions highly prevalent in people living with HIV. Multiple co-morbidities increase with age and witness the multidisciplinary care needs of the HIV aging population. |
| P301 | DO CEREBRAL FUNCTION TEST RESULTS CORRELATE WHEN MEASURED BY A COMPUTERISED BATTERY TEST AND A MEMORY QUESTIONNAIRE IN HIV-1 INFECTED SUBJECTS? J Int AIDS Soc 2008, 11(Suppl 1):P301 doi:10.1186/1758-2652-11-S1-1-P301 LJ Garvey, D Yerrakalva and A Winston The PRMQ is not a good screening tool for NCI in HIV-1 infected subjects. However, the PRMQ did demonstrate correlation between identification of memory and learning deficits, when compared to the computerised battery test, and identified individuals with MI at similar rates to population data. We may thus be observing two distinct processes; HIV-related NCI and early stages of cortical memory loss with both tools having different utilities in future clinical practice. |
| P302 | SEXUAL DYSFUNCTION IN HIV-INFECTED WOMEN: PREVALENCE AND RELATED FACTORS J Int AIDS Soc 2008, 11(Suppl 1):P302 doi:10.1186/1758-2652-11-S1-1-P302 AM Guelar, J Villar, ML Sorlí, M Velat, O Urbina, A Gonzalez and H Knobel High prevalence of sexual dysfunction was detected in HIV-infected women. Usually this begins after HIV diagnosis; it is very rarely referred spontaneously. It is related to low CD4 cell count; low education level; the absence of stable relationship; menopause; and psychological disturbances. |
| P303 | INCREASED RISK FOR ACUTE HIV INFECTION FROM NONULCERATIVE STI'S IN MSM: AGGRESSIVE STI ERADICATION PROGRAMS NEEDED FOR REDUCTION IN HIV INCIDENCE J Int AIDS Soc 2008, 11(Suppl 1):P303 doi:10.1186/1758-2652-11-S1-1-P303 RK Bolan1, SD Tilekar1, E Clay1, A Uniyal2, M Chein2, PR Kerndt2 and JD Scott3 When acute HIV and an STI are co-infections, presenting signs/symptoms are more likely due to the STI than HIV, although non-specific symptoms consistent with Acute HIV Infection Syndrome can occur. Pharyngeal gonorrhea was often symptomatic in the setting of acute HIV. All at-risk anatomical sites should be tested for STIs. A high proportion of acute HIV infections in this MSM population are attributable to nonulcerative STIs. Pooled NAATs for HIV and STI testing provide an opportunity for early HIV detection and STI treatment. For the HIV-negative individual, screening and treatment of STIs is crucial for HIV prevention. For the HIV-infected individual, the screening and treatment strategy will reduce further spread of HIV and STIs. |
| P304 | DISTRIBUTION OF AUTOANTIBODIES AND RHEUMATOLOGICAL MANIFESTATIONS IN HIV-POSITIVE PATIENTS FROM THE UNIVERSITY CLINIC OF BONN – A PILOT STUDY J Int AIDS Soc 2008, 11(Suppl 1):P304 doi:10.1186/1758-2652-11-S1-1-P304 EA Becker, JC Wasmuth, E Voigt, C Schwarze-Zander, J Emmelkamp and J Rockstroh The presence of joint or muscle pain was high with 32.81% expressing corresponding complaints. Also, the prevalence of autoantibodies was higher than in the general population with 18.97%. In this small group of patients, however, no correlation was found between HIV disease stage markers and the occurrence of rheumatological disease manifestations or presence of autoantibodies. |
| P305 | PERCEPTIONS OF OBESITY AMONGST A MIXED HIV COHORT IN LONDON, UK &NDASH; SLIM IS NO LONGER SLIM J Int AIDS Soc 2008, 11(Suppl 1):P305 doi:10.1186/1758-2652-11-S1-1-P305 CS Bradbeer1 and MS Abu Bakar2 This study highlights a high prevalence of overweight individuals living with HIV/AIDS, especially among Black African/Caribbeans, who were often unaware they had a weight problem. Obesity is multifactorial and it is likely that the association of HIV infection and being 'slim' creates a social pressure towards obesity. A multidisciplinary effort (e.g. dietician, physiotherapist) should focus on changing the currently accepted larger body size among this cohort. Overweight and obese patients should be told about their health risk and encouraged to lose weight. |
| P306 | NRTI BACKBONE PAIRS FOR TREATMENT-NAÏVE ADULTS WITH HIV INFECTION: A UK ECONOMIC EVALUATION J Int AIDS Soc 2008, 11(Suppl 1):P306 doi:10.1186/1758-2652-11-S1-1-P306 AJ Brogan1, F Everhard2, SE Talbird1, E Hutt3 and E Zimovetz4 TDF/FTC was predicted to be both more effective and cost saving compared with ABC/3TC and to be cost-effective, using a threshold of £20,000 per QALY gained, compared with ZDV/3TC in treatment-naïve adults with HIV infection in the UK. In addition, TDF/FTC offers convenient, once-daily dosing. Results were driven by better efficacy and tolerability of TDF/FTC compared with the other NRTI pairs. |
| P307 | COST-EFFECTIVENESS OF SWITCHING TO SECOND-LINE THERAPY WITH LOPINAVIR/RITONAVIR IN AFRICA: ESTIMATES BASED ON DART TRIAL RESULTS AND COSTS FOR UGANDA J Int AIDS Soc 2008, 11(Suppl 1):P307 doi:10.1186/1758-2652-11-S1-1-P307 KN Simpson1, B Dietz2, SX Rahim3 and R Rajagopalan3 Under the WHO benchmark for cost-effective ICERs based on two times a country's per capita GDP, with Uganda's 2007 GDP of $1,100 (International Monetary Fund) a switch to a LPV/r regimen using stringent clinical or immunological failure criteria appears to be quite cost-effective for a country such as Uganda. |
| P308 | 96 WEEKS PHARMACOECONOMIC OUTCOME OF LOPINAVIR/R MONOTHERAPY AS MAINTENANCE STRATEGY IN HIV+ PATIENTS WITH SUPPRESSED VIRAL LOAD. OK04-PHARMECO ANALYSIS J Int AIDS Soc 2008, 11(Suppl 1):P308 doi:10.1186/1758-2652-11-S1-1-P308 JR Arribas1, F Pulido2, I Méndez3, P Lázaro3, M Norton4, E Cabrero5 and A Burgos5 LPV/r MT (including re-introduction of nucleosides as needed) is an efficient option for maintenance therapy in HIV-infected patients when compared with LPV/r T. This may become a breakthrough treatment decision criterion in current health saving costs environment. |
| P309 | COST-EFFECTIVENESS OF TENOFOVIR/EMTRICITABINE COMPARED WITH OTHER NRTI PAIRS IN TREATMENT-NAÏVE ADULTS WITH HIV INFECTION IN THE USA J Int AIDS Soc 2008, 11(Suppl 1):P309 doi:10.1186/1758-2652-11-S1-1-P309 AJ Brogan1, F Everhard2, SE Talbird1 and E Hutt3 TDF/FTC was predicted to be both more effective and cost saving compared with ZDV/3TC and ABC/ 3TC in treatment-naïve adults with HIV infection in the US. Cost savings were largely due to avoidance of more expensive subsequent lines of therapy and lower costs associated with adverse events and disease-related resource use. Results were robust to parameter uncertainty and modeling assumptions. |
| P310 | AN ECONOMIC EVALUATION OF USING RALTEGRAVIR IN TREATMENT-EXPERIENCED HIV-1 INFECTED PATIENTS IN THE UK J Int AIDS Soc 2008, 11(Suppl 1):P310 doi:10.1186/1758-2652-11-S1-S1-P310 E Elbasha1, W Dunlop2, MA Chaudhary1 and RN Kumar3 Raltegravir is the first in the new class of integrase inhibitors. In treatment-experienced patients with advanced HIV disease, raltegravir in combination with optimized background therapy (OBT) showed superior efficacy compared with placebo with OBT at week 16, 24, and 48. This research focuses on the cost-effectiveness of raltegravir from the National Health Service (NHS) perspective. |
| P311 | COST-EFFECTIVENESS AND BUDGET IMPACT OF LOPINAVIR/RITONAVIR AND ATAZANAVIR PLUS RITONAVIR REGIMENS BASED ON 48-WEEK RESULTS FROM THE CASTLE STUDY J Int AIDS Soc 2008, 11(Suppl 1):P311 doi:10.1186/1758-2652-11-S1-1-P311 KN Simpson1, R Rajagopalan2 and B Dietz3 The use of an ATV+RTV-based regimen in ARVnaïve patients with a CHD risk similar to patients in the CASTLE study is not a cost-effective use of scarce resources. The very small added CHD risk incurred by LPV/r treatment is more than offset by its short- and long-term cost savings. |
| P312 | ECONOMIC MODELING OF THE COMBINED EFFECTS OF HIV DISEASE, HEART DISEASE AND LIPOATROPHY BASED ON ACTG 5142 TRIAL DATA J Int AIDS Soc 2008, 11(Suppl 1):P312 doi:10.1186/1758-2652-11-S1-1-P312 KN Simpson1, R Rajagopalan2, B Dietz3, K Garren4, S Riddler5 and R Haubrich6 Initiating an LPV/r-containing regimen on ARV-naïve patients appears cost-effective compared to an EFV-based regimen, when the cost and consequences of lipoatrophy are included. |
| P313 | COST-EFFECTIVENESS OF DRV/R 600/100 MG BID IN TREATMENT-EXPERIENCED, LPV/R-NAÏVE, PI-RESISTANT, HIV-INFECTED ADULTS IN THE UK, BELGIUM, ITALY AND SWEDEN J Int AIDS Soc 2008, 11(Suppl 1):P313 doi:10.1186/1758-2652-11-S1-1-P313 K Moeremans1, LC Hemmett2, J Hjelmgren3, G Allegri4 and E Smets5 From the British, Swedish, Italian and Belgian payer perspective, DRV/r 600/100 mg BID is predicted to be cost-effective vs. LPV/r in the management of LPV/r-naïve, PI-resistant, HIV-infected adults with a broad range of prior PI use/failure. |
| P314 | COST-EFFECTIVENESS ANALYSIS OF HLA-B*5701 SCREENING IN PREVENTING ABACAVIR HYPERSENSITIVITY IN SPAIN J Int AIDS Soc 2008, 11(Suppl 1):P314 doi:10.1186/1758-2652-11-S1-1-P314 D Nieves1, O de la Calle2, JA Iribarren3, A Rivero4, L García-Bujalance5, I Pérez-Escolano5 and M Brosa1 Systematic HLA-B*5701 screening prior to abacavir prescription in HIV patients is associated with a limited additional cost that could be offset by its benefits in terms of lower HSR incidence. |
| P315 | A COST-EFFECTIVENESS ANALYSIS OF MARAVIROC IN TREATMENT-EXPERIENCED HIV PATIENTS IN SCOTLAND J Int AIDS Soc 2008, 11(Suppl 1):P315 doi:10.1186/1758-2652-11-S1-1-P315 I Lekander1, J Berg1, A Christie2, C Leen3 and M Nelson4 The results indicated that it is potentially costeffective to treat patients with MVC compared to standard OBT treatment in highly treatment-experienced HIV patients in Scotland. |
| P316 | COST-MINIMISATION ANALYSIS OF THE USE OF ETRAVIRINE OR RALTEGRAVIR IN TREATMENT-EXPERIENCED HIV-1-INFECTED PATIENTS J Int AIDS Soc 2008, 11(Suppl 1):P316 doi:10.1186/1758-2652-11-S1-1-P316 S Martin and E Smets Both ETR and RAL showed similar efficacy rates in achieving undetectable VL. As a result, a cost-minimisation approach can be taken when evaluating the addition of ETR or RAL to a HAART regimen for treatment-experienced HIV-1- infected patients. |
| P317 | NON-NUCLEOSIDE-BASED ANTIRETROVIRAL REGIMENS ARE MOST DURABLE AND COST-EFFECTIVE AS FIRST TREATMENTS IN AN URBAN SETTING FROM A DEVELOPING COUNTRY J Int AIDS Soc 2008, 11(Suppl 1):P317 doi:10.1186/1758-2652-11-S1-1-P317 E Bissio and GD Lopardo In this population, patients starting with a NNbased regimen show a low rate of treatment change or discontinuation. This regimens proved to be durable and effective (even in patients starting with high viral loads or low CD4 counts), and have the advantage to be much cheaper than PI-based regimens, a key issue in developing countries. Toxicity is by far the most cause common for first treatment discontinuation. |
| P318 | COST CONSEQUENCES OF HIV-ASSOCIATED LIPOATROPHY J Int AIDS Soc 2008, 11(Suppl 1):P318 doi:10.1186/1758-2652-11-S1-1-P318 J Hornberger1, R Rajagopalan2, A Shewade1 and M Loutfy3 HIV-associated lipoatrophy may affect up to 35% of patients who have received antiretroviral therapy for more than one year, and results in depression, social isolation, and career barriers. Interventions, such as dermal fillers, are licensed for restoration of facial fat loss in persons living with HIV. As only few insurance plans, if any, provide reimbursement for such procedures, patients must consider the pros and cons of such interventions, weighing these against the other costs of daily life. The primary goal of this study is to provide reliable estimates of the costs of treating HIV-associated lipoatrophy, specifically facial lipoatrophy. |