7th Annual Conference of the British HIV Association 27 – 29 April 2001, The Hove Centre, Brighton

Oral Abstracts
O1	CD4 CELL RESPONSE FOLLOWING HAART INITIATED AT DIFFERENT TIMES FROM HIV SEROCONVERSION BHIVA Conf 2001 Apr 27-29;7:O1 K Porter, on behalf of CASCADE collaboration Our results suggest that a CD4 rise of at least 100 cells/µl can be achieved within 6 months of starting potent antiretroviral therapy regardless of how long after infection it is initiated. Long-term follow-up is required to assess more durable response. Download Abstract Book 2001
O2	BELIEFS ABOUT HIV AND HAART AND THE DECISION TO ACCEPT OR REJECT HAART BHIVA Conf 2001 Apr 27-29;7:O2 R Horne1, V Cooper1, M Fisher2, D Buick1 This study has identified the types of beliefs that influence the decision to decline or accept HAART. The study is ongoing, but these preliminary findings have implications for the type of support offered to people who are faced with decisions about HAART. Download Abstract Book 2001
O3	COMPARISON OF FIRST-LINE ANTIRETROVIRAL THERAPY SUCCESS IN A COHORT ANALYSIS OF OVER 1000 PATIENTS (PROTEASE INHIBITOR VS NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR) BHIVA Conf 2001 Apr 27-29;7:O3 GV Matthews1, CA Sabin2, S Mandalia1, AN Phillips2, MR Nelson1, M Bower1, F Lampe2, MA Johnson2, BG Gazzard1 This large treatment-naïve cohort analysis suggests that EFV may be associated with a better initial virological response at 6 months than either PIs or NVP, both of which had similar responses. Download Abstract Book 2001
O4	SHORT-COURSE HAART IN PRIMARY HIV INFECTION (PHI) BHIVA Conf 2001 Apr 27-29;7:O4 S Fidler, M Brady, A Oxenius, D Price, R Phillips, JN Weber Short-course HAART at PHI preserves HIV-specific CD4 T-cell responses and is associated with good long-term virological control. Download Abstract Book 2001
O5	RESPONSE TO AMPRENAVIR IN ANTIRETROVIRAL THERAPY-EXPERIENCED PATIENTS BHIVA Conf 2001 Apr 27-29;7:O5 D Pillay1, CA Sabin2, on behalf of the Amprenavir Expanded Access Programme In a highly drug-experienced population with multiple drug resistance, APV-containing regimens can lead to short-term virological benefit in the majority of patients. Download Abstract Book 2001
O6	THE EFFICACY OF LOPINAVIR (ABT378) IN INDIVIDUALS EXPERIENCING PROTEASE INHIBITOR (PI) FAILURE BHIVA Conf 2001 Apr 27-29;7:O6 MR Nelson, Y Gilleece, NA Qazi, JM Morlese, S Mandalia, BG Gazzard, A Pozniak Despite extensive PI experience, patients treated with a regimen containing ABT378/r had very high levels of response, with 76% of individuals on treatment at 6 months experiencing a viral load <500 HIV-1 RNA copies/ml and 67% <50 copies/ml. Download Abstract Book 2001
O7	THE IMPACT OF BASELINE POLYMORPHISMS IN REVERSE TRANSCRIPTASE AND PROTEASE ON THE OUTCOME OF HAART IN HIV-1 INFECTED AFRICAN PATIENTS BHIVA Conf 2001 Apr 27-29;7:O7 AJ Frater1, A Beardall1, K Ariyoshi2, D Churchill1, S Galpin1, JR Clarke1, MO McClure1, JN Weber1 The response of patients infected with African subtypes of HIV-1 to HAART appears to be independent of regimen, clade and baseline polymorphisms. Non-B subtypes are fully sensitive to HAART, and accordingly, therapy should not be withheld from African patients for reasons of viral diversity. Download Abstract Book 2001
O8	RESISTANCE-ASSOCIATED MUTATIONS IN SUBTYPE C HIV-1 PROTEASE FROM PROTEASE INHIBITOR (PI)-EXPERIENCED AND -NAÏVE PATIENTS IN UK BHIVA Conf 2001 Apr 27-29;7:O8 P Cane1, A de Ruiter2, L Navaratne2, P Rice3, M Wiselka4, R Fox5, D Pillay1 The spectrum and prevalence of PI-associated resistance mutations differed between subtype B and C viruses. Genotypic resistance data from non-B viruses should be interpreted carefully. Download Abstract Book 2001
O9	TRANSMISSION OF HIV-1 INFECTION IN THE UK: THE USE OF PHYLOGENETIC ANALYSIS TO DEMONSTRATE RELATEDNESS BETWEEN VIRUSES FROM SOURCE AND INDEX INDIVIDUALS BHIVA Conf 2001 Apr 27-29;7:O9 S Taylor1,5, J Workman1, P Cane1, D Ratcliff1, R Hextall2, J Clarke3, R Nandwani4, S Drake5 and D Pillay1 Molecular epidemiological techniques provide a powerful tool to explore the HIV epidemic, and demonstrates the complexity in determining transmission events between individuals. Download Abstract Book 2001
O10	PATTERNS OF NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR (NNRTI) GENOTYPIC AND PHENOTYPIC RESISTANCE IN PATIENTS INFECTED WITH EITHER B OR NON-B HIV-1 SUBTYPES AND FAILING THERAPY WITH TWO NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIS) AND NEVIRAPINE (NVP) BHIVA Conf 2001 Apr 27-29;7:O10 AM Geretti1,2, M Smith2, N Osner2, BA Larder3, M Zuckerman2, PJ Easterbrook1 Y181C was more prevalent than K103N for non-B. ZDV+NVP did not favour the emergence of K103N over Y181C. Download Abstract Book 2001
O11	GENOTYPIC DRUG-RESISTANCE TESTING AFTER ZIDOVUDINE (ZDV) MONOTHERAPY TO REDUCE MOTHER-TO-CHILD TRANSMISSION (MCT) BHIVA Conf 2001 Apr 27-29;7:O11 N Larbalestier, J Mullen, S. O'Shea, F Cottam, I Chrystie, A de Ruiter The development of drug resistance in this cohort appears uncommon. The only primary mutation evident occurred in a woman whose baseline VL was high and who, with current guidelines, would now receive highly active antiretroviral therapy. Monotherapy is an attractive intervention to reduce MCT as it limits fetal drug exposure and is well tolerated. In this cohort of asymptomatic women with low VL, future treatment options seem preserved. Download Abstract Book 2001
O12	MISSED OPPORTUNITIES: LATE PRESENTATION OR DELAYED RECOGNITION OF HIV INFECTION BHIVA Conf 2001 Apr 27-29;7:O12 N Baxter2, B Moran2, J Welsh2, DR Churchill2, M Fisher2 A high proportion of avoidable deaths were due to late recognition of HIV infection. There is clearly a role for increased education of non-HIV specialists about HIV infection. Download Abstract Book 2001
O13	CHANGING DEMOGRAPHICS OF NEW HIV DIAGNOSES AT THE ROYAL FREE HOSPITAL FROM 1994 TO 2000 BHIVA Conf 2001 Apr 27-29;7:O13 SM Barry, S Madge, S Lloyd-Owen, A Cozzi-Lepri, A Evans and MA Johnson There has been a substantial drop in new HIV diagnoses among white patients (mainly gay men) and a rise in the number of black Africans at this institution from 1994 to 2000. By 2000, white patients were presenting later than blacks with a similar disease stage. Download Abstract Book 2001
O14	HIV ANTIBODY TESTING BHIVA Conf 2001 Apr 27-29;7:O14 AJ Palfreeman, K Sivakumar HIV is now a treatable condition and this study has shown that uptake of the test can be significantly raised in a way that is acceptable to patients and staff. Download Abstract Book 2001
O15	INCIDENCE OF HIV INFECTION AMONG GAY MEN SEEKING A REPEAT HIV TEST BHIVA Conf 2001 Apr 27-29;7:O15 J Elford1, S Leaity2, H Wells2, R Miller2, MA Johnson2, L Sherr1 In this London HIV-testing clinic, gay men with a history of three or more previous HIV tests reported an increased incidence of HIV infection. For some gay men, repeatedly receiving a negative HIV test result may produce a disinhibiting effect and reinforce high-risk sexual behaviour. Download Abstract Book 2001
O16	THE ROLE OF THE MULTIDRUG TRANSPORTER P GLYCOPROTEIN (P-GP) IN HIV DISEASE BHIVA Conf 2001 Apr 27-29;7:O16 M Hennessy1, K Motumise1, FM Mulcahy2, S Clarke2, C Bergin2, D Kelleher3, J Feely1, M Barry1 P-gp expression in HIV patients is inversely related to viral load independently of disease stage or treatment. P-gp was functional in all groups and inhibited by ritonavir. In vivo, P-gp appears important for immune reconstitution associated with adequate viral suppression. Download Abstract Book 2001
O17	CLINICAL IMPLICATIONS OF INTRACELLULAR PROTEASE INHIBITOR CONCENTRATIONS BHIVA Conf 2001 Apr 27-29;7:O17 M Hennessy1, M Barry1, S Clarke2, C Bergin2, S Khoo3, D Back3, FM Mulcahy2 For discordant patients, IC IDV concentrations may provide better correlation with virological response than plasma levels. All patients on NFV remained suppressed. This highlights marked differences between PIs with respect to IC accumulation and pharmacokinetic behaviour and has important implications for drug penetration into sanctuary sites and therapeutic drug monitoring. The correlation between plasma and IC AUC was r2= 0.6 (P<0.05), in contrast to NRTIs. Download Abstract Book 2001
O18	PENETRATION OF EFAVIRENZ INTO THE MALE GENITAL TRACT: DRUG CONCENTRATIONS AND ANTIVIRAL ACTIVITY IN SEMEN AND BLOOD PLASMA OF HIV-1 INFECTED MEN (THE TRIPLE S STUDY) BHIVA Conf 2001 Apr 27-29;7:O18 S Taylor1,2, H Reynolds3, CA Sabin4, S Drake2, DJ White2, D Back3 and D Pillay1 Standard EFV doses give greater than expected SP concentrations according to protein-binding considerations alone. These data suggest that EFV has antiviral activity in the male genital tract. Download Abstract Book 2001
O19	THE SERUM LEVEL OF SOLUBLE UPAR IS A STRONG PREDICTOR FOR DEVELOPMENT OF AIDS AND DEATH IN HIV INFECTED INDIVIDUALS BHIVA Conf 2001 Apr 27-29;7:O19 J Eugen-Olsen1, T Benfield1, J Gerstoft2, K Krogsgaard1, C Pedersen3, N Sidenius4 suPAR is a strong and independent prognostic factor for HIV disease progression. It is easy to measure and has the potential to be an important tool for determining when to initiate therapy in HIV infected individuals. Download Abstract Book 2001
O20	LACTIC ACIDOSIS AND HYPOGLYCAEMIA IN THREE NEONATES EXPOSED TO HAART IN UTERO BHIVA Conf 2001 Apr 27-29;7:O20 CJ Foster1, H Boix2, D Acolet2, G Tudor-Williams1, EGH Lyall1 Although we fully condone the use of antiretroviral therapy in pregnancy, these infants appeared to show acute mitochondrial toxicity, exacerbating neonatal stress. We suggest that all infants perinatally exposed to this therapy require early metabolic assessment. Download Abstract Book 2001
O21	SERUM MARKERS OF BONE TURNOVER AND SCREENING FOR ABNORMAL BONE MINERAL DENSITY (BMD) IN AN HIV-POSITIVE POPULATION BHIVA Conf 2001 Apr 27-29;7:O21 AL Moore1, A Vashist1, CA Sabin2, AN Phillips1, JWW Studd1, MA Johnson2 The predictive value of the combined marker test is such that we cannot accurately identify those at risk of abnormal BMD as determined by DEXA scan. These markers are more likely to be useful when used in conjunction with DEXA scans in longitudinal monitoring of bone turnover. Download Abstract Book 2001
O22	IMMUNOLOGICAL CHANGES DURING TREATMENT INTERRUPTIONS (TI): RISK FACTORS AND CLINICAL SEQUELAE BHIVA Conf 2001 Apr 27-29;7:O22 M Poulton1, CA Sabin2, M Fisher1 Treatment interruptions are accompanied by significant CD4 cell loss and associated disease progression. Individuals with lower nadir CD4 counts and more rapid CD4 cell loss prior to HAART are more at risk and should be fully informed of the potential risks of TIs. Download Abstract Book 2001
O23	ACUTE ONSET LACTIC ACIDOSIS AND PANCREATITIS IN THE THIRD TRIMESTER OF PREGNANCY AS A RESULT OF ANTIRETROVIRAL MEDICATION. BHIVA Conf 2001 Apr 27-29;7:O23 L Sarner, A Fakoya Studies show that late pregnancy may be associated with low riboflavin levels. This, in combination with mitochondrial toxicity, may precipitate sudden-onset severe lactic acidosis. Heightened awareness and further evaluation of risk factors and screening tools is required. Download Abstract Book 2001
O24	DIFFERENCES IN POSTPRANDIAL LIPID METABOLISM IN PATIENTS WITH PROTEASE INHIBITOR (PI)-ASSOCIATED AND NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR (NRTI)-ASSOCIATED LIPODYSTROPHY BHIVA Conf 2001 Apr 27-29;7:O24 L Ware1, JM Morlese2, G Burdge1, A Jackson1, BG Gazzard2, S Wootton1 While the PI-treated lipodystrophy group showed an increased retention time of dietary lipid within the circulation as lipoprotein TAG, the NRTI-treated lipodystrophy group showed an increased retention time of dietary lipid within the circulation as NEFA. These results suggest that there may be different effects of these two drug classes on lipid metabolism in vivo which may influence the development of the changes in body composition. Download Abstract Book 2001
O25	ETHNIC AND GENDER DIFFERENCES IN NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR (NNRTI)-INDUCED RASH BHIVA Conf 2001 Apr 27-29;7:O25 C Mazhude, S Jones, PJ Easterbrook, C Taylor The 7% incidence of rash in those starting NVP falls within ranges described previously. Female sex is strongly associated with a higher risk of NVP-induced rash. These data do not suggest a difference in the risk of NVP rash on the basis of black/white ethnicity. Download Abstract Book 2001
O26	HIV-1 SPECIFIC LYMPHOPROLIFERATIVE RESPONSES AND VIRAL BLIPS IN PATIENTS ON HAART RECEIVING INTERLEUKIN-2 THERAPY WITH OR WITHOUT REMUNE BHIVA Conf 2001 Apr 27-29;7:O26 AK Sullivan1, N Imami2, G Hardy2, C Burton2, A Pires2, MR Nelson1, R Moss3, FM Gotch2, BG Gazzard1 IL-2 therapy was associated with controlled viral blips and an increase in HIV-1 specific LPR in patients receiving HAART with or without Remune. There was a significant CD4 cell count rise but the VL remained BLD at 24 weeks. Download Abstract Book 2001
O27	SEMEN MITOCHONDRIAL DNA DAMAGE AS A MARKER OF NUCLEOSIDE ANALOGUE TOXICITY: THE EFFECT OF HAART ON SEMEN QUALITY OF HIV-1 INFECTED MEN BHIVA Conf 2001 Apr 27-29;7:O27 D Mital1, JC St John2, S Taylor1, MJ Tomlinson2 and DJ White1 Changes in semen quality can occur in patients commencing HAART and may be drug-specific. Semen mtDNA damage may be a marker of HAART-related toxicity such as lipodystrophy. Download Abstract Book 2001
O28	TAXOL CHEMOTHERAPY FOR ANTHRACYCLINE-REFRACTORY AIDS RELATED KAPOSI'S SARCOMA BHIVA Conf 2001 Apr 27-29;7:O28 M Bower1, T Powles1, A Mohith1, C Fletcher1, P Hewitt2, MR Nelson1, BG Gazzard1 The study was supported by Bristol-Myers Squibb Europe. Download Abstract Book 2001
O29	A PROSPECTIVE STUDY OF THE EFFECTS OF HAART ON KAPOSI'S SARCOMA (KS) AND HUMAN HERPESVIRUS 8 (HHV8) BHIVA Conf 2001 Apr 27-29;7:O29 J Gill1, D Bourboulia2, J Wilkinson1, A Cope2, S Mandalia1, A Marcelin3, V Calvez3, FM Gotch1, C Boshoff2, BG Gazzard1 HIV/HHV8 co-infected individuals have a fall in HHV8 viral load following HAART. Download Abstract Book 2001
O30	THREE-YEAR PROSPECTIVE STUDY: DISCONTINUATION OF MAINTENANCE THERAPY FOR CYTOMEGALOVIRUS RETINITIS IN AIDS PATIENTS ON HAART BHIVA Conf 2001 Apr 27-29;7:O30 AA Obi, BG Gazzard, SM Mitchell To our knowledge, this is the longest and largest study of discontinuation of anti-CMV maintenance therapy and supports previous reports suggesting that therapy can be safely stopped in selected patients responding to HAART. However, ophthalmic intervention remains important in view of the vision-threatening complications of previous CMVR. Download Abstract Book 2001
O31	THE IMPACT OF HIV INFECTION ON THE HEPATITIS B (HBV)-SPECIFIC CD8 RESPONSE IN HIV/HBV COINFECTED PATIENTS BHIVA Conf 2001 Apr 27-29;7:O31 RM Lascar1, RJC Gilson1, R Johnstone1, R Bertoletti2, MK Maini1 These data suggest impairment of the size, multispecificity and function of the HBV-specific CD8 response in HIV-infected patients. This impairment of the CD8 response to HBV could be due to impaired CD4 help. The impact of highly active antiretroviral therapy on HBV-specific immune responses will be analysed prospectively. Download Abstract Book 2001
O32	IMMUNE RESPONSES AND RECONSTITUTION IN HIV-1 INFECTED INDIVIDUALS: IMPACT OF ANTIRETROVIRAL THERAPY, CYTOKINES AND THERAPEUTIC VACCINES BHIVA Conf 2001 Apr 27-29;7:O32 FM Gotch1, N Imami1, G Hardy1, C Burton1, A Pires1, R Moss2, BG Gazzard1 Viral reservoirs in the latently infected resting CD4+ T cells, on follicular dendritic cells or infected thymic epithelium might be involved in clonal suppression/anergy, which present major obstacles to the maintenance of HIV-1 specific responses and to the eventual eradication of HIV-1. Download Abstract Book 2001
O33	IMMUNOTHERAPY IN THE HAART ERA: T-CELL RESPONSES AND RECONSTITUTION IN CHRONIC HIV-1 INFECTION BHIVA Conf 2001 Apr 27-29;7:O33 G Hardy1, N Imami1, AK Sullivan1, MR Nelson1, C Burton1, R Moss2, BG Gazzard1 and FM Gotch1 HIV-1 specific CD8 and CD4 T-cell responses are inducible in HAART-treated chronic HIV-1 infection by therapeutic vaccination and IL-2 therapy, or by interruption of HAART. Download Abstract Book 2001
O34	HIV-1 GAG P24-SPECIFIC T-HELPER CELL RESPONSES ASSOCIATED WITH CONTROL OF VIRAEMIA ARE NOT AFFECTED BY DIFFERENTIAL PRODUCTION OF INTERLEUKIN-4 (IL-4) BHIVA Conf 2001 Apr 27-29;7:O34 N Imami1, G Hardy1, BG Gazzard2, FM Gotch1 These findings suggest that strong type-1 virus-specific HTL and CTL responses, not affected by type 2 responses, are present in HIV-1 infected individuals whose viraemia is successfully controlled. Download Abstract Book 2001
O35	DURATION OF HIV-1 SPECIFIC PROLIFERATIVE AND INTERFERON (IFN)γ PRODUCING T-CELL RESPONSES DURING TREATMENT INTERRUPTION BHIVA Conf 2001 Apr 27-29;7:O35 C Burton1, P Hay2, BG Gazzard3, FM Gotch1, N Imami1 Patients may opt for structured TI, in an attempt to allow re-stimulation of immune responses to HIV-1 in the absence of drug toxicity. Our data suggest that longer cessation of HAART results in loss of regained HIV-1 specific responses. Download Abstract Book 2001
O36	EFFECT OF INTERLEUKIN-2 THERAPY ON T-CELL PHENOTYPES IN HIV-1 INFECTED PATIENTS RECEIVING NO ANTIRETROVIRAL THERAPY BHIVA Conf 2001 Apr 27-29;7:O36 AK Sullivan1, P Amjadi2, C Richardson1, MR Nelson1, J Tavel3, FM Gotch2, M Youle1, BG Gazzard1 CD4 and CD8 activation markers rose acutely and transiently following IL-2 therapy in HIV-1 infected patients not receiving highly active antiretroviral therapy, returning to baseline within 4 weeks. CD25 also rose transiently in response to IL-2 therapy in the absence of HAART. No adverse effect on viral load was seen in this subset or in the Vanguard study population. Download Abstract Book 2001
Poster Abstracts
P1	META-ANALYSES: MAGIC AND RUN OF THE MILL BHIVA Conf 2001 Apr 27-29;7:P1 K Porter, on behalf of CASCADE collaboration A balance between imposing excessively complicated and more simple file specifications, which may lead to queries, is difficult. The time and effort required to combine individual studies into a highquality data set for analysis should not be underestimated. Download Abstract Book 2001
P2	FAMILIAL HIV: A UNIQUELY IRISH PHENOMENON? BHIVA Conf 2001 Apr 27-29;7:P2 G Courtney, FM Mulcahy, C Bergin This study suggests that diffusion of HIV needs to be looked at not only in the geographical context but also in the family context and that there is a need for qualitative work to profile at-risk families and devise appropriate interventions. Download Abstract Book 2001
P3	HIV TESTS IN CHILDREN ATTENDING A GENITOURINARY MEDICINE (GUM) CLINIC BHIVA Conf 2001 Apr 27-29;7:P3 A Apoola, PS Allan, AAH Wade A large proportion of those counselled for HIV testing in this age group went on to have an HIV test. Rape/assault is the commonest recorded complaint in children receiving an HIV pre-test counselling session. There is a need for more sex education and riskreduction education programmes targeted at adolescents. Download Abstract Book 2001
P4	SEXUALLY TRANSMITTED DISEASES AND HIV/AIDS CONCERNS OF 15-YEAR-OLD STUDENTS IN MIDDLESBROUGH BHIVA Conf 2001 Apr 27-29;7:P4 AA Opaneye, J Clark, S Relph These questions serve as framework for discussions and role play for the students. Staff from the GUM/HIV clinic are able to address what the students want rather than follow a set plan. It is hoped that these sessions will educate and inform students and teachers alike. Since we started, more schools have requested our input into their PSE sessions. Download Abstract Book 2001
P5	THE HIV EPIDEMIC: IS THIS A TURNING POINT? BHIVA Conf 2001 Apr 27-29;7:P5 F Lyons, S Clarke, S Hopkins, FM Mulcahy, C Bergin This clinic has seen a rapid rise in the numbers of new HIV cases in the 12-month period from January to December 2000. Many explanations exist that will be explored in detail. A regrouping of efforts aimed at minimising further increases is mandatory to curb this trend. Download Abstract Book 2001
P6	HIV AND NON-HIV ASSOCIATED MORTALITY IN THE TAYSIDE HIV COHORT, 1990–1998 BHIVA Conf 2001 Apr 27-29;7:P6 S Defres, GD Barlow, AJ France IVDUs have a higher risk of potentially preventable, non-HIV related death. Hetero- and homosexuals in Tayside, however, appear to present later in the course of their illness. Download Abstract Book 2001
P7	THE IMPACT OF NON-EU NATIONALS ON A GENITOURINARY MEDICINE AND INFECTIOUS DISEASE CLINIC BHIVA Conf 2001 Apr 27-29;7:P7 C Forkin, S Hopkins, C Bergin, FM Mulcahy The growing needs of an immigrant population are continually highlighted as we experience their differing requirements from medical, cultural and socioeconomic view points. The impact of differing demographics and spectrum of disease presentation on a standardised, established service must be acknowledged if we are to identify the areas where resources need to be improved and intensified in order to ensure the delivery of an appropriate service. Download Abstract Book 2001
P8	GENDER DIFFERENCES IN RATE OF HOSPITAL ADMISSION AND DISEASE PROGRESSION IN THE ERA OF HAART BHIVA Conf 2001 Apr 27-29;7:P8 AL Moore, CA Sabin, AN Phillips, MA Johnson Our results suggest a possible benefit in females over males in clinical response to HAART but provide no concrete evidence as confidence intervals are wide. Further analysis with longer followup or with greater numbers would allow a more powerful analysis. Download Abstract Book 2001
P9	IMPACT OF DEPRIVATION IN THE EDINBURGH HIV COHORT BHIVA Conf 2001 Apr 27-29;7:P9 RP Brettle, A Wilson In Edinburgh, deprivation is associated (but not necessarily causally) with mode of acquisition of HIV and survival from AIDS but not with access to antiviral therapy or overall survival from the time of infection. Download Abstract Book 2001
P10	IMPROVED DETECTION OF SEROCONVERSION BY TARGETED SURVEILLANCE BHIVA Conf 2001 Apr 27-29;7:P10 GL Dean1, DR Churchill1, JV Parry2, D McElborough1, M Fisher1 By increasing awareness within the clinic and instituting active case-finding with supplementary laboratory investigations we substantially increased the pick-up rate in 2000. It is likely that the detuned assay will play an increasingly important role in case confirmation and monitoring of seroincidence. Download Abstract Book 2001
P11	TEENAGERS AND HIV: WHAT'S THE PROBLEM? BHIVA Conf 2001 Apr 27-29;7:P11 KP Prime1, G Sethi2, GL Dean3 ,L Navaratne4 ,E Fox5, A de Ruiter4, M Fisher3, C Taylor5, GP Taylor2, SG Edwards1 Despite most teenagers being diagnosed in GUM clinics and 25% having a co-existing STI, further STIs were common. Psychiatric morbidity is common and the loss to follow-up high. These data suggest that current approaches to the care of newly diagnosed teenagers are inadequate and a more focused approach is required. Download Abstract Book 2001
P12	ETHNIC DIFFERENCES IN STAGE OF PRESENTATION OF ADULTS NEWLY DIAGNOSED WITH HIV-1 INFECTION IN SOUTH LONDON BHIVA Conf 2001 Apr 27-29;7:P12 AE Boyd, PJ Easterbrook Despite the widespread availability of HIV services, BA patients in south London continue to present with more advanced HIV disease compared with Wh patients, and to present for HIV testing at the onset of suggestive symptoms. There is an urgent need to address the continuing barriers to the uptake of HIV testing in the African communities. Download Abstract Book 2001
P13	BIOCHEMICAL ABNORMALITIES ASSOCIATED WITH HYPERLACTATAEMIA IN HIV-1 POSITIVE PATIENTS BHIVA Conf 2001 Apr 27-29;7:P13 D Datta, S Mandalia, JM Morlese, G Moyle, D Asboe, BG Gazzard Although it has been suggested that routine measurement of lactate may be unhelpful, hyperlactataemia in HIVpositive patients on antiretroviral medication was significantly associated with a number of other biochemical abnormalities, including high alanine aminotransferase (ALT), glucose and cholesterol levels. Hyperlactataemia was also significantly associated with low chloride, bicarbonate and phosphate levels. No association was found between hyperlactataemia and amylase levels. Download Abstract Book 2001
P14	EFFECTS OF EFAVIRENZ ON LIPID METABOLISM IN ANTIRETROVIRAL-NAÏVE AND -EXPERIENCED HIV-POSITIVE PATIENTS WITH MORPHOLOGIC AND METABOLIC ALTERATIONS BHIVA Conf 2001 Apr 27-29;7:P14 G Ravasi, C Zocchetti, R Bruno, R Maserati Treatment with EFV was not associated with metabolic alterations (type IV) during a 9-month follow-up in antiretroviral-naïve patients. In PI-experienced patients switched to EFV because of MMA, a significant reduction in Tg levels was observed with resolution of type IV MMA in some cases. Download Abstract Book 2001
P15	PSYCHOLOGICAL ASSESSMENT OF PATIENTS REFERRED TO A MULTIDISCIPLINARY LIPODYSTROPHY/METABOLIC CLINIC BHIVA Conf 2001 Apr 27-29;7:P15 G Frieze1, A Guimaraes-Walker1, C de Souza1, C Brain1, M Kapembwa2 and G Scullard1 A high degree of psychological symptoms and concerns over body image and general health are present in these patients. Close follow-up by a multidisciplinary team is associated with improvements in all these areas. Download Abstract Book 2001
P16	SHORT-TERM INCREASES IN ABT-378/R DOSE DOES NOT AFFECT POSTPRANDIAL LIPAEMIA IN HIV-1 SEROPOSITIVE PATIENTS BHIVA Conf 2001 Apr 27-29;7:P16 JM Morlese, NA Qazi, B O’Donnovan, BG Gazzard, A Pozniak Although the pattern of the postprandial rise in plasma triglyceride concentrations after 2-h and 4-h was the same after increasing the dose of ABT-378/r, there was no significant difference between the two studies. Therefore, this evidence suggests that increasing the dose of ABT-378/r does not alter postprandial lipaemia in the short term. Download Abstract Book 2001
P17	INTERFERON-α THERAPY INCREASES PLASMA TRIGLYCERIDE CONCENTRATIONS IN HIV-1 POSITIVE PATIENTS BHIVA Conf 2001 Apr 27-29;7:P17 JM Morlese, NA Qazi, D Asboe, BG Gazzard, MR Nelson Plasma Tg concentrations are increased in HIV-1 seropositive patients treated with exogenous interferon-α therapy. This evidence supports the hypothesis that increased cytokine concentrations may play a role in the development of dyslipidaemia and lipodystrophy in HIV-infected patients treated with highly active antiretroviral therapy. Download Abstract Book 2001
P18	HEPATOTOXICITY IN NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR-CONTAINING REGIMENS BHIVA Conf 2001 Apr 27-29;7:P18 JM Turner, A Wilson, CLS Leen, RP Brettle In this retrospective analysis of a cohort of patients with a high incidence of co-infection with HCV, there was no statistical difference between NVP- and EFV-containing regimens and the incidence of abnormal ALT results. Download Abstract Book 2001
P19	THE NATURAL HISTORY OF LIPODYSTROPHY IN HIV BHIVA Conf 2001 Apr 27-29;7:P19 L Judges1, R Kulasegaram1, CA Sabin2, A Duncan1, BS Peters1 A change in HAART is not always required to avoid progressive FR. With adequate counselling and monitoring at regular intervals, patients can make a more informed choice of whether to switch therapy or wait. Download Abstract Book 2001
P20	A COMPARATIVE STUDY OF DIETARY ADVICE WITH AND WITHOUT PRAVASTATIN FOR THE TREATMENT OF ANTIRETROVIRAL THERAPY-ASSOCIATED HYPERLIPIDAEMIA BHIVA Conf 2001 Apr 27-29;7:P20 G Moyle, C Orkin, M Lloyd, B Reynolds, C Baldwin, BG Gazzard Both dietary advice and pravastatin reduce total and increase HDL cholesterol. Pravastatin + DA has significantly greater effects on total and LDL cholesterol than DA alone. No adverse events occurred. Virological control was maintained despite the addition of pravastatin. Download Abstract Book 2001
P21	REDUCTION IN LACTIC ACIDAEMIA WITH DICHLOROACETATE IN HIV-1 INFECTED PATIENTS BHIVA Conf 2001 Apr 27-29;7:P21 E Davies, J Morlese, D Asboe, T Wilton, D Datta, G Moyle, BG Gazzard Dichloroacetate (DCA) has been used successfully to treat lactic acidosis (LA) in severe burns and sepsis. We therefore introduced DCA into our treatment protocol for antiretroviral therapy (ART)- associated LA and have reviewed its use to date. Download Abstract Book 2001
P22	HIGH INCIDENCE OF SEXUAL DYSFUNCTION IN PATIENTS REFERRED TO A MULTIDISCIPLINARY LIPODYSTROPHY/METABOLIC CLINIC BHIVA Conf 2001 Apr 27-29;7:P22 A Guimaraes-Walker1, G Frieze1, C de Souza1, C Brain1, M Kapembwa2 and G Scullard1 There is a high incidence of sexual dysfunction in both males and females referred to this clinic. A moderate number of males have associated high oestradiol levels, but not abnormal testosterone levels. Download Abstract Book 2001
P23	THE SAFETY, TOLERABILITY AND EFFICACY OF SWITCHING FROM NEVIRAPINE TO EFAVIRENZ BHIVA Conf 2001 Apr 27-29;7:P23 MR Nelson, S Bhagani, BG Gazzard In patients with an undetectable viral load, switching from NVP to EFV is safe, generally well tolerated and maintains viral suppression efficacy. Download Abstract Book 2001
P24	EFAVIRENZ VERSUS PROTEASE INHIBITORS IN TREATMENT-NAÏVE PATIENTS BHIVA Conf 2001 Apr 27-29;7:P24 M Tadolini, L Fortunato, M Borderi, S Spinosa, F Chiodo These preliminary results suggest that a first-line PI-sparing regimen using NRTIs and EFV is highly effective, safe and appropriate for treatment-naïve patients and seems to be superior in terms of virological efficacy with a quicker viral load fall than PIs. Download Abstract Book 2001
P25	IS IT SAFE TO SWITCH FROM A NON-FAILING ANTIRETROVIRAL REGIMEN TO LOPINAVIR? BHIVA Conf 2001 Apr 27-29;7:P25 Y Gilleece, NA Qazi, JM Morlese, A Pozniak, BG Gazzard, MR Nelson In this study, 93.7% of patients who switched to ABT-378 for reasons other than virological failure maintained a negative viral load. Download Abstract Book 2001
P26	CHANGING USE AND COST OF HIV SERVICE PROVISION IN NPMS-HHC SITES, 1996-1999 BHIVA Conf 2001 Apr 27-29;7:P26 EJ Beck1, S Mandalia1, D Parmar1, A Miners1, M Youle1, BG Gazzard1, M Fisher2, J Innes2, MA Johnson2, G Kinghorn2, A Pozniak2, A Tang2 and I Williams2 for the NPMS-HHC Steering Group The mean use of services decreased, especially for people with AIDS, less so for people with asymptomatic HIV infection or symptomatic non-AIDS. Estimated costs for treatment with various antiretroviral drugs also decreased over this period. Download Abstract Book 2001
P27	AN AUDIT OF FIRST-LINE ANTIRETROVIRAL PRESCRIBING BHIVA Conf 2001 Apr 27-29;7:P27 J Erwin, K Gray, D Pao, BS Peters Results from this on-going study indicate that prescribing of first-line HAART in the study clinic meets BHIVA guidelines. The BHIVA guideline recommendations offer a broad scope for variations in prescribing practice. Further data on variations in practice and a discussion of the applications and limitations of the BHIVA guidelines will be presented. Download Abstract Book 2001
P28	SEQUENCING TO NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR/NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR COMBINATIONS FOLLOWING VIROLOGICAL FAILURE OF PROTEASE INHIBITOR-CONTAINING ANTIRETROVIRAL THERAPY BHIVA Conf 2001 Apr 27-29;7:P28 D Asboe, S Mandalia, BG Gazzard Virological success was low at 12 months in patients changing to NRTIs/NNRTI. EFV-containing combinations were significantly better. The use of three NTRIs warrants further study. Download Abstract Book 2001
P29	ABACAVIR AS SALVAGE THERAPY IN ANTIRETROVIRAL-EXPERIENCED PATIENTS BHIVA Conf 2001 Apr 27-29;7:P29 F Martin, A Martin, S Mandalia, S Bulbeck, BG Gazzard, MR Nelson Abacavir is efficacious as salvage therapy in heavily pretreated HIV-positive patients in combination with either PIs or NNRTIs. Download Abstract Book 2001
P30	A STUDY TO EVALUATE THE EFFECTS OF RECYCLING NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTIS) IN HEAVILY ANTIRETROVIRAL THERAPY-EXPOSED HIV-1 INFECTED PATIENTS WITH DETECTABLE VIRAL LOADS BHIVA Conf 2001 Apr 27-29;7:P30 C Orkin, S Brown, B Darby, MR Nelson, BG Gazzard, A Pozniak The fall in viral load at 12 weeks was greater in the d4T/ddI group although this did not reach statistical significance. No significant differences were found in the CD4 count in either group. Additional patients are being recruited to the study. Resistance tests at both time points are pending. Download Abstract Book 2001
P31	EFFECTS OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN PRIMARY/ACUTE HIV-1 INFECTION BHIVA Conf 2001 Apr 27-29;7:P31 A Pires1, A Pozniak2, MR Nelson2, BG Gazzard2, FM Gotch1, N Imami1 The CD4+ HTL dysfunction in HIV-1 infection, which occurs early during infection even before the decline in absolute numbers of CD4+ T cells, and which is marked by an early loss of HIV-1 specific responses in terms of both proliferation and IL-2 production, appears distinct from the antigen-induced intracellular IFNγ production. Up-regulation of HLA-DR in immune hyperactivation is suggestive of T:T presentation which is associated with anergy. Early treatment with HAART reverses the anergic state; however, whether these virus-specific responses are sustained, and their long-term effect on the immune control of HIV-1 disease, remains to be elucidated. Download Abstract Book 2001
P32	FACTORS PREDICTING OUTCOME OF THERAPY IN THE EDINBURGH INJECTING DRUG USER POPULATION: A RETROSPECTIVE STUDY BHIVA Conf 2001 Apr 27-29;7:P32 AM Richardson, C Child, CLS Leen, A Wilson, RP Brettle The fact that IDUs have 'caught up' with other groups may be because of doctor and/or patient confidence in treatment. It may be that the IDUs under treatment more recently are those who are more chaotic and that concerns about their ability to adhere were justified. It is encouraging that 62% of the IDU population treated have attained a very low viral load. Download Abstract Book 2001
P33	OBSERVATIONAL PROTEASE INHIBITOR SALVAGE STUDY, USING EFAVIRENZ PLUS TWO NEW NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS BHIVA Conf 2001 Apr 27-29;7:P33 J Carmena, C Ricart, M Jordan, R Vicente, C Pérez, MJ Alcaraz, P León Salvage therapy with EFV plus two new NRTIs or EFV/d4T/ ddI/ABC gave VLU in 66% of patients at 13 months, depending on treatment adherence and the presence or absence of baseline K103N. Download Abstract Book 2001
P34	ONCE DAILY HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN TREATMENT-EXPERIENCED PATIENTS IN EDINBURGH BHIVA Conf 2001 Apr 27-29;7:P34 S Morris, A Chiswick, M Gentleman, RP Brettle, CLS Leen Once-daily HAART was successful in 90% of a small cohort of mostly treatment-experienced patients with adherence problems. Once-daily therapy may be a useful option for certain patients with adherence problems. Download Abstract Book 2001
P35	WHY DO SOME PATIENTS HAVE A LOW CD4 COUNT IN THE ERA OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)? BHIVA Conf 2001 Apr 27-29;7:P35 CA Sabin, S Madge, M Tyrer, F Lampe, M Youle, M Lipman, AN Phillips, MA Johnson There are a number of reasons why some patients have low CD4 counts, despite free access to HAART. At our centre, many of these CD4 counts can be explained by poor compliance and treatment interruptions following virological failure or adverse events. Download Abstract Book 2001
P36	PHARMACOKINETIC STUDY OF INDINAVIR AT 600 MG TWICE A DAY AND RITONAVIR AT 200 MG TWICE A DAY IN PLASMA AND SEMEN OF HIV-1 INFECTED MEN BHIVA Conf 2001 Apr 27-29;7:P36 S Taylor1,3, H Reynolds2, S Drake3, C Stradling3, DJ White, S Gibbons2, D Pillay1 and D Back2 IDV was well above the median effective concentration (MEC) of 100 ng/ml at all times. RTV was above the MEC of 2100 ng/ml for approximately 1/2 of the dosing period. Four of six patients had BPVL <50 copies/ml and all six had SPVL<400 copies/ml at 24 weeks. Download Abstract Book 2001
P37	THE ROLE OF NURSE TRIAGE IN FACILITATING NON-ROUTINE MEDICAL CARE OF PATIENTS IN AN HIV CLINIC BHIVA Conf 2001 Apr 27-29;7:P37 E Nixon, J Wastie, B James, L Navaratne, M Fisher While defining conditions which may or may not be related to HIV can be complicated, this study demonstrates the potential for nurse triage in facilitating more appropriate use of services for patients requiring non-routine medical care. Download Abstract Book 2001
P38	SHARPS INJURIES AMONG HEALTHCARE WORKERS: MANAGEMENT AND OUTCOME BHIVA Conf 2001 Apr 27-29;7:P38 LJ Tucker, V Harindra, JM Tobin The majority (96.0%) of subjects in this study were not at significant risk of acquiring HIV occupationally. However, anxiety levels are very high, and therefore staff who provide advice should be knowledgeable about the risks and benefits of PEP. Prevention of occupational exposure is ideal. All HCWs should be aware of local reporting and management policies if a sharps injury occurs. Download Abstract Book 2001
P39	SURVIVING AIDS: THE EXPERIENCES OF PEOPLE WITH AIDS WHO HAVE RESPONDED WELL TO HAART BHIVA Conf 2001 Apr 27-29;7:P39 TA Fernandez, MA Johnson The experience of revival is associated with mixed emotions, which need acknowledgement and consideration when working with this patient group. Specialist nursing skills and a questioning of how we measure 'good health' can further help meet these patients' needs. There are clearly limitations in such a small study. However, a larger study of uncertainty in HIV illness is long overdue. Download Abstract Book 2001
P40	VIAGRA USE AND SEXUAL RISK BEHAVIOUR IN HIV-POSITIVE AND -NEGATIVE GAY MEN IN LONDON BHIVA Conf 2001 Apr 27-29;7:P40 L Sherr, G Bolding, J Elford One in five gay men in this study had used sildenafil. While the use of sildenafil appeared to be associated with general risk-taking behaviour, there was no evidence that sildenafil per se led to high-risk sexual behaviour among HIV-positive or -negative gay men. Over one-third of HIV-positive men had used sildenafil; both they and their physicians should be aware of its potential interaction with protease inhibitors. Download Abstract Book 2001
P41	NEEDLESTICK INJURIES AMONGST SURGEONS IN THE WEST MIDLANDS BHIVA Conf 2001 Apr 27-29;7:P41 S Bhaduri1, A Miller2, J Stockley2, CE Constantine2 Free text comments included the need to test all patients for blood-borne viruses pre-operatively, the difficulties in reporting needlesticks and the need for regular updates on guidelines. The data show a high frequency of needlestick injuries, especially amongst general surgical trainees, although few were higher risk. There is a need to improve awareness of guidelines regarding PEP. Download Abstract Book 2001
P42	ANTENATAL HIV SCREENING BHIVA Conf 2001 Apr 27-29;7:P42 AJ Palfreeman Although no positive cases of HIV were detected, these results show a high uptake of HIV testing and therefore the Opt-out method of antenatal HIV screening proved to be successful. This may help to considerably reduce the vertical transmission rate of HIV even further by detection and management at an earlier stage. Download Abstract Book 2001
P43	FACTORS THAT MAY LIMIT THE ACCEPTANCE OF ANTIRETROVIRAL THERAPY BY INJECTING DRUG USERS BHIVA Conf 2001 Apr 27-29;7:P43 S Clarke, S Delamere, L McCullough, S Hopkins, C Bergin, FM Mulcahy This study highlights the chaotic lifestyle and often difficult social circumstances related to IDU. Such factors were not, however, associated with acceptance of HAART. The primary factor associated with both the acceptance of and adherence to HAART was regular and stable MMT. Download Abstract Book 2001
P44	AN ASSESSMENT OF CURRENT HIV ADHERENCE SERVICES IN THE UK BHIVA Conf 2001 Apr 27-29;7:P44 J Walsh, on behalf of the Adherence Strategy Group There is a need for training and direction within current adherence approaches. National guidelines could provide a valuable framework for healthcare professionals. Download Abstract Book 2001
P45	A NOVEL SCHEME OF HOME DELIVERY OF HIV MEDICINES BHIVA Conf 2001 Apr 27-29;7:P45 D Robertson-Bell, Z Mitchla, D Johnson, S Madge, CA Sabin, R Sim, R Urquhart, A Solamalai, MA Johnson This scheme has been well received, and has now been extended to over 200 patients. Some of the cost implications of this scheme will be discussed. Download Abstract Book 2001
P46	DIFFERENCES IN PERCEPTIONS OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY BETWEEN PEOPLE DIAGNOSED BEFORE AND AFTER THE ADVENT OF COMBINATION THERAPY BHIVA Conf 2001 Apr 27-29;7:P46 V Cooper1, M Fisher2, R Horne1 Patients who were diagnosed with HIV before 1995 have a more negative view of HAART and may be less inclined to accept antiretroviral treatment. We are conducting further studies to determine whether these findings are due to early experiences of monotherapy, or merely reflect a longer duration of diagnosis on perceptions of HAART. These factors should be considered when initiating or discussing HAART with this patient group. Download Abstract Book 2001
P47	SYSTEMATIC OVERVIEW OF ADHERENCE STUDIES: FINDINGS AND IMPLICATIONS BHIVA Conf 2001 Apr 27-29;7:P47 L Sherr Interventions are effective, but too few exist for guidance. Prevention and adherence may need to be coupled and stressed in the ongoing management of people on HAART. Download Abstract Book 2001
P48	CAN THE ANALYSIS OF LUNG CD8 PHENOTYPE PROVIDE USEFUL DIAGNOSTIC INFORMATION IN HIV-INFECTED PATIENTS WITH RESPIRATORY DISEASE? BHIVA Conf 2001 Apr 27-29;7:P48 SM Barry, MA Johnson, G Janossy The BAL CD8 phenotype appears to differ in some cases of TB and PCP infections in patients with HIV. Download Abstract Book 2001
P49	TRANSIENT CLINICAL DETERIORATION IN HIV PATIENTS WITH PNEUMOCYSTIS CARINII PNEUMONIA AFTER STARTING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY: ANOTHER CAUSE OF IMMUNE RESTORATION INFLAMMATORY SYNDROME? BHIVA Conf 2001 Apr 27-29;7:P49 GL Dean, DI Williams, DR Churchill, M Fisher Worsening PCP symptomatology was temporally related to the initiation of HAART associated with a marked VL fall, as in other immune-restoration disorders. Timing of HAART in PCP patients is vital. Download Abstract Book 2001
P50	AN ATTRACTIVE ALTERNATIVE TO RADIOTHERAPY FOR INTRAOCULAR LYMPHOMA (IOL) BHIVA Conf 2001 Apr 27-29;7:P50 T Powles, SM Mitchell, MR Nelson, BG Gazzard, M Bower This novel treatment is not well described, but is an attractive, less toxic alternative to radiotherapy. Download Abstract Book 2001
P51	PREVALENCE OF HEPATITIS IN AN IRISH HIV DRUG-USING COHORT BHIVA Conf 2001 Apr 27-29;7:P51 S Hopkins, K Rogers, F Lyons, S Clarke, FM Mulcahy, C Bergin The prevalence of HCV in our population is similar to that reported previously. The increasing prevalence of RNA detected with respect to year of diagnosis may be due to reactivation of latent HCV in hepatocytes. The high prevalence of both HAV and HBV suggests that this population should have screening serologies performed prior to routine vaccination. Download Abstract Book 2001
P52	UNSUCCESSFUL TREATMENT OF CD20-POSITIVE REFRACTORY AIDS-RELATED LYMPHOMA WITH RITUXIMAB BHIVA Conf 2001 Apr 27-29;7:P52 JAG Buchanan, A Mohith, MR Nelson, BG Gazzard, M Bower Despite abundant expression of CD20, there was no response to Rituximab in this patient with chemotherapy-refractory ARL and advanced immunosuppression. Lack of response may, in part, be due to deficiency of cellular effectors of ADCC. Nonetheless, controlled randomised studies are under way to evaluate the value of Rituximab in combination with chemotherapy for the management of ARL. Download Abstract Book 2001
P53	PEGYLATED INTERFERONα-2B IN HIV-RELATED KAPOSI'S SARCOMA BHIVA Conf 2001 Apr 27-29;7:P53 A Mohith, JAG Buchanan, MR Nelson, BG Gazzard, M Bower An early subjective response to KS was seen after only five further injections, and after a total of nine injections, there was an objective partial response (ACTG criteria). No other local or systemic therapy was given for KS and he remains on PEG-IFN, ddI, d4T and NVP. A cumulative dose of 38 µg/kg PEG-IFN has so far been administered and he has reported flu-like symptoms, moderate emesis and depression. There has been no significant change in CD4, CD8, CD19 or VL during PEG-IFN therapy. Further studies are warranted to establish the efficacy of PEG-IFN in HIV-related KS. Download Abstract Book 2001
P54	REACTIVATION OF LATENT HEPATITIS B INFECTION WITH HIV-RELATED IMMUNOSUPPRESSION BHIVA Conf 2001 Apr 27-29;7:P54 C Mazhude1, GL Dean2, S Creighton1, M Fisher2, C Taylor1 Reactivation of latent HBV infection occurs with advanced HIV-related immunosuppression and can cause LFT abnormalities. In patients on ART who develop abnormal LFTs, repeat HBV serology testing can be important. Download Abstract Book 2001
P55	THERMAL THRESHOLD TESTS IN HIV-POSITIVE PATIENTS BHIVA Conf 2001 Apr 27-29;7:P55 J Brown1, A Chiswick2, M Walker1, RP Brettle2, CLS Leen2, R Grant1 Significant sensory neuropathy can occur in the absence of clinical signs. Hot TTs demonstrate an ability to discriminate between patients with and without peripheral neuropathy. Thermal threshold may be useful for early diagnosis of peripheral neuropathy. Download Abstract Book 2001
P56	HIV QUASI-SPECIES DERIVED FROM THE LUNG AND BLOOD ARE EVOLUTIONARILY RELATED DESPITE COMPARTMENTALISATION OF RESISTANCE MUTATIONS BHIVA Conf 2001 Apr 27-29;7:P56 NC White, D Israel-Biet, R Coker, D Mitchell, JN Weber, JR Clarke Jefferiss Research Trust Laboratories, Wright-Fleming Institute, Differences exist between HIV quasi-species, both between the lung and blood, and within each compartment. These differences are not attributed to separate evolution between the two compartments, as demonstrated by phylogenetic analysis. Differences in mutations between the lung and blood may be due to differences in drug penetration, intracellular drug levels or phosphorylation of NRTIs. These data may help us to understand the basis of HAART drug failure. Download Abstract Book 2001
P57	OUTCOMES OF GENOTYPIC TESTS IN CLINICAL PRACTICE BHIVA Conf 2001 Apr 27-29;7:P57 H Noble1, A Chowdhury1, J Norman2, C Aitken2, AJ Pinching1, CJ Skinner1 The utility of GART in antiretroviral-experienced patients remains uncertain and further refinement is necessary. Download Abstract Book 2001
P58	RETROSPECTIVE AUDIT OF GENOTYPIC RESISTANCE TESTING IN EDINBURGH BHIVA Conf 2001 Apr 27-29;7:P58 CLS Leen1, S Morris1, C Wilson1, RP Brettle1, G Scott2, D Pillay3, S Burns4 A significant number of plasma samples failed to amplify. Patients who received three or more new drugs had a good virological response following genotypic resistance testing. Download Abstract Book 2001
P59	CLINICAL FEATURES OF PRIMARY HIV INFECTION BHIVA Conf 2001 Apr 27-29;7:P59 DM Cornforth1, PJ Newton1, JM Bennett2, RF Miller1, NS Brink2, IG Williams1 A broad spectrum of clinical features is associated with PHI together with a high psychological morbidity. Transmission of HIV drug-resistant strains was demonstrated in four subjects. Download Abstract Book 2001
P60	MODULATION OF HIV-SPECIFIC IMMUNE RESPONSES BY AN EFAVIRENZ-CONTAINING THERAPEUTIC PROTOCOL IN HIV-INFECTED DRUG-EXPERIENCED PATIENTS BHIVA Conf 2001 Apr 27-29;7:P60 M Clerici1, S Lo Caputo2, D Trabattoni1, M Di Pietro2, G Ravasi3, F Mazzotta2, R Maserati3 Therapy with EFV, NFV and d4T increases HIV-specific type 1 cytokine production and CD4 counts, and reduces plasma viraemia. EFV-including therapeutic regimens should be considered in advanced HIV infection. Download Abstract Book 2001
P61	IMMUNE RECONSTITUTION MIMICKING RELAPSE OF NON-HODGKINS LYMPHOMA IN HIV BHIVA Conf 2001 Apr 27-29;7:P61 T Powles, MR Nelson, BG Gazzard, M Bower These three cases demonstrate the need for a histological conformation of relapsed NHL to exclude other diagnosis, including immune reconstitution syndromes that may mimic recurrent NHL. Download Abstract Book 2001
P62	TRUE GYNAECOMASTIA, ANOTHER IMMUNE RECONSTITUTION DISEASE? BHIVA Conf 2001 Apr 27-29;7:P62 NA Qazi, JM Morlese, DM King, RS Ahmad, BG Gazzard, MR Nelson Gynaecomastia is associated with a decreased ratio of free androgens to oestrogens, but the endocrine profile of our patients was normal. After starting HAART, there is improvement in the T-helper cell cytokine response, specifically an increased IL-2 production which has been shown to increase breast tissue proliferation in vitro. Also, IL- 6 has been shown to increase aromatase activity in breast tissue with a consequent increase in oestrogen available to stimulate breast growth. As all these patients were on successful HAART regimens, we hypothesise that successful immune restoration may result in altered breast tissue oestrogen availability and hence gynaecomastia. Download Abstract Book 2001
P63	VIROLOGY AND IMMUNOLOGY OF KAPOSI'S SARCOMA-ASSOCIATED HERPES VIRUS IN PATIENTS TREATED WITH HIGHLY ACTIVE ANTIRETROVIRAL THERAPY BHIVA Conf 2001 Apr 27-29;7:P63 D Aldam1, D Bourboulia2, A Cope2, C Boshoff2, IG Williams1 Of homosexual men recruited, 78% were KSHV Abpositive and most (61%) had increased KSHV Ab on HAART. Patients with KSHV may be baseline-negative and become positive on HAART. Download Abstract Book 2001
P64	LIMITED THYMIC CONTRIBUTION IN CD4 T-CELL RESTORATION DURING EARLY HIGHLY ACTIVE ANTIRETROVIRAL THERAPY BHIVA Conf 2001 Apr 27-29;7:P64 J Pido-Lopez, N Imami, A Pires, AK Sullivan, C Burton, G Hardy, BG Gazzard, R Aspinall, FM Gotch Maintenance or increase in CD4 T-cell numbers during the first few weeks of HAART may involve some thymic contribution but appears to be largely due to expansion of existing cells in the periphery. The contribution of the thymus to the restoration of CD4 T cells becomes apparent, particularly in younger patients, during the later course of therapy, approximately 12–16 weeks post HAART. Download Abstract Book 2001
P65	RELATIONSHIP BETWEEN LYMPHOCYTE PROLIFERATIVE RESPONSES AND CLINICAL, IMMUNOLOGICAL AND VIROLOGICAL VARIABLES IN PATIENTS BEFORE THE COMMENCEMENT OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY BHIVA Conf 2001 Apr 27-29;7:P65 GV Matthews, G Hardy, S Mandalia, AK Sullivan, MR Nelson, N Imami, FM Gotch, BG Gazzard This cross-sectional study showed that patients with the lowest proliferative responses to a range of antigens tended to have higher CD4 counts, contrary to the belief that proliferative responses are progressively weakened as the CD4 count falls, and may be related to 'stunning' of cellular immune responses in earlier HIV infection, overexpression of the T-cell regulatory response (e.g. 'tolerance') or related to the burden of antigen present. Follow-up is continuing. Download Abstract Book 2001
P66	DEPLETION AND INFECTION OF BLOOD DENDRITIC CELLS IN PATIENTS WITH HIV-1 BHIVA Conf 2001 Apr 27-29;7:P66 H Donaghy1, BG Gazzard2, A Pozniak2, NA Qazi2, S Patterson1 DC are potent antigen-presenting cells. HIV-1 infected patients experience loss of blood DC numbers and this loss may contribute to disease progression. Therefore, therapeutic strategies should aim to restore the DC population. Download Abstract Book 2001
P67	CD4 COUNT PREDICTION FROM CD4 PERCENTAGE BHIVA Conf 2001 Apr 27-29;7:P67 A Apoola There can be no absolute correlation between the CD4 count and percentage because the count is dependent on the lymphocyte count and is subject to inter- and intra-individual variation. With a missing lymphocyte count in our cohort it may be possible to predict the CD4 count from the percentage, bearing in mind the above limitations. Download Abstract Book 2001

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