10th Anniversary Conference of the British HIV Association 15–17 April 2004, City Hall, Cardiff, UK

Oral Abstracts
O1	PHARMACOKINETICS (PKS) OF SAQUINAVIR HARD GEL (SQV-HG)/RITONAVIR (RTV) WITH ATAZANAVIR (ATV) OR FOSAMPRENAVIR (FPV) IN HIV+ PATIENTS (PTS) BHIVA Conf 2004 Apr 15-17;10:O1 M Boffito1, DJ Back2, M Kurowski4, L Dickinson2, G Kruse4, A Hill3, G Moyle1, M Nelson1, C Higgs1, C Fletcher1, B Gazzard1, A Pozniak1 SQV use in double-boosted PI-containing regimens is very promising from a safety and PK prospective. Download Abstract Book 2004
O2	CLINICAL EXPERIENCE OF ATAZANAVIR: TOLERABLE AND EFFECTIVE BHIVA Conf 2004 Apr 15-17;10:O2 C McDonald1, N Mackie2, C Smyth1, N Tamm2, R Weston2, G Scullard2, M Fisher1 ATV is well tolerated, efficacious and enables resolution of PI-related toxicity in many recipients. Download Abstract Book 2004
O3	MORBIDITY OF HIV-INFECTED CHILDREN IN GROOTE SCHUUR HOSPITAL, CAPE TOWN, SOUTH AFRICA: A TALE OF THE LUCKY 149 BHIVA Conf 2004 Apr 15-17;10:O3 LJ Neal1, K Yoganathan2, P Roux3 The results show that antiretroviral therapy reduces both the number of hospital admissions for HIV-related problems and the number of HIV-related diagnoses present during each admission. We conclude that antiretroviral therapy profoundly improves the health of children with HIV in Cape Town and urge that funding be made available for all HIV-infected children, not just the lucky 149. Download Abstract Book 2004
O4	TO ERR IS HUMAN: LEARNING FROM MEDICATION ERRORS IN HIV BHIVA Conf 2004 Apr 15-17;10:O4 H Leake Date1, D Godfrey2, Jane Nicholls3, on behalf of HIVPA4 The human and financial ramifications of medication errors are enormous. This survey highlights significant clinical risks and training needs for HIV multidisciplinary teams. Strategies are needed to improve patient safety and meet the DH target of a 40% reduction in serious medication errors. Download Abstract Book 2004
O5	EFFECTS OF COMBINATION ANTIRETROVIRAL THERAPY (CART) ON METABOLITE LEVELS IN CHILDREN BHIVA Conf 2004 Apr 15-17;10:O5 M Rhoads1, CJ Smith2, G Tudor-Williams1, P Kyd3, S Walters1, C Sabin2, EGH Lyall3 In children, CART raises cholesterol above basal levels and this increases over time. Both HIV and CART may increase cardiovascular risk; thus on-going monitoring of lipids in children and adolescents is important. However, lactate need only be measured in those with symptoms. Download Abstract Book 2004
O6	THE STOP STUDY: AFTER DISCONTINUATION OF EFAVIRENZ (EFV), PLASMA CONCENTRATIONS CAN PERSIST FOR >2 WEEKS BHIVA Conf 2004 Apr 15-17;10:O6 S Taylor1, S Allen2, E Smit3, S Fidler4, S Gibbons5 S Drake1, A Wade2, P Cane3, J Fox4, DJ Back5 Virological data from persons fully suppressed at the time of stopping therapy suggest EFV can be stopped 7 days before other shorter-acting drugs. These extended PK data suggest the stop window should be increased to 2–3 weeks (or switch from EFV to cover this). Download Abstract Book 2004
O7	PERSISTENCE OF TRANSMITTED RESISTANCE-ASSOCIATED HIV-1 MUTATIONS IN 16 PATIENTS BHIVA Conf 2004 Apr 15-17;10:O7 PA Cane1, G Dean2, M Fisher2, D Pao2, S Drake3, D Pillay1,4 and collaborating clinicians Certain resistance-associated mutations are stable in the long term, and may be indicators of infection with drug-resistant virus. However, others may disappear rapidly, possibly as a result of fitness changes. Thus it would be better to undertake resistance testing at the time of diagnosis rather than waiting until treatment is indicated. Download Abstract Book 2004
O8	ADJUNCTIVE USE OF THE SEROLOGICAL TESTING ALGORITHM FOR HIV SEROCONVERSION (STARHS) IDENTIFIES A HIGH AND INCREASING PROPORTION OF NEWLY DIAGNOSED INFECTIONS AS INCIDENT BHIVA Conf 2004 Apr 15-17;10:O8 M Fisher1, G Dean1, V Cooper2, G Murphy3, D Pao1, J Parry3 Adjunctive use of STARHS identified a high and increasing proportion of new HIV diagnoses as incident, which may confirm significant ongoing transmission, enabling early intervention, which could benefit both the individual and the population. Download Abstract Book 2004
O9	MOTHER-TO-CHILD TRANSMISSION OF HUMAN HERPESVIRUS-8 (HHV8) IN SOUTH AFRICA BHIVA Conf 2004 Apr 15-17;10:O9 M Dedicoat1,4, R Newton2, J Sheldon3, K Alkarsah3, I Szabados3, B Ndlovu4, T Page4, C Gilks1, S Cassol4, T Schulz3 We provide evidence of mother-to-child transmission of HHV8 and show that maternal saliva is a likely route. Download Abstract Book 2004
O10	IS THERE A SIGNIFICANT DIFFERENCE BETWEEN HIV-1 IN THE BLOOD AND THE FEMALE GENITAL TRACT? BHIVA Conf 2004 Apr 15-17;10:O10 A Mears1, J Mullen2, S O'Shea1, I Cormack1, V Magaya1, S Costelloe1, I Chrystie2, A de Ruiter1 These data indicate genetic diversity between viral populations in the blood and FGT. Selection of drug-resistant variants in the blood and FGT can differ, which could impact on postexposure prophylaxis following perinatal and sexual exposure. Download Abstract Book 2004
O11	USE OF COALESCENCE THEORY TO ESTIMATE TIME OF INTRODUCTION OF HIV-1 STRAINS INTO THE UK, AND SUBSEQUENT POPULATION GROWTH DYNAMICS BHIVA Conf 2004 Apr 15-17;10:O11 S Hué1, OP Pybus2, D Pillay1 This is the first estimate of the dates of introduction, and growth rates of the UK HIV-1 epidemic using coalescence theory. We illustrate the important epidemiological information inherent in viral sequence data acquired over time. Download Abstract Book 2004
O12	GENOTYPIC RESISTANCE TO ANTIRETROVIRAL THERAPY IN HIV-1 INFECTED PREGNANT WOMEN TAKING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) IN PREGNANCY BHIVA Conf 2004 Apr 15-17;10:O12 F Lyons1, S Coughlan2, C Byrne2, S Hopkins1, W Hall2, C Bergin1, F Mulcahy1 In this cohort, 13% demonstrated primary genotypic resistance post-partum despite HAART. Download Abstract Book 2004
O13	MOLECULAR AND EPIDEMIOLOGICAL CHARACTERISTICS OF PRIMARY HIV-1 INFECTIONS AMONG A COHORT OF PREDOMINANTLY MEN WHO HAVE SEX WITH MEN (MSM) IN A DEFINED GEOGRAPHICAL AREA: TRANSMISSION EVENTS ASSOCIATED WITH HIGH-RISK ACTIVITY AND SEXUALLY TRANSMITTED INFECTIONS (STIS) BHIVA Conf 2004 Apr 15-17;10:O13 D Pao1, M Fisher1, G Dean1, T Maher1, S Hué2, P Cane3, C Sabin4, D Pillay2 We found high rates of viral clustering in individuals with PHI. The associated behavioural factors we observed can facilitate onward transmission. Increased awareness and targeted identification of individuals during PHI may usefully interrupt transmission networks. Download Abstract Book 2004
O14	TRENDS IN GENOTYPIC RESISTANCE IN CLINICAL SAMPLES SUBMITTED FOR ROUTINE HIV RESISTANCE ANALYSIS BHIVA Conf 2004 Apr 15-17;10:O14 NE Mackie1, C Sabin2, S Dustan1, JR Clarke1, JN Weber1 Despite some reduction, mutations in HIV pol remain common. NRTI-associated mutations are still most common. The reduction in PI-associated mutations may reflect decreased first-line use of PIs, shifts to using more potent boosted-PI regimens and introduction of new agents with less well described mutation pathways. Increasing uptake of resistance testing and alterations in clinic demographics may contribute to some of the changes. Download Abstract Book 2004
O15	LATE DIAGNOSIS OF HIV INFECTION AMONG INDIVIDUALS WITH LOW OR UNACKNOWLEDGED RISKS IN ENGLAND, WALES AND NORTHERN IRELAND BHIVA Conf 2004 Apr 15-17;10:O15 VL Gilbart, S Dougan, K Sinka, BG Evans GPs should consider HIV as a possibility when patients without an apparent risk of HIV infection present with symptoms indicative of immune suppression. Sensitive partner-notification practices that enable a greater number of individuals to inform their partners should be explored. Download Abstract Book 2004
O16	A COMPARISON OF CHANGES IN RESPONSE TO HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) OVER TIME BETWEEN REGIONS OF EUROPE: RESULTS FROM THE EUROSIDA STUDY BHIVA Conf 2004 Apr 15-17;10:O16 W Bannister1, J Gatell2, O Kirk3, A Phillips1, A Mocroft1, J Lundgren3 Only small improvements in response were observed in later years, more especially in northern and eastern regions, despite new antiretrovirals and better toxicity management. Download Abstract Book 2004
O17	HIV-INFECTED ADOLESCENTS: AN EVOLVING UK COHORT BHIVA Conf 2004 Apr 15-17;10:O17 CJ Foster, EGH Lyall, K Dierholt, T Duong, PA Tookey, M Sharland, G Tudor-Williams, V Novelli, K Butler, A Riordan, DM Gibb HIV-infected children are surviving into adult life. In this cohort, many have been heavily pretreated with antiretroviral therapy with suboptimal responses, and will challenge therapeutics in adult services. Download Abstract Book 2004
O18	AN UPDATE OF THE UK HIV EPIDEMIC USING NATIONAL SURVEILLANCE DATA BHIVA Conf 2004 Apr 15-17;10:O18 K Sinka, B Evans and the CDSC HIV/AIDS Reporting Section 2003 will again see the highest number of new diagnoses of HIV infection in the UK in a single year, with 5047 reports already received and over 7000 anticipated for the year once delayed reports are received. Behind this figure is a rise in new diagnoses of HIV in men who have sex with men (MSM) and the continuing influence of the global epidemic. Over 2000 new diagnoses are expected in MSM for 2003, giving the highest annual total in this group in the epidemic to date. For the seventh consecutive year, new diagnoses in heterosexual men and women have risen substantially, and the divergence between diagnoses in males and females continues. Since 2001, heterosexual women have been the largest risk group diagnosed, and in 2003, heterosexual women made up 36% (1827) of all new diagnoses so far received, and a further 1000 reports could reasonably be expected. Only part of this increase is explained by increased detection and diagnosis antenatally. Download Abstract Book 2004
O19	TENOFOVIR IN THE TREATMENT OF HEPATITIS B (HBV)/HIV CO-INFECTED INDIVIDUALS BHIVA Conf 2004 Apr 15-17;10:O19 Y Gilleece, MR Nelson, A Clarke, M Fisher, M Bower, M Atkins, BG Gazzard Tenofovir is effective against HBV in HIV co-infected lamivudine-experienced individuals. Download Abstract Book 2004
O20	ACUTE HEPATITIS C VIRUS (HCV) IN A COHORT OF HIVPOSITIVE MEN: OUTCOMES AND RESPONSE TO PEGYLATED INTERFERON-α2B (PEG-IFN-α2B) AND RIBAVIRIN BHIVA Conf 2004 Apr 15-17;10:O20 S Bhagani1, M Danta2, C Hui1, G Slapak2, G Dusheiko2, MA Johnson1 Spontaneous clearance of HCV is possible, despite HIV co-infection. Initial results suggest a favourable response to early treatment despite unfavourable genotypes and high HCV viral loads. Download Abstract Book 2004
O21	TUBERCULOSIS (TB) AND HIV CO-INFECTION AMONG HEALTHCARE WORKERS IN SOUTH-WEST LONDON BHIVA Conf 2004 Apr 15-17;10:O21 CFJ Rayner, TBL Ho, T Lindfield, RJ Whitfield, Y Young Healthcare workers contribute significantly to the number of patients with TB and a significant proportion is co-infected with HIV. The majority of these patients are migrant workers. The current guidelines for screening healthcare workers state that only those without a BCG scar are tuberculin skin-tested. 52% of our patients would not have required skin testing at initial screening. Download Abstract Book 2004
O22	DO ALL HIV-POSITIVE PATIENTS CO-INFECTED WITH HEPATITIS C GENOTYPES 2 AND 3 REQUIRE 12 MONTHS OF TREATMENT WITH RIBAVIRIN AND PEGYLATED (PEG) INTERFERON (IFN)? BHIVA Conf 2004 Apr 15-17;10:O22 C Donnelly, S Hopkins, E Devitt, G Farrell, F Mulcahy, C Bergin Six months of treatment for hepatitis C genotype 2 and 3 co-infected patients resulted in an SVR in 94%. All these patients had CD4 counts of >200 cells/µl, negative hepatitis C PCR results after 12 weeks on treatment, and had no dose reduction of their IFN or ribavirin. Download Abstract Book 2004
O23	THE IMPACT OF AN HIV DIAGNOSIS ON FERTILITY BHIVA Conf 2004 Apr 15-17;10:O23 S Cliffe Pregnancy decision-making among HIV-positive women is complex. Many women have had children and many desire to do so in the future. This will have important implications for ongoing HIV education and care provision. Download Abstract Book 2004
O24	MATERNAL BREAST-FEEDING BEHAVIOUR AND PREVALENCE OF HIV-1 IN RURAL SOUTH AFRICA BHIVA Conf 2004 Apr 15-17;10:O24 M Dedicoat1,2, R Newton3, D Casabonne3, A Berrington de González3, Z Buthelezi1, T Page1, T Shulz4, C Gilks5, S Cassol1 The finding that mothers of young infants are more likely to have regular mixed feeding if they are HIV-infected than if they are not suggests that a policy of exclusive breast-feeding may be difficult to implement among HIV-infected mothers. Furthermore, we find no evidence to support the view that exclusive breast-feeding is associated with a lower prevalence of HIV infection in children. Download Abstract Book 2004
O25	PREGNANCY OUTCOME OF HIV-POSITIVE WOMEN IN LONDON, 1998–2002 BHIVA Conf 2004 Apr 15-17;10:O25 GP Taylor1, W Khan2, L Navaratne3, F Martin4, L Sarner5, J White1, C Walsh2, Z Penn2, EGH Lyall1, Penn2, D Mercey6, S O'Shea3, J Anderson4, A Fakoya5, DA Hawkins2, A de Ruiter3 Pre-eclampsia and EmgCS rates were higher in women taking CART. The continued high PLCS rate in women on CART may reflect the paucity of data on transmission among women on CART with undetectable HIV viraemia. Download Abstract Book 2004
O26	LONG-TERM FOLLOW-UP OF HIV-POSITIVE PREGNANT WOMEN IN LONDON BHIVA Conf 2004 Apr 15-17;10:O26 GP Taylor1, W Khan2, L Navaratne3, F Martin4, L Sarner5, D Mercey6, J Anderson4, A Fakoya5, DA Hawkins2, A de Ruiter3 Good immune function is documented up to 5 years post-partum in this cohort with a low incidence of ADIs. Download Abstract Book 2004
O27	IS 'HIGH ONCOGENIC RISK' HUMAN PAPILLOMAVIRUS (HR HPV) INFECTION PREDICTIVE OF THE EVOLUTION OF CERVICAL NEOPLASIA IN WOMEN WITH HIV? BHIVA Conf 2004 Apr 15-17;10:O27 BM Holden, DK Gill, M Byrne, CJN Lacey Use of antiretroviral therapy led to a low average burden of HIV replication. About 7% of women had evidence of HSIL at entry, and 4% developed it during the follow-up. HPV typing is not useful because: (1) untyped/uncommon HPV types are frequent and (2) the test is insensitive in the setting of low-incidence HSIL. Download Abstract Book 2004
O28	ANTIRETROVIRAL TREATMENT REGIMENS AND THE PREVENTION OF SYSTEMIC HIV-RELATED NON-HODGKIN'S LYMPHOMA (NHL) BHIVA Conf 2004 Apr 15-17;10:O28 A Waterston, J Stebbing, C Thirlwell, T Newsom-Davis, S Mandalia, MR Nelson, BG Gazzard, M Bower HAART-induced maintenance of CD4 and CD8 counts protects patients from systemic AIDS-related NHL. Download Abstract Book 2004
O29	HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) DOES NOT PREVENT ANAL CANCER BHIVA Conf 2004 Apr 15-17;10:O29 C Thirlwell, T Powles, T Newsom-Davis, A Waterston, S Mandalia, MR Nelson, BG Gazzard, M Bower HAART has not reduced the incidence of anal cancer. Among possible explanations for this is the lack of clear correlation between anal cancer and the CD4 cell count and the fact that HAART does not cause regression of anal intraepithelial neoplasia, the presumed precursor of anal cancer. Download Abstract Book 2004
O30	PROTEASE INHIBITORS POTENTIATE CHEMOTHERAPY-INDUCED NEUTROPENIA BHIVA Conf 2004 Apr 15-17;10:O30 N McCall-Peat, N Ryan, L Davies, AM Young, MR Nelson, BG Gazzard, M Bower PI-based HAART potentiates the myelotoxicity of CDE chemotherapy and this is believed to be a consequence of microsomal enzyme inhibition reducing the metabolism of cytotoxics, particularly etoposide in this regimen. Download Abstract Book 2004
Poster Abstracts
P1	SIMPLIFICATION TO TRIZIVIR IN PATIENTS WITH AN UNDETECTABLE VIRAL LOAD BHIVA Conf 2004 Apr 15-17;10:P1 L Swaden, C Sabin, F Lampe, S Bhagani, M Youle, J Ballinger, MA Johnson Although a sustained viral rebound was seen in 22% of these patients, there were no new AIDS events and CD4 counts continued to increase. Download Abstract Book 2004
P2	THE EFFECT OF GENDER ON HAEMOGLOBIN AS A MARKER OF HIV DISEASE PROGRESSION IN THE ERA OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) BHIVA Conf 2004 Apr 15-17;10:P2 S Shah, CJ Smith, FC Lampe, MS Youle, MA Johnson, AN Phillips, CA Sabin Haemoglobin changes following HAART vary by sex, age and risk group, but remain significantly associated with prognosis in both sexes. Download Abstract Book 2004
P3	RENAL DYSFUNCTION WITH TENOFOVIR DF (TDF)-CONTAINING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) REGIMENS IS NOT OBSERVED MORE FREQUENTLY: A COHORT AND CASE–CONTROL STUDY BHIVA Conf 2004 Apr 15-17;10:P3 R Jones, J Stebbing, MR Nelson, G Moyle, M Bower, S Mandalia, BG Gazzard TDF is not associated with renal dysfunction more frequently than other antiretrovirals and the occurrence of renal dysfunction in this context is a rare and idiosyncratic event. Download Abstract Book 2004
P4	TENOFOVIR USE AND CREATININE CLEARANCE IN AN UNSELECTED COHORT OF HIV POSITIVE PATIENTS BHIVA Conf 2004 Apr 15-17;10:P4 D Sloan, SE Peters, R Fox, A Seaton, E Lamont, D Kennedy There was no overall decline in CrCl; however, nephrotoxicity did occur but was rare. Download Abstract Book 2004
P5	PARTICIPATION IN CLINICAL TRIALS AT THE ROYAL FREE HOSPITAL: CHARACTERISTICS OF THOSE INCLUDED AND IMPACT ON TREATMENT OUTCOMES BHIVA Conf 2004 Apr 15-17;10:P5 CJ Smith1, Z Cuthbertson2, A Carroll2, CA Sabin1, FC Lampe1, AN Phillips1, MA Johnson2, MS Youle2 Patients included in first-line HAART RCTs are reflective of the cohort, except for risk group. Those in an RCT were less likely to discontinue an antiretroviral and may have an improved short-term virological response but a similar immunological response compared to those starting HAART as part of routine clinical care. Download Abstract Book 2004
P6	TRIZIVIR AND TENOFOVIR (TT): A SIMPLE REGIMEN FOR SALVAGE THERAPY BHIVA Conf 2004 Apr 15-17;10:P6 V Latham A simple regimen of Trizivir/tenofovir is associated with improvement in outcome in heavily pretreated patients, provided there are less than four TAMs in their resistance history. TT does not adversely affect total cholesterol. Download Abstract Book 2004
P7	RITONAVIR-BOOSTED DOUBLE PROTEASE INHIBITORS IN SALVAGE THERAPY BHIVA Conf 2004 Apr 15-17;10:P7 M Shah, C Michailidis, E Davies, S Mandalia, M Bower, BG Gazzard, MR Nelson Double boosted protease inhibitors have limited efficacy in salvage therapy, but are more effective in patients with three or more active drugs within the regimen. Patients on LPV/SQV-containing regimens are less likely to succeed if they have more than four protease mutations. Download Abstract Book 2004
P8	A HIGH PERCENTAGE OF PATIENTS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) CONSISTENTLY HAVE UNDETECTABLE VIRAL LOADS BHIVA Conf 2004 Apr 15-17;10:P8 F Clark, M Browning, S Hingston, S Williams In all three data collections, over 80% of patients on HAART for longer than 3 months had a VL of <50 copies/ml, and consistently over 90% had a VL of <100 copies/ml. Download Abstract Book 2004
P9	TREATMENT OF PRIMARY HIV INFECTION: A LOCAL EXPERIENCE BHIVA Conf 2004 Apr 15-17;10:P9 S Bhaduri, P Nottingham, A Miller The benefit of short-course HAART in acute primary infection remains unclear and points to the need for local availability of clinical trials. Download Abstract Book 2004
P10	A REVIEW OF TENOFOVIR (TDF) USE IN THE EDINBURGH HIV COHORT BHIVA Conf 2004 Apr 15-17;10:P10 RJ Lessells, CLS Leen The effectiveness of TDF in clinical trials is also apparent in routine clinical practice. Download Abstract Book 2004
P11	EFFICACY, TOLERABILITY AND DURABILITY OF SECOND-LINE PROTEASE INHIBITOR (PI)-BASED THERAPY FOLLOWING FAILURE OF FIRST-LINE NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR (NNRTI)-BASED THERAPY IN AN ETHNICALLY MIXED COHORT BHIVA Conf 2004 Apr 15-17;10:P11 K Aderogba1, J Schultz2, R Kulasegaram3, C Taylor1, C Mazhude4, T Newell5, P Hay6, AM Geretti2 A high rate of discontinuation of second-line therapy mostly reflected intolerability/poor adherence, not virological failure. Download Abstract Book 2004
P12	COMPARISON OF STANDARD LABORATORY LACTATE ANALYSIS WITH A RAPID FINGER-PRICK LACTATE MEASUREMENT IN A COHORT OF HIV-INFECTED INDIVIDUALS BHIVA Conf 2004 Apr 15-17;10:P12 L Johnson, P Lewthwaite, J Day, EM Dunbar The hand-held finger-prick lactate device can be effectively used in monitoring serum lactate levels in HIV-infected individuals, particularly in the out-patient setting. It appears to have a tendency to overestimate the result, which should be recognised. Download Abstract Book 2004
P13	LATE PRESENTERS WITH HIV IN THE ERA OF HAART: HOW EFFECTIVE IS THERAPY? BHIVA Conf 2004 Apr 15-17;10:P13 CA Sabin, H Gumley, M Youle, CJ Smith, F Lampe, AN Phillips, MA Johnson Late presenters may make large demands on clinical resources, particularly in the early months after presentation. Download Abstract Book 2004
P14	THE DURABILITY OF TENOFOVIR (TDF) AND DIDANOSINE (DDI) WHEN DOSED TOGETHER USING LOW-DOSE DDI (250 MG) BHIVA Conf 2004 Apr 15-17;10:P14 M Tung, S Mandalia, M Bower, BG Gazzard, MR Nelson Our clinical cohort has shown that using TDF plus ddI at 250 mg is a safe, well-tolerated and effective combination. Download Abstract Book 2004
P15	TOLERABILITY AND DURABILITY OF NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIS) AND REASONS FOR CHANGING THE 'BACKBONE': 5-YEAR OBSERVATIONAL COHORT DATA BHIVA Conf 2004 Apr 15-17;10:P15 LJ Haddow, CW Wood, JG Ainsworth NNRTI-containing regimens were commonly used in this cohort of mainly black, heterosexual patients, were durable and had rates of toxicity comparable to published data. Download Abstract Book 2004
P16	THE EFFECT OF CD4 CELL NADIR ON THE TOXICITY PROFILES OF ANTIRETROVIRAL REGIMENS BHIVA Conf 2004 Apr 15-17;10:P16 CJ Smith1, CA Sabin1, FC Lampe1, S Shah, MS Youle2, MA Johnson2, AN Phillips1 Lower CD4 nadirs were not found to be associated with either a higher risk of toxicity or of discontinuing an antiretroviral. Download Abstract Book 2004
P17	IMMUNOLOGICAL SUCCESS IN HIV-INFECTED PATIENTS STARTING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) WITH A CD4 COUNT OF <200 CELLS/µL BHIVA Conf 2004 Apr 15-17;10:P17 L Waters, R Jones, C Michailidis, S Sawleshwarkar, J Stebbing, M Bower, MR Nelson, BG Gazzard This study shows a better immunological response to NNRTI or boosted-PI based HAART compared with a single PI. It also shows that boosted-PI regimens are at least as effective as those that are EFV-based and that NVP has similar immunological success to EFV. Download Abstract Book 2004
P18	EPIDEMIOLOGICAL AND CLINICAL TRENDS IN LEVELS OF ANTIRETROVIRAL THERAPY UPTAKE, USING NATIONAL SURVEILLANCE DATA (1998–2002) BHIVA Conf 2004 Apr 15-17;10:P18 B Patel, TR Chadborn, BD Rice, BG Evans, V Delpech A third of individuals starting TT had AIDS, reflecting late presentation. Within each clinical stage there was a trend towards lower CD4 counts at the start of TT. Additionally, there was a trend towards starting treatment while patients were asymptomatic. Download Abstract Book 2004
P19	THE PSYCHOLOGICAL IMPACT OF HIV-RELATED LIPODYSTROPHY BHIVA Conf 2004 Apr 15-17;10:P19 AJ Evans, R Bor, MA Johnson The implications for counselling psychology and medical practice are discussed. Suggestions are made regarding adherence, assessment and psychological approaches to treatment. Download Abstract Book 2004
P20	SEXUAL DYSFUNCTION IN HIV-INFECTED MEN: A COHORT ANALYSIS BHIVA Conf 2004 Apr 15-17;10:P20 D Richardson, H Lamba, C Bell, D Goldmeier Depression, peripheral neuropathy, lipodystrophy and antiretroviral use, with or without elevated oestradiol levels, are possible aetiological factors in HIV-associated male sexual dysfunction. Sexual dysfunction may impact upon adherence to highly active antiretroviral therapy and must be considered in clinical practice. Download Abstract Book 2004
P21	ARE HIV/AIDS SERVICES IN LEEDS ABLE TO MEET THE NEEDS OF ASYLUM-SEEKERS? BHIVA Conf 2004 Apr 15-17;10:P21 CI Allan1, J Clarke2 Asylum-seekers and UK residents were equally satisfied with HIV/AIDS services at the Leeds Centre for Sexual Health. Other agencies such as the Health Access Team and Terrence Higgins Trust had different strengths, which provided valuable support for this client group. Unmet needs of asylum-seekers were identified, such as specialist services for torture victims and opportunities for education. In areas of asylum-seeker dispersal with increased case loads, this methodology may assist the development of client-centred care networks. Download Abstract Book 2004
P22	COST-EFFECTIVENESS OF FIRST-LINE REGIMENS OF HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) IN THE UK: NONNUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NNRTIS) VERSUS PROTEASE INHIBITORS (PIS) BHIVA Conf 2004 Apr 15-17;10:P22 EJ Beck1, S Mandalia1, G Baily2, R Brettle2, M Fisher2, M Gompels2, G Kinghorn2, B McCarron2, E Ong2, A Pozniak2, A Tang2, M Youle1, BG Gazzard1 on behalf of the NPMS–HHC Steering Group First-line NNRTI- and PI-containing HAART regimens had similar effectiveness, but the NNRTI regimens were less expensive than the PI regimens. Cost is also an important factor in selecting HAART regimens. Download Abstract Book 2004
P23	HIGH LEVEL OF SOCIAL NEED AMONG ASYLUM-SEEKERS IN SOUTH LONDON BHIVA Conf 2004 Apr 15-17;10:P23 I Thevarajan, S Murad, M Mvere, R Goncalves, PJ Easterbrook This study highlights the high level and complexity of social problems especially among HIV-positive asylum-seekers in south London. Download Abstract Book 2004
P24	UPTAKE OF HIV TESTING IN A BUSY SOUTH LONDON GENITOURINARY MEDICINE (GUM) CLINIC: WILL WE REACH NATIONAL SEXUAL HEALTH STRATEGY TARGETS AND ARE WE TESTING THOSE AT RISK? BHIVA Conf 2004 Apr 15-17;10:P24 S Roedling, AJ Williams, EF Fox We have already exceeded the targets set by the National Sexual Health Strategy across higher-risk ethnic groups and gay men, but these groups should be targeted further. Download Abstract Book 2004
P25	ONE SIZE FITS ALL? THE CHANGING NEEDS OF HIV-POSITIVE TEENAGERS BHIVA Conf 2004 Apr 15-17;10:P25 D Melvin1, KP Prime2, J Dodge1, C Hanley1, J Sudlow2, L Kirkpatrick2, S O'Farrell2, SG Edwards2 These youngsters welcomed the opportunity to comment on their care. While healthcare concerns and service needs varied between younger and older teenagers, the common theme was around opportunities that increase independence and choice. Download Abstract Book 2004
P26	RELIEVING THE BURDEN: COULD NURSE PRACTITIONERS TAKE ON ROUTINE HIV OUT-PATIENT CARE FOR SELECT COHORTS? BHIVA Conf 2004 Apr 15-17;10:P26 C Griffiths1, K Miles1,2, B George2, P Twist3, R Power1, J Stephenson1, N Penny2, SG Edwards2 Proposals to develop alternative models of care were welcomed. Ongoing work will determine the model of care most suitable. Evaluation will determine impact on service utilisation, health and economic outcomes. The role of the 'expert patient' warrants further investigation. Download Abstract Book 2004
P27	COMPARING HIV AND HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART) WITH OTHER NATIONAL HEALTH SERVICE (NHS) PRIORITY DISEASES AND THEIR ASSOCIATED TREATMENTS BHIVA Conf 2004 Apr 15-17;10:P27 G Gandhi, C Avila The evidence indicated that HIV patients are constrained by a poorer QoL than patients in many NHS priority diseases. HAART is efficient relative to NICE-approved interventions. Download Abstract Book 2004
P28	CURRENT NATIONAL HEALTH SERVICE (NHS) PRIORITIES TOWARDS SEXUAL HEALTH AND HIV/AIDS: IMPLICATIONS FOR HIV TREATMENT BHIVA Conf 2004 Apr 15-17;10:P28 D Khiytani1, G Gandhi2, M Mallinson1 The current failure to designate HIV as a government priority may result in restrictions on whom and when to treat with antiretrovirals, irrespective of treatment guidelines. Re-instatement of HIV as a government priority may be necessary to ensure appropriate provision and delivery of HIV care. Download Abstract Book 2004
P29	HEALTH PLANNING SYSTEMS FAIL TO PROVIDE APPROPRIATE RESOURCES AND RESPONSES TO SEXUAL ILL HEALTH IN ENGLAND BHIVA Conf 2004 Apr 15-17;10:P29 L Power, P Ward, J Kinniburgh The health planning system continues to fail to give sexual health and HIV appropriate attention, resulting in long-term public health costs. Download Abstract Book 2004
P30	WHAT FACTORS MAY IMPACT ON THE ABILITY OF AFRICAN PATIENTS TO GET THE MOST FROM THEIR HIV SERVICE? BHIVA Conf 2004 Apr 15-17;10:P30 D Stainer, MA Johnson, C Beveridge, D Levitt, S Jarrett, A Somalali, B Nandutu, J Lubega The following have been implemented: advocacy and interpreter service, cultural and language-appropriate patient information, staff training in cultural and sexual practices; and a culturally targeted male/female condom pack. These results have implications for service developments to meet the HIV and sexual health needs of African patients. Download Abstract Book 2004
P31	IS DISPERSAL OF HIV-POSITIVE PERSONS WITH INSECURE IMMIGRATION SEEKING ASYLUM (PIISAS) APPROPRIATE? A POSTAL SURVEY OF GENITOURINARY MEDICINE (GUM) CLINICS BHIVA Conf 2004 Apr 15-17;10:P31 S Creighton1, G Sethi2, SG Edwards1, RF Miller1,3 The data suggest that there are problems with dispersal of HIV-positive PIISAs. HIV specialists should work with NASS to ensure that PIISAs are dispersed in a safe and medically justifiable manner. Download Abstract Book 2004
P32	ATTITUDES OF HIV-POSITIVE WOMEN TO CERVICAL SCREENING BHIVA Conf 2004 Apr 15-17;10:P32 S Shah, CJ Smith, C Sabin, H Evans, MA Johnson Cultural differences and language are important factors in women’s perception of cervical screening. Download Abstract Book 2004
P33	HAART IN CANADA: COST-EFFECTIVENESS 1991–2001 BHIVA Conf 2004 Apr 15-17;10:P33 S Mandalia1, EJ Beck2,3, M Gaudreault2, C Brewer3, H Zowall3, N Gilmore3,4, M Klein3,4, R Lalonde3,4, T Murphy3,4, A Piché5, R Platt3, J Roy2, A de la Sablonnière5, C Hankins2,3 HAART was a cost-effective intervention for HIV patients in Canada. Download Abstract Book 2004
P34	HIV TESTING IN TUBERCULOSIS (TB) PATIENTS: MEETING THE LONDON STANDARD BHIVA Conf 2004 Apr 15-17;10:P34 S Dart, D Alder, M Mamdani, S Kirkby, A Evans, N Johnson, MA Johnson, I Cropley, M Lipman Our results indicate that we are far from achieving 100% coverage. Improvements may arise from using alternative testing strategies and qualitative analysis of decision-making by healthcare professionals and patients in the two settings. Download Abstract Book 2004
P35	THE OUTCOME OF PATIENTS WITH HIV-RELATED GERM-CELL TUMOURS (GCTS): A CASE–CONTROL STUDY BHIVA Conf 2004 Apr 15-17;10:P35 T Powles1, J Shamash3, J Stebbing1, J Ong3, G Daugaard2, A de Ruiter4, MA Johnson5, M Fisher6, J Anderson3, MR Nelson1, BG Gazzard1, T Oliver3, M Bower1 HIV-related GCT is not more aggressive than GCT in the general population. Download Abstract Book 2004
P36	CANCER IN RURAL KWAZULU/NATAL, SOUTH AFRICA BHIVA Conf 2004 Apr 15-17;10:P36 M Dedicoat1, R Newton2, F Sittas3 Cancers of the lung and cervix are relatively frequent in KwaZulu/Natal, reflecting the prevalence of risk factors such as tobacco and human papillomavirus infection. Kaposi's sarcoma has increased in frequency with the recent spread of HIV infection. The impact on health of sexually transmitted infections and tobacco are clearly evident in these cancer registration data, but cancer incidence represents only a small proportion of morbidity and mortality associated with these factors. Download Abstract Book 2004
P37	STUDY OF FINE-NEEDLE ASPIRATIONS AND LYMPH-NODE BIOPSIES IN HIV-INFECTED PATIENTS BHIVA Conf 2004 Apr 15-17;10:P37 AE Clarke, J Watson, A de Ruiter Using these as indicators of a more significant underlying pathology and hence the need to investigate further, the number of unnecessary lymph-node investigations could be reduced in those with PGL as the cause. Download Abstract Book 2004
P38	RESOLUTION OF AIDS-RELATED CASTLEMAN'S DISEASE WITH ANTI-CD20 MONOCLONAL ANTIBODIES IS ASSOCIATED WITH DECLINING INTERLEUKIN (IL)-6 AND TUMOUR NECROSIS FACTOR (TNF)-α LEVELS BHIVA Conf 2004 Apr 15-17;10:P38 T Newsom-Davis, J Stebbing, R Gupta, C Thirlwell, MR Nelson, BG Gazzard, M Bower Rituximab was effective therapy in this patient and the response was associated with declines in KSHV viral titres and circulating cytokines. Download Abstract Book 2004
P39	CASE HISTORY: REGRESSION OF ADVANCED CONJUNCTIVAL CARCINOMA IN PATIENT ON ANTIRETROVIRAL THERAPY BHIVA Conf 2004 Apr 15-17;10:P39 S Holkar, I Rennie Unprecedented tumour regression may be related to immune recovery. A human papilloma virus (HPV) aetiology is possible in orbital carcinoma (work ongoing). Only the patient’s religious faith (against medical advice) prevented ultimately unnecessary mutilative surgery. Download Abstract Book 2004
P40	THE VALUE OF ANAL CYTOLOGY AND HUMAN PAPILLOMA VIRUS (HPV) TYPING IN THE DETECTION OF ANAL INTRAEPITHELIAL NEOPLASIA: A REVIEW OF CASES FROM AN ANOSCOPY CLINIC BHIVA Conf 2004 Apr 15-17;10:P40 PA Fox, M Bower, JE Seet, J Stebbing, N Francis, SE Barton, S Strauss, TG Allen-Mersh, BG Gazzard Anal cytology by the Palefsky method is simple to undertake, has a sensitivity and specificity comparable with cervical cytology and can therefore be used as the basis of a pilot screening project in centres with large cohorts of HIV-positive homosexual men who have a high risk of developing anal carcinoma. HPV genotyping is not a useful adjunct to cytological screening. Download Abstract Book 2004
P41	INVASIVE ANAL CANCER: SINGLE INSTITUTION EXPERIENCE BHIVA Conf 2004 Apr 15-17;10:P41 C Thirlwell, A Waterston, AM Young, T Powles, T Newsom-Davis, MR Nelson, BG Gazzard, M Bower This cohort study is the largest series reported so far. The 5-year overall survival is worse than for the general population; however, the 2-year survival rate is 74%, with no relapses of anal cancer occurring after this time and all subsequent deaths attributed to HIV infection. These results are encouraging as they include two patients who received palliative care only. Download Abstract Book 2004
P42	END-STAGE LIVER DISEASE WAS THE PRIMARY CAUSE OF MORTALITY IN HIV-POSITIVE PATIENTS BHIVA Conf 2004 Apr 15-17;10:P42 A Khalid, D Barry, S Hopkins, C Bergin, F Mulcahy 89 patients (28 females, 61 males) died in the study period, 79 as in-patients, four in other hospitals, two in a hospice and four in the community. The mean age at death was 41 years (range 21–58). The mode of HIV acquisition included intravenous drug use (IVDU) in 47 (53%), men having sex with men 16 (18%) and heterosexual five (6%). The mean viral load was 108,770 HIV-1 RNA copies/ml, range (<50 to 430,000), and the mean CD4 count was 79 cells/µl (range 9–754). The mean time between first registration with the service and time of death was 7.7 years (SD ± 4.17 years, range <1 month to 14 years). Among patients who died in the hospital, 70% had previous antiretroviral therapy (ART) experience and 51% were on ART. Endstage liver disease (ELSD) was a cause of death in 43 patients (48.3%), who were also hepatitis C co-infected (41 IVDUs and two haemophiliacs). Active chronic hepatitis B infection was diagnosed in two of the 41 IVDUs. Only eight of the 43 patients who died from ESLD had problematic alcohol-drinking. The other common causes of mortality were HIV-associated malignancy (four lymphoma, one Kaposi's sarcoma), end-stage HIV disease (five), opportunistic infections (one) and accidental death (four). Two patients died from lactic acidosis secondary to ART, one compounded by acute hepatitis A. Download Abstract Book 2004
P43	PEGYLATED INTERFERON-α2B AND RIBAVIRIN FOR CHRONIC HEPATITIS C VIRUS (HCV) INFECTION IN INDIVIDUALS WITH HIV/HCV CO-INFECTION BHIVA Conf 2004 Apr 15-17;10:P43 TT Yee1, S Bhagani2, A Griffioen1, C Hui2, G Dusheiko3, CA Lee1, MA Johnson2 The cohort has a median age of 40 years (range 28–48); all had a CD4 count of >200 cells/µl; the pretreatment median HCV viral load was 891,000 iu/ml (range 18,500–13,300,000); 12 patients were G1, four G2, nine G3 and one G4. Nine were antiretroviral-naïve. A sustained virological response (SVR) was found in 10/26 patients (39%) of all genotypes, in 7/13 (54%) with G2/G3 and in 4/13 (31%) with G1/G4 (31%). After achieving an end-of-therapy response, 4/13 (31%) with G2/G3 relapsed. Anaemia was universal but did not require any erythropoietin support nor any ribavirin dose reduction. No adverse drug interactions were noted. Three female patients developed symptomatic hypothyroidism. In this cohort of patients, pegylated interferon-α2b and ribavirin are safe and well tolerated. The SVR was lower in G 1/4 patients, and there was a high relapse rate (31%) in G2/3 patients treated for 24 weeks. Download Abstract Book 2004
P44	HEPATITIS B VIRUS (HBV) RE-ACTIVATION DURING COMBINATION CHEMOTHERAPY FOR AIDS-RELATED LYMPHOMA IS UNCOMMON AND DOES NOT ADVERSELY AFFECT OUTCOME BHIVA Conf 2004 Apr 15-17;10:P44 A Waterston, J Stebbing, M Atkins, MR Nelson, T Newsom-Davis, BG Gazzard, M Bower HBV re-activation during chemotherapy for AIDS-related lymphoma appears uncommon. In HBV surface antigen-negative HIV-1 infected individuals with AIDS-related lymphoma, the risk of HBV-related hepatitis during chemotherapy appears insignificant. Download Abstract Book 2004
P45	HEPATITIS C (HCV) VIRAL KINETICS IN PATIENTS COINFECTED WITH HIV TREATED WITH PEGYLATED INTERFERON AND RIBAVARIN BHIVA Conf 2004 Apr 15-17;10:P45 SE Peters1, S Cameron2, A Seaton1, R Fox1 A detectable viral load at week 12 predicted a lack of response but an undetectable viral load at week 12 or 24 could not accurately predict the response at 48 weeks. Download Abstract Book 2004
P46	HEPATITIS C (HCV) AND HIV IN THE REGIONAL INFECTIOUS DISEASES UNIT EDINBURGH (RIDU): WHO IS A CANDIDATE FOR HCV TREATMENT? BHIVA Conf 2004 Apr 15-17;10:P46 JM Turner, CLS Leen In this cohort, HCV treatment is currently appropriate in only 30 patients (23%). This low figure reflects patients with a CD4 count of <200 cells/µl and those who declined further assessment or treatment (24%). The reasons for the latter warrant further study. Download Abstract Book 2004
P47	EXPERIENCE OF HEPATITIS C VIRUS (HCV) TREATMENT IN THE EDINBURGH HIV COHORT BHIVA Conf 2004 Apr 15-17;10:P47 RJ Lessells, CLS Leen The outcomes of HCV treatment in co-infected patients are poor. There is an urgent need to determine how the results of recent studies involving pegylated interferon and ribavirin can be applied to clinical practice. Download Abstract Book 2004
P48	VIRAL TROPISM AND ENDOGENOUS INTERFERON PRODUCTION IN PATIENTS WITH ACUTE HEPATITIS C VIRUS (HCV) BHIVA Conf 2004 Apr 15-17;10:P48 C Thomas, S Patterson, MR Nelson, BG Gazzard The presence of HCV in T cells confirms the importance of the T-cell response in acute HCV. IFN-α levels rise in acute HCV, which may play a role in subsequent viral clearance. Download Abstract Book 2004
P49	USE OF ULTRASENSITIVE MUTATION DETECTION SYSTEM TO IDENTIFY THE IN VIVO EFFICACY OF TENOFOVIR AGAINST LAMIVUDINE-RESISTANT AND -SUSCEPTIBLE HEPATITIS B VIRUS (HBV) SUBPOPULATIONS IN LAMIVUDINEEXPERIENCED HBV/HIV-1 CO-INFECTED INDIVIDUALS BHIVA Conf 2004 Apr 15-17;10:P49 P Punia1, S Bissett1, S Ijaz1, C-G Teo1, P Cane, N Saunders1, MR Nelson3, M Fisher4, S Bhagani5, CLS Leen6, D Pillay1,2 Our results are compatible with an equivalent potency of tenofovir against lamivudine-sensitive and -resistant viruses, with the fitness deficit of the latter further reducing mutant concentrations after 16 weeks. Download Abstract Book 2004
P50	A COHORT STUDY TO REVIEW THE EFFICACY OF THE TOTAL LYMPHOCYTE COUNT (TLC) AS A PREDICTOR OF AIDS-DEFINING OPPORTUNISTIC INFECTION (ADOI) IN HIVINFECTED PATIENTS BHIVA Conf 2004 Apr 15-17;10:P50 S Sawleshwarkar, C Michailidis, R Jones, J Stebbing, MR Nelson, M Bower, S Mandalia, BG Gazzard A TLC is only moderately less reliable than a CD4 count. Download Abstract Book 2004
P51	CHEMOKINE RECEPTOR ANALYSIS OF A UK COHORT WITH CHRONIC HIV-1 INFECTION BHIVA Conf 2004 Apr 15-17;10:P51 CT Burton1, MR Nelson2, B Gazzard2, FM Gotch1, N Imami1 In this study, numbers of HIV-negative Δ32 heterozygous individuals were higher than published values, possibly due to ethnic differences. Lower numbers were seen in the HIV-1-positive subjects. Our CCR2 data support the findings of others. Published data have indicated a link between chemokine receptor mutations and the failure of viral suppression by antiretroviral therapy. We have shown that β- chemokine levels are altered by the choice of antiretroviral therapy. We propose that knowledge of the effects of β-chemokines and chemokine-receptor mutation may become important for new classes of antiretroviral therapy. Download Abstract Book 2004
P52	HIGH LEVELS OF HIV-1 INFECTION OF CD8 LYMPHOCYTES EXPRESSING CD4 IN VIVO BHIVA Conf 2004 Apr 15-17;10:P52 A Cochrane1, S Imlach1, CLS Leen2, G Scott3, P Simmonds1 Infection of activated cells rather than intrathymic cells is the major route of production of circulating HIV-infected CD8 lymphocytes. The high HIV proviral loads in CD8 lymphocytes expressing CD4 suggest targeted infection of CD8 lymphocytes responding to antigen. Download Abstract Book 2004
P53a	FUNCTION AND DISTRIBUTION OF NATURAL KILLER (NK) CELL SUBSETS IN HIV-1 POSITIVE INDIVIDUALS IN THE PRESENCE AND ABSENCE OF VIRAEMIA BHIVA Conf 2004 Apr 15-17;10:P53a CM Mela1, MR Goodier1, CT Burton1, N Imami1, BG Gazzard2, FM Gotch1 Increases in the viral load are associated with decreases in absolute numbers of NK cells and a deficient redistribution of their subsets. Download Abstract Book 2004
P53b	PREVALENCE OF SKIN DYSPLASIA AND MALIGNANCY IN HIV-POSITIVE INDIVIDUALS BHIVA Conf 2004 Apr 15-17;10:P53b SF Forsyth1, E Agius1, F Vega-Lopez2, IG Williams3, SG Edwards1 Both HIV and ultraviolet radiation may contribute to reduced tumour surveillance in the skin. Our data highlight the need for clinicians to advise patients about risk factors and monitor them in order to diagnose skin cancers promptly. Download Abstract Book 2004
P54	RETROSPECTIVE STUDY OF ANTIRETROVIRAL THERAPY IN HIV-INFECTED CHILDREN AT THE ROYAL FREE HOSPITAL BHIVA Conf 2004 Apr 15-17;10:P54 D Patel, L Swaden. J Ballinger, M Greenberg, V Van Someron, MA Johnson Difficulty adhering to complex regimens was the prime reason for uncontrolled viral suppression, resulting in either rapid cycling of antiretroviral agents or continuation of a partially resistant regimen. Download Abstract Book 2004
P55	TEACHING PILL-SWALLOWING IN HIV-INFECTED CHILDREN REVISITED BHIVA Conf 2004 Apr 15-17;10:P55 D Krechevsky, S Head Details and difficulties of the technique will be discussed. Download Abstract Book 2004
P56	FOLLOW-UP OF CHILDREN EXPOSED TO ANTIRETROVIRAL THERAPY IN PREGNANCY (CHART): A ROLE FOR HIV PHYSICIANS? BHIVA Conf 2004 Apr 15-17;10:P56 CD Hankin1, PA Tookey1, EGH Lyall2, CS Peckham1 Developing a practical, acceptable method of follow-up is necessary in light of the variety of antiretroviral therapy regimens, increasing numbers of antiretroviral-exposed children and implications for workloads. Involvement of HIV physicians may increase as enrolled children are discharged from paediatric care. Download Abstract Book 2004
P57	PATTERNS OF ATTENDANCE POST-DELIVERY FOR ANTENATALLY DIAGNOSED HIV POSITIVE WOMEN BHIVA Conf 2004 Apr 15-17;10:P57 N Saulsbury1, SF Forsyth1, D Thorburn1, J Baruah1, P Whyte2 Regular attendance after delivery for these women is poor for many reasons. Having integrated clinics and identifying those most likely to be lost may improve their health outcome. Download Abstract Book 2004
P58	IDENTIFICATION OF DISCORDANT WOMEN IN A DEDICATED HIV-POSITIVE WOMEN'S CLINIC: A DESCRIPTIVE ANALYSIS BHIVA Conf 2004 Apr 15-17;10:P58 C Bell, M Wall, D Richardson, L Greene, J Walsh, D Wilkinson In this cohort, serodiscordant women had a greater awareness of PEP, reported greater use of condoms and were more likely to be taking highly active antiretroviral therapy than seroconcordant women. However, both groups had similar proportions of acute STIs (35% and 33%). Targeted women's services that promote safer sex, PEP awareness and STI screening may reduce HIV transmission to negative partners, by encouraging health-seeking behaviour for the rapid treatment of STIs. Download Abstract Book 2004
P59	ADAPTING TO CHANGING NEEDS: 10 YEARS OF A FAMILY CLINIC BHIVA Conf 2004 Apr 15-17;10:P59 D Melvin, J Dodge, S Walters, C Hanley, R Biggs, EGH Lyall, C Locher The multidisciplinary family approach has been an effective way of delivering medical, social and psychological care. It is now adapting its approach in response to the changing needs of families and older children. Download Abstract Book 2004
P60a	SETTING STANDARDS: ANALYSIS OF THE EFFECTIVENESS OF THE CARE PATHWAY FOR HIV-INFECTED PREGNANT WOMEN BHIVA Conf 2004 Apr 15-17;10:P60a A Saleem, J Dhar All females received care in line with BHIVA guidelines. The care pathway enabled us to achieve the above-mentioned standards, and allowed us to audit the outcome. Inconsistencies in documentation were noted, and recommendations will be discussed. Download Abstract Book 2004
P60b	DEDICATED SERVICES FOR HIV POSITIVE ADOLESCENTS: WHY BOTHER? BHIVA Conf 2004 Apr 15-17;10:P60b KP Prime, SF Forsyth, EA Jungmann, SG Edwards Increasing numbers of HIV-infected, multidrug classexperienced children will be surviving into adolescence and becoming sexually active. There is an urgent need to further develop dedicated adolescent services to minimise loss to follow-up, encourage adherence to antiretroviral therapy and prevent the transmission of drug-resistant virus in this vulnerable group. Download Abstract Book 2004
P61	SEXUAL HEALTH IN HIV-POSITIVE PATIENTS ATTENDING AN INFECTIOUS DISEASES UNIT BHIVA Conf 2004 Apr 15-17;10:P61 JM Turner, D Wilks, S Morris In this survey, most patients want sexual-health screening to take place in the same setting as HIV care. This is not being met by our current service. The survey highlights ongoing transmission risks of both STIs and HIV, with 44% of patients not always using condoms for penetrative sex. Download Abstract Book 2004
P62	A RETROSPECTIVE AUDIT OF THE MANAGEMENT OF HEPATITIS C (HCV) AND HIV CO-INFECTION: HOW CLOSE IS CURRENT PRACTICE TO THE BHIVA GUIDELINES AND AUDIT STANDARDS? BHIVA Conf 2004 Apr 15-17;10:P62 JM Turner, CLS Leen, A Wilson, S Morris Improvements are needed in hepatitis A (HAV) vaccine coverage. At present we have no formal documentation of this ongoing process. The documented episodes are for patients with ongoing risks. Download Abstract Book 2004
P63	A REGIONAL AUDIT OF THE ANTENATAL AND PERINATAL MANAGEMENT OF HIV-INFECTED WOMEN, AND THE POSTNATAL MANAGEMENT OF THEIR CHILDREN IN THE NORTHWEST OF ENGLAND, 2002-2003 BHIVA Conf 2004 Apr 15-17;10:P63 E. Clarke, EGL Wilkins, on behalf of the NW Audit Team This audit has underlined the importance of a multidisciplinary approach to maternal and neonatal care, the need for well-circulated and agreed guidelines, and regular staff training to convey best practice. Download Abstract Book 2004
P64	ADHERENCE SERVICES IN PRACTICE BHIVA Conf 2004 Apr 15-17;10:P64 C Stradling, J Home Implementation of a local HAART adherence protocol is achievable. We met the BHIVA guidelines for patients commencing HAART. However, we were unable to provide ongoing assessment and support to maintain adherence, due to inadequate staff resources. Download Abstract Book 2004
P65	AN AUDIT OF BASELINE HISTORY, EXAMINATION AND INVESTIGATIONS OF PATIENTS INFECTED WITH HIV: A COMPARISON OF PRACTICES BETWEEN DEPARTMENTS OF GENITOURINARY MEDICINE (GUM) AND INFECTIOUS DISEASES (ID) BHIVA Conf 2004 Apr 15-17;10:P65 M Gupta1, G Sandhu2, M Verghese2, H Ponsford2, D Thorburn2, E Evans1, S Al-Abri2, M Bradley1, FJ Nye2, NJ Beeching2 A universal patient proforma would aid equality of documentation and care for newly diagnosed HIV patients in the two units, as well as providing an audit tool in the face of new BHIVA guidelines. Download Abstract Book 2004
P66	AN AUDIT OF OUT-PATIENT MANAGEMENT AND SCREENING INVESTIGATIONS OF PATIENTS INFECTED WITH HIV: A COMPARISON OF PRACTICES BETWEEN DEPARTMENTS OF GENITOURINARY MEDICINE (GUM) AND INFECTIOUS DISEASES (ID) BHIVA Conf 2004 Apr 15-17;10:P66 M Gupta1, G Sandhu2, M Verghese2, H Ponsford2, D Thorburn2, E Evans1, S Al-Abri2, M Bradley1, FJ Nye2, NJ Beeching2 Both departments are poor at documenting repeat screening investigations, assessment of risk for sexually transmitted infections and treatment adherence. A 'reminder' proforma will be introduced and outcomes audited again against the new guidelines produced by BHIVA. Download Abstract Book 2004
P67	HIV-RELATED PULMONARY HYPERTENSION: A CASE REPORT AND LITERATURE REVIEW BHIVA Conf 2004 Apr 15-17;10:P67 P Panagopoulos, G Poulakou, I Katsarolis, S Kopanakis, G Koratzanis, A Antoniadou, H Giamarellou HIV-associated pulmonary hypertension should be included in the differential diagnosis in patients with pulmonary hypertension and respiratory failure, despite the absence of typical symptoms. Download Abstract Book 2004
P68	ELEVATED INTRACRANIAL PRESSURE AND IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME COMPLICATING CRYPTOCOCCAL MENINGITIS BHIVA Conf 2004 Apr 15-17;10:P68 J York, I Reeves, P Riordan Eva, I Bodi, P Easterbrook This case highlights the complex interpretation and management of a possible IRIS, causing sustained high ICP in cryptococcal disease. Download Abstract Book 2004
P69	THE BOTTOM LINE: A CASE OF TUBERCULOSIS (TB) IN THE BUTTOCK OF A PATIENT CO-INFECTED WITH HIV BHIVA Conf 2004 Apr 15-17;10:P69 Shamela de Silva, Andrew Shaw We will display photographs, radiographs and discuss the optimal investigation and management (steroids, aspiration, surgical drainage) of paradoxical reactions. We will also debate the value of secondary prophylaxis for MTB, which may have prevented such a case. Download Abstract Book 2004
P70	CASE REPORT: BILATERAL PSOAS ABSCESSES IN AN HIV-POSITIVE PATIENT BHIVA Conf 2004 Apr 15-17;10:P70 L Kozakis, T Ballachandran As the prevalence of tuberculosis among HIV-positive patients is high, and extrapulmonary presentations are more common, there is a need for increased awareness of this diagnosis. Download Abstract Book 2004
P71	COMPLICATED VARICELLA ZOSTER VIRUS (VZV) INFECTION IN AN AIDS PATIENT BHIVA Conf 2004 Apr 15-17;10:P71 N Lomax1, M Westcott1,3, J Hutchinson1,2 Retrobulbar neuritis, retinitis and myelopathy are rare but recognised complications of VZV infection. Data on the treatment of complicated VZV are sparse. This case suggests that steroids may be beneficial in addition to prolonged antiviral therapy. Download Abstract Book 2004
P72	HERPES SIMPLEX VIRUS (HSV) INFECTION OF THE CENTRAL NERVOUS SYSTEM (CNS) IN HIV BHIVA Conf 2004 Apr 15-17;10:P72 D Grove1, W Newsome1, NS Brink2, H Manji3, RF Miller1 HIV-1 infected patients with HSV infection of the CNS have a varied clinical presentation. Diagnosis by PCR on CSF identified the majority of cases. With specific treatment, the outcome was good. Download Abstract Book 2004
P73	INCREASED PREVALENCE OF REVERSE TRANSCRIPTASE (RT) MUTATION Q207D/E IN LAMIVUDINE (3TC)-EXPERIENCED VERSUS TREATMENT-NAÏVE PATIENTS SUGGESTS A ROLE IN NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR (NRTI) RESISTANCE BHIVA Conf 2004 Apr 15-17;10:P73 G Nebbia1, F Mattes1, M Smith2, AM Geretti1 Q207D/E occurs in treatment-naïve patients, especially those infected with subtype C, and increases in prevalence upon treatment with 3TC-based regimens not including ZDV, suggesting a role in drug resistance. G196E, R211K and L214F did not appear to be associated with drug exposure. H208Y was rare in both treatment-naïve and treatment-experienced patients. Download Abstract Book 2004
P74	THERAPEUTIC DRUG MONITORING (TDM) IN PATIENTS TAKING FOSAMPRENAVIR AND KALETRA AS DUAL PROTEASE INHIBITOR (PI)-BASED ANTIRETROVIRAL THERAPY BHIVA Conf 2004 Apr 15-17;10:P74 C Bell, A Hughes, D Richardson, K Asher, G Scullard, J Walsh We conclude that in this heavily treatment-experienced sample, Kaletra/fosamprenavir in combination is effective providing TDM is used to ensure a 12-hour trough concentration [Cmin (12 h)] within the therapeutic range. Download Abstract Book 2004
P75	IS THERE EVIDENCE FOR WEIGHT-ADJUSTED DOSING OF KALETRA? BHIVA Conf 2004 Apr 15-17;10:P75 S Gibbons, L Robinson, G Davies, DJ Back, and SH Khoo LPV exposure appears to be affected by body weight. The clinical relevance of these findings should be explored further. Download Abstract Book 2004
P76	SAQUINAVIR HARD GEL (SQV-HG)/RITONAVIR (RTV) PHARMACOKINETICS (PKS): EFFECT OF HIGH-FAT MEALS, PLASMA CONCENTRATION DIURNAL VARIATION AND INTRAPATIENT VARIABILITY BHIVA Conf 2004 Apr 15-17;10:P76 M Boffito1, DJ Back2, L Dickinson2, A Hill3, G Moyle1, MR Nelson1, C Higgs1, C Fletcher1, BG Gazzard1, A Pozniak1 SQV-hg/RTV absorption is not dependent on the amount of fat contained in a meal. Significant diurnal variations and wide intrapatient variability have been observed in SQV and RTV Ctrough. Download Abstract Book 2004
P77	DISOPROXIL FUMARATE (TDF) IN HIV-INFECTED ADULTS RECEIVING SAQUINAVIR HARD GEL (SQV)/RITONAVIR (RTV) AT 1000/100 MG TWICE A DAY BHIVA Conf 2004 Apr 15-17;10:P77 M Boffito1, A D’Avolio2, G Di Perri2, M Sciandra2, S Bonora2, DJ Back3, A Hill4, G Moyle1, M Nelson1, C Higgs1, J Tomkins1, B Gazzard1, A Pozniak1 Tenofovir t1/2 and overall exposure were comparable with previously published data. SQV/RTV does not appear to have any impact on tenofovir PKs. Download Abstract Book 2004

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