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14th Annual Conference of the British HIV Associations23–25 April 2008, Belfast |
Cite as: HIV Med. 2008 May; 9(Suppl 1):page number (abstract no. xx)
Example: HIV Med 2008 May; 9(Suppl 1):1 (abstract no. O1)
| ORAL ABSTRACTS Abstracts O1 to O30, pages 1 through 9 |
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| O1 | SHOULD WE TARGET COMMUNITY AND PRIMARY CARE HIV TESTING EFFORTS IN CERTAIN AREAS? ESTIMATES OF HIV PREVALENCE FOR KEY PREVENTION GROUPS BY REGION AND LOCAL AUTHORITY (LA) IN ENGLAND HIV Med. 2008 May; 9(Suppl 1):1 (abstract no. O1) T Chadborn, K Hutton, V Delpech and B Rice Discussions continue about how to enhance HIV testing but the epidemiology suggests a localized approach of targeting offers of HIV testing based on a simple risk assessment. This would also allow for local patient acceptability and setting appropriateness to be considered. Partner notification (including of the long-term diagnosed) is likely to be key to the earlier diagnosis of people in low prevalence areas. |
| O2 | FIRST PRESENTATION OF VERTICALLY ACQUIRED HIV INFECTION IN ADOLESCENCE HIV Med. 2008 May; 9(Suppl 1):1 (abstract no. O2) K Prime1, R Ferrand2, C Foster3, A Judd4, J Masters5, H Lyall3 and E Jungmann6 Young people with vertically acquired HIV infection are surviving childhood without ART and being diagnosed in adolescence. In this cohort a third were asymptomatic, highlighting the importance of testing all children born to HIV-infected women, regardless of age or symptoms. Increased awareness amongst clinicians is urgently required to prevent presentation with advanced disease and to reduce ongoing transmission as this population become sexually active. |
| O3 | DOES POINT-OF-CARE HIV TESTING IMPROVE TESTING AND DIAGNOSIS IN A HOSPITAL-BASED VOLUNTARY TESTING CLINIC? HIV Med. 2008 May; 9(Suppl 1):1 (abstract no. O3) G Nebbia1, A Evans2, Miss S Chaytor2, U Nandakumar2, T Fernandez2, G Clewley2, M Johnson1 and AM Geretti1 In a clinic-based voluntary HIV testing service, compared with same-day laboratory-based testing, HIV POCT reduces the number of those who do not wait for results. This comes at the cost of a high false positivity rate (1:11) and a significant delay in detecting early infection. |
| O4 | IDENTIFYING HIV INFECTION IN DIAGNOSTIC HISTOPATHOLOGY TISSUE SAMPLES HIV Med. 2008 May; 9(Suppl 1):1 (abstract no. O4) L Alarcon, U Mahadeva, M Moonim, J van der Walt and S Lucas Diagnostic histopathology can identify HIV infection directly in tissue samples when the viral load is sufficiently high. As well as confirming specific pathologies such as PGL and HIV encephalitis, p24 staining identifies patients not previously known to be HIV-infected. This technique should be applied more widely to diagnose HIV+ve patients earlier and bring them into treatment programmes. |
| O5 | DIAGNOSING THE UNDIAGNOSED: IDENTIFYING SYMPTOMATIC PRIMARY HIV INFECTION (PHI) PRESENTING TO PRIMARY AND EMERGENCY HEALTHCARE PHYSICIANS HIV Med. 2008 May; 9(Suppl 1):2 (abstract no. O5) K Nambiar1, D Pao1, J Whetham1, D Sudarshi1, G Homer1, G Murphy2, J Parry2 and M Fisher1 The PHI prevalence is substantially lower than expected. This may be due to patients not being venesected if an unspecified viral illness is suspected. It therefore remains essential that physicians are vigilant for symptoms of possible PHI and have a low threshold to test for HIV, particularly in high risk groups. The overall 1% undiagnosed HIV prevalence, however, suggests that more widespread testing in primary/ emergency care may be warranted. |
| O6 | UNDERSTANDING THE BARRIERS TO GP INVOLVEMENT IN THE CARE OF PATIENTS WITH HIV HIV Med. 2008 May; 9(Suppl 1):2 (abstract no. O6) M Kennedy1, Y Gilleece1, N Perry1, A Cressey1, J Wastie2, H Smith1 and M Fisher1 This study showed a much higher level of GP involvement compared to pre-HAART studies suggesting that a high level of primary care is achievable. Barriers still remain however for a significant minority of patients. These include a perceived lack of GP knowledge and experience of HIV and the issue of confidentiality. Secondary care providers need to work with patients and primary care to address these issues. |
| O7 | LOW PREVALENCE OF TRANSMITTED ANTIRETROVIRAL DRUG RESISTANCE IN A LARGE UK HIV-1 COHORT HIV Med. 2008 May; 9(Suppl 1):2 (abstract no. O7) B Payne1, E Nsutebu2, E Hunter3, O Olarinde4, P Collini4, J Dunbar5, M Basta2, J Elston6, M Schmid3, H Thaker6 and D Chadwick1 In a large unselected UK cohort, with high coverage of TDR testing, the prevalence of TDR was substantially lower than in most published literature. Differences in population mix did not appear to explain this low rate. TDR rates in the UK may now be falling compared with historical data. |
| O8 | THE IMPACT OF RESISTANCE TESTING IN ARV-NAÏVE PATIENTS: DOES IT GUIDE OPTIMAL THERAPY SELECTION AND IMPROVE LONG-TERM OUTCOMES? HIV Med. 2008 May; 9(Suppl 1):2 (abstract no. O8) L Bansi1, AM Geretti1, D Dunn2 and C Sabin1, UK CHIC Steering Committee1 Patients with low GSS tend to have poorer long-term outcomes and hence, as well as tolerability, selection of first-line HAART should take into account the presence of transmitted drug resistance, together with other recognised predictors of virological outcomes. |
| O9 | GAG-PROTEASE INTERRELATIONSHIPS IN DRUG RESISTANCE AND VIRAL FITNESS HIV Med. 2008 May; 9(Suppl 1):3 (abstract no. O9) CM Parry, A Kohli and D Pillay Many existing RC assays are limited in an ability to fully explore protease gag interrelationships -important in light of increasing evidence of gag effects on drug susceptibility and replication. We demonstrate a complete restoration of RC for a highly mutated protease by full-length gag, and are able to better identify the determinants of viral fitness. |
| O10 | EFFECT OF HIV-1 SUBTYPE ON VIROLOGICAL AND IMMUNOLOGICAL RESPONSES TO FIRST-LINE HAART HIV Med. 2008 May; 9(Suppl 1):3 (abstract no. O10) L Harrison1, AM Geretti2, H Green1, D Dunn1 and E Fearnhill1 Persons infected with prevalent non-B subtypes in the UK show excellent and durable responses to first-line HAART. Subtypes A and C respond more rapidly than B. Further studies are needed to explore the influence of ethnicity, risk group and adherence. |
| O11 | EMERGENCE OF DRUG RESISTANCE IN HIV-1 INFECTED PATIENTS AFTER FIRST-LINE HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART): A SYSTEMATIC REVIEW OF CLINICAL TRIALS HIV Med. 2008 May; 9(Suppl 1):3 (abstract no. O11) RK Gupta1, A Hill2, A Sawyer3 and D Pillay1 Initial therapy with boosted PI-based regimens results in less resistance within and across drug classes, preserving more treatment options at time of virological failure. |
| O12 | RESPONSES TO HAART AND CLINICAL EVENTS IN PATIENTS WITH A LOW CD4 COUNT: LATE PRESENTERS VERSUS LATE STARTERS HIV Med. 2008 May; 9(Suppl 1):3 (abstract no. O12) LJ Waters1, MJ Fisher2, J Anderson3, C Wood4 and C Sabin5, for the UK CHIC Study Group5 Late presenters achieve similar rates of viral suppression to subjects who present early but start HAART with CD4 <200 but CD4 rise is significantly less at 48 weeks. New AIDS events were significantly more common for late presenters versus late starters which may reflect factors, additional to CD4 count, associated with late presentation. |
| O13 | PREDICTORS OF VIROLOGICAL TREATMENT FAILURE IN THE HIV ROLL-OUT COHORTS OF THE WESTERN CAPE PROVINCE, SOUTH AFRICA HIV Med. 2008 May; 9(Suppl 1):4 (abstract no. O13) MI Datay1, A Boulle2, P Yudkin1 and D Mant1 The high prevalence of a very low baseline CD4 is concerning in light of its association with failure. Our study adds insight into the role of TI, choice of NNRTI and MTCT exposure. Further study of TI and travel is needed working towards intervention. |
| O14 | PREGNANCY LOSS IN HIV-POSITIVE WOMEN ATTENDING ANTENATAL CARE AT A LONDON CENTRE HIV Med. 2008 May; 9(Suppl 1):4 (abstract no. O14) J Anderson, R Evans-Jones, D Janga, L Sivyour, E Dorman and S Tariq Eight-percent of pregnancies resulted in late pregnancy loss; notably more than in a non-HIV setting. Post-mortems were performed in over 70%. The most common finding was chorioamnionitis, in keeping with the literature. A significant proportion of the women had complex psychosocial issues but all engaged with HIV follow-up after their loss. We advocate further large-scale research to elucidate the mechanisms underlying late pregnancy loss in HIV. |
| O15 | UNEXPECTEDLY HIGH RATES OF VITAMIN D DEFICIENCY IN AN INNER-CITY LONDON HIV CLINIC HIV Med. 2008 May; 9(Suppl 1):5 (abstract no. O15) MM Rosenvinge1, K Gedela1, A Wilkinson2, A Copas2, C Sheehy3, MR Pakianathan3, P Hay4 and ST Tariq4 There is an alarmingly high rate of vitamin D deficiency among our HIV cohort, associated with black ethnicity, younger age and higher random blood glucose. Importantly detection and treatment may improve clinical outcomes including insulin resistance, bone disease and susceptibility to TB. |
| O16 | PLASMA EXPOSURE OF 100 MG ONCE (OD) AND TWICE DAILY (BID) DECREASES HDL AND CD36 EXPRESSION BUT ONLY BID DOSING INCREASES TRIGLYCERIDES (TG): POTENTIAL IMPACT OF RTV ON CARDIOVASCULAR DISEASE (CVD) HIV Med. 2008 May; 9(Suppl 1):5 (abstract no. O16) C Fletcher1, M Boffito1, S Collot-Teixeira2, F De Lorenzo3, L Waters1, D Back4, S Mandalia1, A Pozniak1, JL McGregor2,5 and B Gazzard1 Hundred milligrams BID RTV but not 100mg OD RTV gave rise to an increase in TG over 2 weeks in healthy volunteers; the increase was related to higher RTV exposure. Reduced HDL and CD36 expression were observed for both RTV dosages. |
| O17 | HIGH INCIDENCE OF IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME (IRIS) DUE TO DERMATOLOGICAL CONDITIONS AND TUBERCULOSIS IN AN ART PROGRAMME IN SOUTH AFRICA HIV Med. 2008 May; 9(Suppl 1):5 (abstract no. O17) LJ Haddow1, MYS Moosa2, NG Khanyile2, NM Sithole2, Q Zulu2, A Mosam2, F Ibrahim1 and PJ Easterbrook1 IRIS occurred in 23% of patients and was more frequent in patients with advanced disease; most cases were dermatological. Despite low overall mortality, IRIS contributed to 25% of all deaths. |
| O18 | CHRONIC KIDNEY DISEASE IN HIV-INFECTED PATIENTS HIV Med. 2008 May; 9(Suppl 1):5 (abstract no. O18) FA Post1, Ms LJ Campbell1, F Ibrahim1, M Fisher2, SG Holt2 and BM Hendry2 Non-primary renal disease accounted for >90% of CKD in Caucasians. The risk of non-primary CKD in patients initiating IDV or TNF is modified by the presence of other risk factors for CKD, age and, for TNF, renal function and duration of prior antiretroviral treatment. |
| O19 | HIV AND AGEING HIV Med. 2008 May; 9(Suppl 1):6 (abstract no. O19) J Elford1, F Ibrahim1, C Bukutu1 and J Anderson2 In this study of people living with diagnosed HIV in London, just over ten percent were over the age of 50. Nearly half the over 50s were diagnosed in their 50s highlighting that this group does not solely comprise an ageing cohort of people diagnosed with HIV in their 30s and 40s. |
| O20 | WHAT ARE THE IMPLICATIONS OF INCREASING THE RECOMMENDED THRESHOLD FOR STARTING ANTI-HIV THERAPY (ART)? HIV Med. 2008 May; 9(Suppl 1):5 (abstract no. O20) T Chadborn and V Delpech There are likely to be both clinical and public health benefits of recommending all HIV-infected persons to start ART if CD4 <350 but some of the implications are: 1. the definition of late diagnosis should change; 2. treatment costs will increase (1000 additional adults would cost the NHS an additional ≤10 m per year); 3. transmission may be reduced through a reduction in viral load. |
| O21 | UTILITY OF CD4 COUNT MONITORING IN PATIENTS ON HAART WHO MAINTAIN VIRAL LOAD (VL) SUPPRESSION – EXPERIENCE FROM THE VS ARM (CONTINUOUS ART) OF THE SMART STUDY (STRATEGIES FOR MANAGEMENT OF ANTIRETROVIRAL THERAPY STUDY) HIV Med. 2008 May; 9(Suppl 1):6 (abstract no. O21) DN Chilton1, J Neuhaus2, A Palfreeman3, SG Edwards1 and IG Williams4 HIV related clinical events were rare in patients who maintained VL <50. Also in VL suppressed patients, the rate of CD4 decline to <350 is lower and total time with CD4 <350 less, than in those experiencing VL >400. These data suggest that reduced frequency of CD4 monitoring in patients who maintain VL<50 on HAART and have achieved good CD4 recovery (>350) may be clinically acceptable. |
| POSTER ABSTRACTS Abstracts P1 to P150, pages 10 through 50 |
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| P45 | PATIENTS WITH HIV AND HEPATITIS C CO-INFECTION PERIENCE LESS ATAZANAVIR-INDUCED HYPERBILIRUBINAEMIA HIV Med. 2008 May; 9(Suppl 1):21 (abstract no. P45) A Cotter1, A Brown1, J Lambert2, G Sheehan1 and P Mallon2 Being HepC positive protects against ATV-induced byperbilirubinaemia. Further research is needed to determine the mechanism underlying this protective effect. |
| P72 | ASSESSMENT OF STAGING OF LIVER FIBROSIS BY TRANSIENT ELASTOGRAPHY IN HIV-POSITIVE PATIENTS WITH CHRONIC LIVER DISEASE USING LIVER BIOPSY AS THE GOLD STANDARD HIV Med. 2008 May; 9(Suppl 1):29 (abstract no. P72) A Rodger1, T Fernandez1, G Slapak1, G Dusheiko1, MA Johnson1, C Sabin2 and S Bhagani1 FibroScan is a reliable method for the diagnosis of significant fibrosis (>F2) and cirrhosis (F4) in HIV positive patients with chronic liver disease. This technique can effectively inform clinical decisions on the need to proceed to treatment for viral hepatitis coinfection or liver biopsy. The ability of fibroscan to monitor progression or regression of fibrosis over time in individual patients needs further assessment. |
| P94 | TREATMENT OF METATARSAL FAT PAD LIPOATROPHY WITH VOLUMIZING INJECTIONS HIV Med. 2008 May; 9(Suppl 1):35 (abstract no. P94) A Kavouni1, E O’Donovan1, S Brown1, S Barton1, M Nelson1, S Levine2 and E Lautin2 PLLA injections led to improvements in pain distress and activity scores in individuals with lipoatrophy of the foot. There were no adverse effects and the tissue augmentation was significant at 8 weeks after the last injection. |
| P124 | INTERACTIONS BETWEEN IMMUNOSUPPRESSANTS AND ANTIRETROVIRAL THERAPY (ARVT) IN SOLID ORGAN TRANSPLANT RECIPIENTS: A ROLE FOR NON-NUCLEOSIDE REVERSE TRANSCRIPTASE AND PROTEASE INHIBITOR-SPARING REGIMES HIV Med. 2008 May; 9(Suppl 1):43 (abstract no. P124) B Nathan1, M Tredger1, S Doshi1, R Kulasegaram2 and CB Taylor1 Interactions between immunosuppressants, NNRTIs and PIs are common and often unpredictable due to variable interactions with CYP3A4 and P-glycoprotein |