MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'HIV Medicine' source. Tue, 16 Mar 2010 15:30:21 +0100 http://www.medworm.com/index.php?rid=3367799&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00784.x HIV status has commonly been found to affect the serum lipid profile. The aim of this study was to determine the effect of HIV infection on lipid metabolism; such information may be used to improve the management of HIV-infected patients. Samples were collected from December 2005 to May 2006 at Yaounde University Teaching Hospital, Yaounde, Cameroon. Lipid parameters were obtained using colorimetric enzyme assays, while low-density lipoprotein cholesterol (LDLC) values were calculated using the formula of Friedewald et al. (1972) and atherogenicity index by total cholesterol (TC)/high-density lipoprotein cholesterol (HDLC) and LDLC/HDLC ratios. HIV infection was most prevalent in subjects aged 31 to 49 years. Most of the HIV-positive patients belonged to Centers for Disease Control and Pre... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3367799 Tue, 16 Mar 2010 00:00:00 +0100 3367799 http://www.medworm.com/index.php?rid=3344377&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00821.x (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3344377 Tue, 09 Mar 2010 00:00:00 +0100 3344377 http://www.medworm.com/index.php?rid=3344380&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00817.x Lipoatrophy can complicate thymidine analogue nucleoside reverse transcriptase inhibitor (tNRTI)-based antiretroviral therapy (ART). Lipoatrophy may be less likely with ART including ritonavir-boosted lopinavir (LPV/r). Small, placebo-controlled studies found that uridine (in tNRTI recipients) and pravastatin improved HIV lipoatrophy over 12 weeks. Today, most patients with lipoatrophy receive non-tNRTI-based ART; the effect of uridine in such patients is unknown. We performed a prospective, randomized trial in lipoatrophic adults with plasma HIV RNA (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3344380 Mon, 08 Mar 2010 00:00:00 +0100 3344380 http://www.medworm.com/index.php?rid=3344379&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00819.x To evaluate whether etravirine (TMC125) might be effective in patients failing therapy with current nonnucleoside reverse transcriptase inhibitors (NNRTIs), we analysed the prevalence of TMC125 mutations and the possible determinants of genotypic resistance to this drug among sequences reported to a large database in Italy [Antiretroviral Resistance Cohort Analysis (ARCA)]. We analysed the prevalence of TMC125 resistance-associated mutations (RAMs) and the TMC125 weighted genotypic score (WGS) together with the determinants of genotypic resistance. A total of 5011 sequences from 2955 patients failing NNRTI therapy were evaluated. Among the sequences in ARCA, 68% had at least one and 9.8% at least three TMC125 RAMs, whereas 31% had a WGS>2. Frequent RAMs were Y181C, G190A, K101E and A98G, w... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3344379 Mon, 08 Mar 2010 00:00:00 +0100 3344379 http://www.medworm.com/index.php?rid=3344378&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00820.x (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3344378 Mon, 08 Mar 2010 00:00:00 +0100 3344378 http://www.medworm.com/index.php?rid=3319557&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00818.x Sexually transmitted infections (STIs) significantly impact the health of people living with HIV/AIDS, increasing HIV infectiousness and therefore transmissibility. The current study examined STIs in a community sample of 490 HIV-positive men and women. Assessments were performed using confidential computerized interviews in a community research setting. Fourteen per cent of the people living with HIV/AIDS in this study had been diagnosed with a new STI in a 6-month period. Individuals with a new STI had significantly more sexual partners in that time period, including non-HIV-positive partners. Participants who had contracted an STI were significantly more likely to have detectable viral loads and were less likely to know their viral load than participants who did not contract an STI. Mul... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3319557 Tue, 02 Mar 2010 00:00:00 +0100 3319557 http://www.medworm.com/index.php?rid=3299806&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00816.x HIV-infected persons experience different patterns of viral suppression after initiating combination antiretroviral therapy (cART). The relationship between such differences and risk of virological failure after starting a new antiretroviral could help with patient monitoring strategies. A total of 1827 patients on cART starting at least one new antiretroviral from 1 January 2000 while maintaining a suppressed viral load were included in the analysis. Poisson regression analysis identified factors predictive of virological failure after baseline in addition to traditional demographic variables. Baseline was defined as the date of starting new antiretrovirals. Four hundred and fifty-one patients (24.7%) experienced virological failure, with an incidence rate (IR) of 7.3 per 100 person-years... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3299806 Wed, 24 Feb 2010 00:00:00 +0100 3299806 http://www.medworm.com/index.php?rid=3281350&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00812.x Simple noninvasive tests to predict fibrosis, as an alternative to liver biopsy (LB), are needed. Of these, the aspartate aminotransferase (AST) to platelet ratio index (APRI) and the Forns index (FI) have been validated in HIV/hepatitis C virus (HCV) coinfection. However, these indexes may have lower diagnostic value in situations other than the circumscribed conditions of validation studies. We therefore examined the value of the APRI and FI in HIV/HCV-coinfected patients for the detection of significant fibrosis in real-life conditions. HIV/HCV-coinfected patients who had participated in a multicentre cross-sectional retrospective study were selected if they had undergone an LB within 24 months before the last visit. The predictive accuracy of the APRI and FI was measured using the area... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3281350 Thu, 18 Feb 2010 00:00:00 +0100 3281350 http://www.medworm.com/index.php?rid=3277557&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00815.x Among HIV-infected patients, hepatitis C virus (HCV) coinfection is associated with lower cholesterol levels, but it remains unclear how it affects cardiovascular outcomes. We performed logistic regression to evaluate acute myocardial infarction (AMI) and cerebrovascular disease (CVD) events by HCV status among HIV-infected US veterans in the highly active antiretroviral therapy (HAART) era (1996[ndash]2004). We then performed survival analyses to evaluate incident AMI and CVD, exploring antiretroviral therapy (ART) as a time-dependent variable. A total of 19 424 HIV-infected patients [31.6% of whom were HCV-coinfected (HIV/HCV)] contributed 76 376 patient-years of follow-up. HCV coinfection was associated with lower rates of hypercholesterolaemia (18.0% in HIV/HCV vs. 30.7% in HIV-only pa... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3277557 Wed, 17 Feb 2010 00:00:00 +0100 3277557 http://www.medworm.com/index.php?rid=3277558&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00814.x Transmitted HIV strains may harbour drug resistance mutations. HIV-1 drug resistance mutations are currently detected in plasma viral RNA. HIV-1 proviral DNA could be an alternative marker, as it persists in infected cells. This was a prospective study assessing the prevalence and persistence of HIV-1 drug resistance mutations in DNA from CD4 cells before and after protease inhibitor (PI)- or nonnucleoside reverse transcriptase inhibitor (NNRTI)-based therapy initiation in 69 drug-naïve patients. Before therapy, 90 and 66% of detected mutations were present in CD4 cells and plasma, respectively. We detected seven key mutations, and four of these (M184M/V, M184M/I, K103K/N and M46M/I) were only found in the cells. When treatment was started, 40 patients were followed; the mutations detecte... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3277558 Tue, 16 Feb 2010 00:00:00 +0100 3277558 http://www.medworm.com/index.php?rid=3264454&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00813.x According to the Swiss Federal Commission for HIV/AIDS, HIV-infected patients on successful antiretroviral treatment have a negligible risk of transmitting HIV sexually. We estimated the risk that patients considered to have an undetectable viral load (VL) are actually viraemic. A Danish, population-based nationwide cohort study of HIV-infected patients with VL 1000 copies/mL). In 0.6% [95% confidence interval (CI) 0.5[ndash]0.8%] of the overall observation time the patients had VL >1000 copies/mL. In the first 6 months this risk was substantially higher (7.9%; 95% CI 4.5[ndash]11.0%), but thereafter decreased and was almost negligible after 5 years (0.03%; 95% CI 0.0[ndash]0.2%). The risk was higher in injecting drug users, but otherwise did not differ between subgroups of patients. The r... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3264454 Fri, 12 Feb 2010 00:00:00 +0100 3264454 http://www.medworm.com/index.php?rid=3252288&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00811.x The aim of this study was to describe trends in the management of pregnancies in HIV-infected women and their outcomes over a 14-year period in Denmark on a national basis. The study was a retrospective cohort study of all HIV-infected women in Denmark giving birth to one or more children between 1 June 1994 and 30 June 2008. We identified 210 HIV-infected women with 255 pregnancies, ranging from 7 per year in 1995 to 39 per year in 2006. Thirty per cent of the women were Caucasian and 51% were Black African. Knowledge of HIV status before pregnancy increased from 8% (four of 49) in 1994[ndash]1999 to 80% (164 of 206) in 2000[ndash]2008. Only 29% (53 of 183) of the women chose to consult an infectious disease specialist when planning pregnancy, while 14% (27 of 199) received assistance wit... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3252288 Tue, 09 Feb 2010 00:00:00 +0100 3252288 http://www.medworm.com/index.php?rid=3252291&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00806.x As access to antiretroviral drugs increases in developing countries, it will become increasingly important to monitor the emergence of resistance and to define the molecular pathways involved to identify optimal therapeutic regimens. We performed genotypic resistance testing on plasma obtained from 101 HIV-infected treatment-naïve individuals from Mali. Genotyping was carried out using the Virco protocols and HXB2 was used as the reference strain. CRF02_AG was the most common subtype, present in 71.3% of our patient population. Other subtypes included B, C, G, CRF06_CPX, CRF09_CPX, CRF01_AE, A2/CRF16_A2D, A1 and CRF13_CPX. A total of 9.9% [95% confidence interval (CI) 6.9[ndash]12.9%] of patients had at least one resistance mutation. The prevalences of mutations conferring resistance to n... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3252291 Mon, 08 Feb 2010 00:00:00 +0100 3252291 http://www.medworm.com/index.php?rid=3252290&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00807.x The current literature suggests that there has been a decrease in opportunistic diseases among HIV-infected patients since the widespread introduction of highly active antiretroviral therapy (HAART) in 1995. The aim of the study was to investigate the impact of HAART and CD4 lymphocyte count on diseases of the upper gastrointestinal (UGI) tract, digestive symptoms, and endoscopic and histological observations. A review of 706 HIV-infected patients who underwent GI endoscopy was undertaken. The cohort was divided into three groups: group 1 (G1), pre-HAART, consisting of 239 patients who underwent endoscopy between January 1991 and December 1994; group 2 (G2), early HAART, consisting of 238 patients who underwent endoscopy between January 1999 and December 2002; and group 3 (G3), recent HAAR... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3252290 Mon, 08 Feb 2010 00:00:00 +0100 3252290 http://www.medworm.com/index.php?rid=3252289&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00809.x Effective antiretroviral therapy (ART) has transformed the care of people with HIV, but it is important to monitor time trends in indicators of treatment success and antic future changes. We assessed time trends from 2000 to 2007 in several indicators of treatment success in the UK Collaborative HIV Cohort (CHIC) Study, and using national HIV data from the Health Protection Agency (HPA) we developed a model to project future trends. The proportion of patients on ART with a viral load 50 copies/mL. Numbers of deaths are projected to remain low. There have been continued improvements in key indicators of success in patients with HIV from 2000 to 2007. Although the number of patients who have ETCF is projected to rise in the future, the number of such patients with viral loads >50 copies/mL i... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3252289 Mon, 08 Feb 2010 00:00:00 +0100 3252289 http://www.medworm.com/index.php?rid=3233267&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00810.x The aim of the study was to report on HIV and older people in the European Region, including new data stratified by subregion and year. Data were collected from the 2008 World Health Organization Regional Office for Europe, Communicable Diseases Unit survey on HIV/AIDS and health systems. It was found that 12.9% of newly reported cases of HIV infection in Western Europe in 2007 were in people aged 50 years or older. In Central Europe, almost one-in-10 newly reported cases of HIV infection were in older people, while the proportion in Eastern Europe was 3.7% in 2007. The issue of HIV infection among older people is of increasing concern as more people age with HIV infection as a result of the availability of combination antiretroviral therapy. (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3233267 Wed, 03 Feb 2010 00:00:00 +0100 3233267 http://www.medworm.com/index.php?rid=3233270&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00786.x Triple nucleoside reverse transcriptase inhibitor regimens have advantages as first-line antiretroviral therapy (ART), avoiding hepatotoxicity and interactions with anti-tuberculosis therapy, and sparing two drug classes for second-line ART. Concerns exist about virological potency; efficacy has not been assessed in Africa. A safety trial comparing nevirapine with abacavir was conducted in two Ugandan Development of Antiretroviral Therapy in Africa (DART) centres: 600 symptomatic antiretroviral-naïve HIV-infected adults with CD4 counts (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3233270 Tue, 02 Feb 2010 00:00:00 +0100 3233270 http://www.medworm.com/index.php?rid=3233269&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00804.x The aim of the study was to reconstruct the HIV epidemic in Australia for selected populations categorized by exposure route; namely, transmission among men who have sex with men (MSM), transmission among injecting drug users (IDUs), and transmission among heterosexual men and women in Australia. Statistical back-projection techniques were extended to reconstruct the historical HIV infection curve using surveillance data. We developed and used a novel modified back-projection modelling technique that makes maximal use of all available surveillance data sources in Australia, namely, (1) newly diagnosed HIV infections, (2) newly acquired HIV infections and (3) AIDS diagnoses. The analyses suggest a peak HIV incidence in Australian MSM of [sim]2000 new infections per year in the late 1980s, f... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3233269 Tue, 02 Feb 2010 00:00:00 +0100 3233269 http://www.medworm.com/index.php?rid=3233268&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00808.x Our aim was to compare three different definitions of treatment failure and discuss their use as quality outcome measures for a clinical service. Data for treatment-naïve patients who attended the Melbourne Sexual Health Centre (MSHC) between 1 January 2000 and 31 December 2008 were analysed. Definition 1 was the strict Food and Drug Administration (FDA) definition of treatment failure as determined using the time to loss of virological response (TLOVR) algorithm. Definition 2 defined treatment failure as occurring in those whose viral load never fell to (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3233268 Tue, 02 Feb 2010 00:00:00 +0100 3233268 http://www.medworm.com/index.php?rid=3161195&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00787.x Prospective pharmacogenetic screening for the human leucocyte antigen (HLA) B*5701 allele can significantly reduce the number of cases of abacavir-related hypersensitivity among HIV-infected patients treated with this drug. The aim of this study was to establish the frequency of the HLA B*5701 variant in HIV-infected Poles. The sequence-specific primer (SSP) test was used to assess the feasibility of the introduction of such testing in clinical practice. For this purpose, 234 randomly selected HIV-positive patients were screened using a low-resolution SSP assay, with HLA B*5701-positive results confirmed using a high-resolution test. The HLA B*5701 variant was found in 11 of 234 subjects (4.7%). Testing with the selected method proved quick and reliable. (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3161195 Tue, 12 Jan 2010 00:00:00 +0100 3161195 http://www.medworm.com/index.php?rid=3161196&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00785.x We investigated the clinical significance of monitoring the mid-dosing interval atazanavir (ATV) concentration (measured 12 ± 2 h after intake; C12 h) in patients taking this drug once daily in the evening. We retrospectively selected HIV-infected patients harbouring ATV-susceptible virus who underwent therapeutic drug monitoring (TDM) of ATV C12 h during routine out-patient visits, and we correlated C12 h to the 24-week virological response and toxicity. A total of 115 plasma samples from 86 patients (76.7% with baseline HIV RNA0.23 mg/L was an independent predictor of virological response [odds ratio (OR) 4.23, P=0.031]. ATV levels correlated with concomitant unconjugated bilirubin levels (r=0.223, P=0.037), but a concentration cut-off predictive of moderate/severe hyperbilirubinaemia c... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3161196 Mon, 11 Jan 2010 00:00:00 +0100 3161196 http://www.medworm.com/index.php?rid=3144025&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00801.x People living with HIV infection are at increased risk for developing cardiovascular disease (CVD). Safe and effective interventions for lowering CVD risk in HIV infection are high priorities. We conducted a prospective, randomized, controlled study to evaluate whether a yoga lifestyle intervention improves CVD risk factors, virological or immunological status, or quality of life (QOL) in HIV-infected adults relative to standard of care treatment in a matched control group. Sixty HIV-infected adults with mild[ndash]moderate CVD risk were assigned to 20 weeks of supervised yoga practice or standard of care treatment. Baseline and week 20 measures were: 2-h oral glucose tolerance test with insulin monitoring, body composition, fasting serum lipid/lipoprotein profile, resting blood pressures,... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3144025 Wed, 06 Jan 2010 00:00:00 +0100 3144025 http://www.medworm.com/index.php?rid=3140225&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00805.x This study examines the association between microalbuminuria and the development of proteinuria among HIV-infected persons. A total of 948 subjects provided urine samples for albumin, protein and creatinine measurements semiannually. Microalbuminuria was defined as an albumin-to-creatinine ratio of >30 mg/g. Proteinuria was defined as a protein-to-creatinine ratio of [ge]0.350 mg/mg. The progression from microalbuminuria to proteinuria was described. At baseline, 69.4% of the subjects had no detectable proteinuria, 20.2% had microalbuminuria, and 10.4% had proteinuria. Subjects with microalbuminuria and proteinuria were more likely to be black (P=0.02), have lower CD4 cell counts (P=0.02 comparing subjects without abnormal urine protein excretion to subjects with microalbuminuria; P=0.0001... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3140225 Tue, 05 Jan 2010 00:00:00 +0100 3140225 http://www.medworm.com/index.php?rid=3140227&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00800.x The aim of the study was to examine temporal and geographical patterns of mode of delivery in the European Collaborative Study (ECS), identify factors associated with elective caesarean section (CS) delivery in the highly active antiretroviral therapy (HAART) era and explore associations between mode of delivery and mother-to-child transmission (MTCT). The ECS is a cohort study in which HIV-infected pregnant women are enrolled and their infants prospectively followed. Data on 5238 mother[ndash]child pairs (MCPs) enrolled in Western European ECS sites between 1985 and 2007 were analysed. The elective CS rate increased from 16% in 1985[ndash]1993 to 67% in 1999[ndash]2001, declining to 51% by 2005[ndash]2007. In 2002[ndash]2004, 10% of infants were delivered vaginally, increasing to 34% by 2... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3140227 Mon, 04 Jan 2010 00:00:00 +0100 3140227 http://www.medworm.com/index.php?rid=3140226&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00802.x Risks for methicillin-resistant Staphylococcus aureus (MRSA) among those with HIV infection have been found to vary, and the epidemiology of USA-300 community-acquired (CA) MRSA has not been adequately described. We conducted a retrospective review of HIV-infected out-patients from January 2002 to December 2007 and employed multivariate logistic regression (MLR) to identify risks for MRSA colonization or infection. Pulsed-field gel electrophoresis (PFGE) was used to identify USA-300 strains. Seventy-two (8%) of 900 HIV-infected patients were colonized or infected with MRSA. MLR identified antibiotic exposure within the past year [odds ratio (OR) 3.4; 95% confidence interval (CI) 1.5[ndash]7.7] and nadir CD4 count (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3140226 Mon, 04 Jan 2010 00:00:00 +0100 3140226 http://www.medworm.com/index.php?rid=3125445&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00769.x The aim of the study was to determine whether the chemokine (C-C motif) receptor 5 (CCR5) [Delta]32 deletion is associated with long-term response to combination antiretroviral treatment (cART) in HIV-1-infected patients. The genetic substudy of the Agence Nationale de Recherche sur le SIDA (ANRS) CO8 APROCO-COPILOTE cohort included 609 patients who started protease inhibitor-containing cART in 1997[ndash]1999. Patients were considered to have a sustained virological response if all plasma HIV RNA measurements in the period considered were (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3125445 Tue, 29 Dec 2009 00:00:00 +0100 3125445 http://www.medworm.com/index.php?rid=3125446&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00768.x Highly active antiretroviral therapy (HAART) has dramatically changed the natural history of HIV infection in children, but there are few studies in the literature about the incidence of clinical manifestations after HAART in this population, compared with adults. The aim of this study was to describe the influence of the widespread use of HAART on the development of opportunistic infections and organ-specific diseases in HIV-infected children. An observational study of a cohort of 366 vertically HIV-infected children followed from 1990 to 2006 was carried out. According to the main antiretroviral protocol used, three calendar periods (CPs) were defined and compared: CP1 (1990[ndash]1996: no patients on HAART), CP2 (1997[ndash]1999: 60% on HAART). Children experienced a progressive increas... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3125446 Mon, 28 Dec 2009 00:00:00 +0100 3125446 http://www.medworm.com/index.php?rid=3073185&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00780.x The aims of the present study were to estimate the prevalence of renal impairment (RI) among HIV-infected adult patients and to investigate the associated factors. A cross-sectional survey was conducted in a French hospital-based cohort. Clearance of creatinine (CC) was calculated using the Cockcroft[ndash]Gault formula. Four stages of RI were defined: mild (60[ndash]90 mL/min), moderate (30[ndash]60), severe (15[ndash]30) and end stage ( (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3073185 Thu, 10 Dec 2009 00:00:00 +0100 3073185 http://www.medworm.com/index.php?rid=3073187&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00774.x In this study, we analysed data on beliefs and behaviours related to sex, substance use, HIV prevention and other relevant factors for 280 patients at a publicly funded HIV/AIDS clinic in Seattle. All participants completed a baseline audio computer-assisted self interview (ACASI) as part of a larger trial focused on reducing TRBs. Our multivariate model yielded three screening questions that could prove effective in identifying HIV-positive patients in need of focused prevention resources. The resulting screener holds promise as a brief and easily deployed tool that can be used by providers regardless of access to ACASI technology. Additional validation is needed and longitudinal evaluation is currently in progress. (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3073187 Wed, 09 Dec 2009 00:00:00 +0100 3073187 http://www.medworm.com/index.php?rid=3073186&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00778.x The aim of the present study was to assess fluconazole pharmacokinetic measures in serum and cerebrospinal fluid (CSF); and the correlation of these measures with clinical outcomes of invasive fungal infections. A randomized trial was conducted in HIV-infected patients receiving three different regimens of fluconazole plus amphotericin B (AmB) for the treatment of cryptococcal meningitis. Regimens included fluconazole 400 mg/day+AmB (AmB+Fluc400) or fluconazole 800 mg/day+AmB (AmB+Fluc800) (14 days followed by fluconazole alone at the randomized dose for 56 days); or AmB alone for 14 days followed by fluconazole 400 mg/day for 56 days. Serum (at 24 h after dosing) and CSF samples were taken at baseline and days 14 and 70 (serum only) for fluconazole measurement, using gas[ndash]liquid chro... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3073186 Wed, 09 Dec 2009 00:00:00 +0100 3073186 http://www.medworm.com/index.php?rid=3068792&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00782.x To investigate the impact of intermittent interleukin-2 (IL-2) plus combination antiretroviral therapy (cART) on HIV-1 entry co-receptor use. Primary HIV-1 isolates were obtained from 54 HIV-1-positive individuals at baseline and after 12 months using co-cultivation of peripheral blood mononuclear cells (PBMC) with activated PBMC of HIV-negative healthy donors. HIV-1 co-receptor use was determined on U87-CD4 cells. Fourteen out of the 21 (67%) IL-2-treated individuals harbouring a primary CCR5-dependent (R5) HIV-1 isolate at baseline confirmed an R5 virus isolation after 12 months in contrast to 3 out of 7 (43%) of those receiving cART only. After 12 months, only 1 R5X4 HIV-1 isolate was obtained from 21 cART+IL-2-treated individuals infected with an R5 virus at entry (5%) vs. 2/7 (29%) pa... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3068792 Wed, 09 Dec 2009 00:00:00 +0100 3068792 http://www.medworm.com/index.php?rid=3068793&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00777.x This study demonstrates that Australian gay men have had little experience with PREP use and rectal microbicides. About half would be willing to consider participation in trials using ARVs to prevent HIV infection. Extensive community education and consultation would be required before PREP or rectal microbicides could be trialled in populations of gay Australian men. (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3068793 Tue, 08 Dec 2009 00:00:00 +0100 3068793 http://www.medworm.com/index.php?rid=3064801&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00775.x The aim of the study was to investigate the effect of long-term high-physiological-dose recombinant human growth hormone (rhGH) therapy on fat distribution and glucose metabolism in HIV-infected patients. Forty-six HIV-infected Caucasian men on highly active antiretroviral therapy (HAART), with an age range of 21[ndash]60 years and no significant comorbidity, were included in this randomized, placebo-controlled, double-blind, single-centre trial. Twenty-eight subjects were randomized to 0.7 mg/day rhGH, and 18 subjects to placebo, administered as daily subcutaneous injections between 1 and 3 pm for 40 weeks. Endpoints included changes in visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), limb fat mass, percentage of limb fat, plasma lipids, insulin resistance and glucose tol... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3064801 Tue, 08 Dec 2009 00:00:00 +0100 3064801 http://www.medworm.com/index.php?rid=3064800&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00776.x While highly active antiretroviral therapy (HAART) decreases long-term morbidity and mortality, its short-term effect on hospitalization rates is unknown. The primary objective of this study was to determine hospitalization rates over time in the year after HAART initiation for virological responders and nonresponders. Hospitalizations among 1327 HAART-naïve subjects in an urban HIV clinic in 1997[ndash]2007 were examined before and after HAART initiation. Hospitalization rates were stratified by virological responders ([ge]1 log10 decrease in HIV-1 RNA within 6 months after HAART initiation) and nonresponders. Causes were determined through International Classification of Diseases, 9th Revision (ICD-9) codes and chart review. Multivariate negative binomial regression was used to assess f... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3064800 Tue, 08 Dec 2009 00:00:00 +0100 3064800 http://www.medworm.com/index.php?rid=3064799&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00779.x We examined clinical outcomes, patient characteristics and trends over time of non-medically supervised treatment interruptions (TIs) from a free-of-charge antiretroviral therapy (ART) programme in British Columbia (BC), Canada. Data from ART-naïve individuals [ge]18 years old who initiated triple combination highly active antiretroviral therapy (HAART) between January 2000 and June 2006 were analysed. Participants having [ge]3 month gap in HAART coverage were defined as having a TI. Cox proportional hazards modelling was used to examine factors associated with TIs and to examine factors associated with resumption of treatment. A total of 1707 participants were study eligible and 643 (37.7%) experienced TIs. TIs within 1 year of ART initiation decreased from 29% of individuals in 2000 to ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3064799 Tue, 08 Dec 2009 00:00:00 +0100 3064799 http://www.medworm.com/index.php?rid=3064798&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00783.x To study determinants of late HIV diagnosis in a low-HIV-prevalence ( (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3064798 Tue, 08 Dec 2009 00:00:00 +0100 3064798 http://www.medworm.com/index.php?rid=3058397&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00772.x HIV infection and its treatment are associated with dyslipidaemia and increased risk of cardiovascular disease. Accurate high-density lipoprotein (HDL) cholesterol values are necessary for the management of these abnormalities, but current methods have not been properly assessed in these patients. The aim of this study was to assess in HIV-infected patients the consistency and accuracy of a synthetic polymer/detergent homogeneous assay used to measure HDL cholesterol concentrations and to evaluate the impact of storage. HDL cholesterol was measured using a synthetic polymer/detergent homogeneous method in samples from HIV-infected patients and healthy subjects for each of the storage regimens: baseline, after 1 week at 4 °C, and after 12 months at [minus]80 °C. The ultracentrifugation an... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3058397 Sat, 05 Dec 2009 00:00:00 +0100 3058397 http://www.medworm.com/index.php?rid=3058400&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00767.x We report lopinavir (LPV) PB during third trimester (antepartum, AP) compared to [ge]1.7 weeks postpartum (PP) to determine if FU changes compensate for reduced total concentrations reported previously. P1026s enrolled women receiving LPV/ritonavir, soft gel capsules 400/100 mg or 533/133 mg twice daily. LPV FU, albumin and AAG were determined AP and PP. AP/PP samples were available from 29/25 women respectively with all but one woman receiving the same dose AP/PP. LPV FU was increased 18% AP vs. PP (mean 0.96±0.16% AP vs. 0.82±0.21% PP, P=0.001). Mean protein concentrations were reduced AP (AAG=477 mg/L; albumin=3.28 mg/dL) vs. PP (AAG=1007 mg/L; albumin=3.85 mg/dL) (P (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3058400 Thu, 03 Dec 2009 00:00:00 +0100 3058400 http://www.medworm.com/index.php?rid=3058399&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00770.x The aim of the study was to investigate the psychological status and the psychosocial experiences of HIV-positive people using Symptom Check List 90 (SCL-90) in eastern China. Two hundred and fourteen HIV-positive people and 200 controls were recruited to the study. Participants were given an anonymous questionnaire which included questions pertaining to demography, SCL-90 and psychosocial experiences. The mean subscale scores for SCL-90 in the HIV-positive group were all higher than those of the control group (P (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3058399 Thu, 03 Dec 2009 00:00:00 +0100 3058399 http://www.medworm.com/index.php?rid=3058398&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00771.x The aim of the study was to assess whether a simple, routinely available measure of antiretroviral therapy (ART) adherence predicts viral rebound at the next HIV viral load (VL) measurement in virally suppressed patients. The analysis was performed on the Royal Free HIV Cohort, London, UK. Each 'drug coverage[ndash]viral load episode' (DCVL episode) was defined as a 6-month period immediately prior to a VL [le]50 HIV-1 RNA copies/mL (time-zero), during which the patient had been continuously on HAART, with all measured VLs [le]50 copies/mL. The next VL after time-zero was used to assess whether VL rebound (defined as >200 copies/mL) had occurred. Drug coverage, our measure of adherence, was calculated as the proportion of days in the 6-month period covered by a valid prescription for at le... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3058398 Thu, 03 Dec 2009 00:00:00 +0100 3058398 http://www.medworm.com/index.php?rid=3005951&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00803.x (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=3005951 Thu, 19 Nov 2009 00:00:00 +0100 3005951 http://www.medworm.com/index.php?rid=2932594&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00763.x The D:A:D study group reported a 1.9-fold increased relative risk (RR) of myocardial infarction (MI) associated with current or recent use of abacavir. The number needed to harm (NNH) incorporates information about the underlying risk of MI and the increased RR of MI in patients taking abacavir. NNH was calculated as the reciprocal of the difference between the underlying risks of MI with and without abacavir use. A parametric statistical model was used to calculate the underlying risk of MI over 5 years. The relationship between NNH and underlying risk of MI is reciprocal, resulting in wide variation in the NNH with small changes in underlying risk of MI. The smallest changes in NNH are in the medium- and high-risk groups of MI. The NNH changes as risk components are modified; for example... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2932594 Wed, 28 Oct 2009 00:00:00 +0100 2932594 http://www.medworm.com/index.php?rid=2917977&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00764.x The aim of the study was to describe Veterans Healthcare Administration (VHA) system-wide uptake of three HIV protease inhibitors: atazanavir, darunavir and tipranavir. This retrospective cohort study evaluated VHA uptake of three target antiretrovirals and lopinavir/ritonavir in each complete 90-day quarter since approval to December 2007 using VHA HIV Clinical Case Registry data. We assessed uptake using number of new prescriptions, number of providers and facilities prescribing target agents, provider type, clinic type, facility size and location within four US regions. Overall, 6551 HIV-infected veterans received target antiretrovirals. Uptake was generally greatest within the first year after Food and Drug Administration (FDA) approval, and then slightly declined and plateaued. Geogra... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2917977 Thu, 22 Oct 2009 23:00:00 +0100 2917977 http://www.medworm.com/index.php?rid=2917976&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00765.x An open-label, three-period pharmacokinetic study was conducted to investigate the drug interaction potential between fosamprenavir (FPV) and tenofovir disoproxil fumarate (TDF). Thirty-six healthy subjects received TDF 300 mg once daily (qd) for 7 days (period 1), and then were randomized to 14 days of either FPV 1400 mg twice daily (bid) or FPV/ritonavir (RTV) 700/100 mg bid alone or with TDF (period 2). Subjects continued their randomized dose of FPV for 14 more days, adding or removing TDF based upon its receipt in period 2 (period 3). Twenty-four-hour pharmacokinetic sampling was carried out on day 7 of period 1 and on day 14 of periods 2 and 3. Steady-state plasma amprenavir (APV) and tenofovir (TFV) pharmacokinetics were assessed by noncompartmental analysis and parameter values obs... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2917976 Thu, 22 Oct 2009 23:00:00 +0100 2917976 http://www.medworm.com/index.php?rid=2914065&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00766.x HIV-infected patients show an increased cardiovascular disease (CVD) risk resulting, essentially, from metabolic disturbances related to chronic infection and antiretroviral treatments. The aims of this study were: (1) to evaluate the agreement between the CVD risk estimated using the Framingham risk score (FRS) and the observed presence of subclinical atherosclerosis in HIV-infected patients; (2) to investigate the relationships between CVD and plasma biomarkers of oxidation and inflammation. Atherosclerosis was evaluated in 187 HIV-infected patients by measuring the carotid intima-media thickness (CIMT). CVD risk was estimated using the FRS. We also measured the circulating levels of interleukin-6, monocyte chemoattractant protein-1 (MCP-1) and oxidized low-density lipoprotein (LDL), and... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2914065 Wed, 21 Oct 2009 23:00:00 +0100 2914065 http://www.medworm.com/index.php?rid=2829931&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00762.x Human leukocyte antigen (HLA)-B*5701 is strongly associated with developing a hypersensitivity reaction to abacavir (ABC) in White and Hispanic subjects. Across the UK, limited data exist on HLA-B*5701 prevalence in HIV-1-infected subjects. We determined HLA-B*5701 prevalence in the general HIV-1-infected population and in specific ethnic groups, particularly Black Africans who, in general, exhibit greater genetic diversity. We also compared HLA-B*5701 results obtained from local laboratories with those from a central provider. Multi-centre, observational study. All HIV-1-infected adult individuals receiving care at participating centres were eligible, irrespective of treatment status or prior exposure to ABC. Subjects provided samples for HLA-B*5701 assessment by both local (blood) and ce... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2829931 Thu, 24 Sep 2009 23:00:00 +0100 2829931 http://www.medworm.com/index.php?rid=2829933&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00760.x To assess the risk factors associated with heterosexual HIV transmission among South Indian discordant couples enrolled in clinical care. A nested matched case[ndash]control study of serodiscordant couples in which the HIV-infected partner (index case) was enrolled in care. Demographic and clinical characteristics, sexual behaviours, CD4 cell count and plasma HIV-1 RNA loads were measured at enrolment and longitudinally over 12 months of follow-up. The study included 70 cases who seroconverted during study follow-up and 167 matched controls who remained persistently serodiscordant. The incidence of HIV infection among the initially seronegative partners was 6.52 per 100 person-years. Persistently discordant patients were more likely to have initiated highly active antiretroviral therapy (H... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2829933 Wed, 23 Sep 2009 23:00:00 +0100 2829933 http://www.medworm.com/index.php?rid=2829932&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00761.x Facial lipoatrophy can be a stigmatizing side effect of antiretroviral (AVR) treatment for HIV-infected patients. We sought to evaluate the long-term efficacy and safety of a new formulation of hyaluronic acid that can be injected in larger amounts and into deeper skin layers during 3 years of follow-up. Twenty patients received injections of Restylane SubQ[trade]. Refill treatment was offered at 12 and 24 months. Treatment effects were evaluated using ultrasound, the Global Aesthetic Improvement Scale, visual analogue scale (VAS) and the Rosenberg self-esteem scale. Seventeen patients remained at 36 months. Mean (± standard deviation) total cutaneous thickness increased from 6 ± 1 mm at baseline to 12 ± 1 mm (P10 mm) was 70%. Fifteen patients classified their facial appearance as very ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2829932 Wed, 23 Sep 2009 23:00:00 +0100 2829932 http://www.medworm.com/index.php?rid=2826143&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00758.x CD81 is expressed on lymphocytes and confers HCV viral infectivity support. The aim of our study was to quantify CD81 expression in peripheral blood B- and T-cells of HCV/HIV-coinfected patients and healthy subjects to examine its association with several HCV virological characteristics and the therapeutic responsiveness to HCV antiviral treatment. We carried out a cross-sectional study on 122 naïve patients. For a duration of 48 weeks, 24 out of 122 patients underwent HCV antiviral therapy with interferon (IFN)-[alpha] and ribavirin. T- and B-cell subsets were analysed by flow cytometry. We found that HIV/HCV coinfected patients with HCV-RNA [ge]850 000 IU/mL had lower values of %CD19+CD81-CD62L+ and %CD19+CD62L+; and higher values of CD19+CD81+CD62L[minus] and CD19+CD81+ percentages and... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2826143 Wed, 23 Sep 2009 23:00:00 +0100 2826143 http://www.medworm.com/index.php?rid=2791674&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00757.x As those with HIV infection live longer, 'non-AIDS' condition associated with immunodeficiency and chronic inflammation are more common. We ask whether 'non-HIV' biomarkers improve differentiation of mortality risk among individuals initiating combination antiretroviral therapy (cART). Using Poisson models, we analysed data from the Veterans Aging Cohort Study (VACS) on HIV-infected veterans initiating cART between 1 January 1997 and 1 August 2002. Measurements included: HIV biomarkers (CD4 cell count, HIV RNA and AIDS-defining conditions); 'non-HIV' biomarkers (haemoglobin, transaminases, platelets, creatinine, and hepatitis B and C serology); substance abuse or dependence (alcohol or drug); and age. Outcome was all cause mortality. We tested the discrimination (C statistics) of each biom... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2791674 Sun, 13 Sep 2009 23:00:00 +0100 2791674 http://www.medworm.com/index.php?rid=2759837&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00773.x (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2759837 Wed, 02 Sep 2009 23:00:00 +0100 2759837 http://www.medworm.com/index.php?rid=2754461&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00756.x Etravirine (ETV) is a novel nonnucleoside reverse transcriptase inhibitor (NNRTI) with reduced cross-resistance to first-generation NNRTIs, which has been primarily studied in randomized clinical trials and not in routine clinical settings. ETV resistance-associated mutations (RAMs) were investigated by analysing 6072 genotypic tests. The antiviral activity of ETV was predicted using different interpretation systems: International AIDS Society-USA (IAS-USA), Stanford, Rega and Agence Nationale de Recherches sur le Sida et les hépatites virales (ANRS). The prevalence of ETV RAMs was higher in NNRTI-exposed patients [44.9%, 95% confidence interval (CI) 41.0[ndash]48.9%] than in treatment-naïve patients (9.6%, 95% CI 8.5[ndash]10.7%). ETV RAMs in treatment-naïve patients mainly represent p... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2754461 Tue, 01 Sep 2009 23:00:00 +0100 2754461 http://www.medworm.com/index.php?rid=2754464&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00749.x Couples infected with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) are increasingly seeking assisted conception. These couples avoid unprotected intercourse and use condoms at all times in order to minimize the risk of infecting their partner. As this practice inhibits pregnancy, assisted procreation is generally required for safe conception. For many couples, access to such services is restricted on ethical, geographical and financial grounds. The aim of the study was to assess the fertility needs, geographical origin and state funding of patients with blood-borne viral infection. A retrospective review of the medical records of couples referred for fertility treatment between January 1999 and December 2006, where one or both partners were infected with HIV, HBV and/or HCV, wa... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2754464 Mon, 31 Aug 2009 23:00:00 +0100 2754464 http://www.medworm.com/index.php?rid=2754463&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00750.x The aim of the study was to determine whether the incidence of first-line treatment discontinuations and their causes changed according to the time of starting highly active antiretroviral therapy (HAART) in an Italian cohort. We included in the study patients from the Italian COhort Naïve Antiretrovirals (ICoNA) who initiated HAART when naïve to antiretroviral therapy (ART). The endpoints were discontinuation within the first year of [ge]1 drug in the first HAART regimen for any reason, intolerance/toxicity, poor adherence, immunovirological/clinical failure and simplification. We investigated whether the time of starting HAART (stratified as 'early', 1997[ndash]1999; 'intermediate', 2000[ndash]2002; 'recent', 2003[ndash]2007) was associated with the probability of reaching the endpoint... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2754463 Mon, 31 Aug 2009 23:00:00 +0100 2754463 http://www.medworm.com/index.php?rid=2754462&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00755.x This study was designed to determine the incidence of a discordant response at two time-points, soon after 6 months and at 12 months, and to determine the relationship with clinical outcomes. Data obtained in the UK Collaborative HIV Cohort Study were analysed. A total of 2584 treatment-naïve patients starting HAART with HIV viral load (VL)>1000 HIV-1 RNA copies/mL at baseline and (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2754462 Mon, 31 Aug 2009 23:00:00 +0100 2754462 http://www.medworm.com/index.php?rid=2717886&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00754.x Symptomatic hyperlactataemia and lactic acidosis (SHLA) are potentially life-threatening complications associated with stavudine (d4T), an antiretroviral therapy (ART) drug widely used in developing countries. Cases comprised all symptomatic patients with measured lactates [ge]5 mmol/L referred to a South African hospital between August 2003 and November 2005. Matched controls were selected according to facility and duration on ART. Seventy-one cases and 142 controls were included in the study. The majority of cases presented between 6 and 18 months on ART. Female sex [adjusted odds ratio (AOR) 23.4; 95% confidence interval (CI) 4.0[ndash]136.6], a baseline weight between 60 and 75 kg (AOR 4.5; 95% CI 1.4[ndash]14.1) or, in particular, [ge]75 kg (AOR 19.4; 95% CI 4.1[ndash]82.5) at ART ini... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2717886 Thu, 20 Aug 2009 23:00:00 +0100 2717886 http://www.medworm.com/index.php?rid=2717887&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00753.x The aim of the study was to describe the prevalence of and examine the factors associated with immunosuppression (CD4200 cells/[mu]L (group B; late presenters). Of 4589 patients, 10.2% (467) had at least one CD4 count (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2717887 Wed, 19 Aug 2009 23:00:00 +0100 2717887 http://www.medworm.com/index.php?rid=2697595&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00752.x The toxicities, cost and complexity of triple combinations warrant the search for other treatment options, such as boosted protease inhibitor (PI) monotherapy. MONotherapy AntiRetroviral Kaletra (MONARK) is the first randomized trial comparing lopinavir/ritonavir monotherapy to triple combination therapy with zidovudine/lamivudine and lopinavir/ritonavir in antiretroviral-naïve patients. A total of 136 antiretroviral-naïve patients, with a CD4 cell count above 100 cells/[mu]L and a plasma HIV RNA below 100 000 HIV-1 RNA copies/mL, were randomized and dosed with either lopinavir/ritonavir monotherapy (n=83) or lopinavir/ritonavir+zidovudine/lamivudine (n=53). We focus here on patients in the lopinavir/ritonavir monotherapy arm followed to week 96. The intent-to-treat (ITT) analysis initia... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2697595 Thu, 13 Aug 2009 23:00:00 +0100 2697595 http://www.medworm.com/index.php?rid=2697597&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00748.x The aim of this study was to examine Emergency Department (ED) utilization and clinical and sociodemographic correlates of ED use among HIV-infected patients. During 2003, 951 patients participated in face-to-face interviews at 14 HIV clinics in the HIV Research Network. Respondents reported the number of ED visits in the preceding 6 months. Using logistic regression, we identified factors associated with visiting the ED in the last 6 months and admission to the hospital from the ED. Thirty-two per cent of respondents reported at least one ED visit in the last 6 months. In multivariate analysis, any ED use was associated with Medicaid insurance, high levels of pain (the third or fourth quartile), more than seven primary care visits in the last 6 months, current or former illicit drug use, ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2697597 Wed, 12 Aug 2009 23:00:00 +0100 2697597 http://www.medworm.com/index.php?rid=2697596&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00751.x The aim of the study was to examine whether exposure to abacavir increases the risk for myocardial infarction (MI). This was a prospective nationwide cohort study which included all Danish HIV-infected patients on highly active antiretroviral therapy (HAART) from 1995 to 2005 (N=2952). Data on hospitalization for MI and comorbidity were obtained from Danish medical databases. Hospitalization rates for MI after HAART initiation were calculated for patients who used abacavir and those who did not. We used Cox's regression to compute incidence rate ratios (IRR) as a measure of relative risk for MI, while controlling for potential confounders (as separate variables and via propensity score) including comorbidity. Relative risk of hospitalization with MI in abacavir users compared with abacavir... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2697596 Wed, 12 Aug 2009 23:00:00 +0100 2697596 http://www.medworm.com/index.php?rid=2665357&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00747.x The Honduran HIV/AIDS Program began to scale up access to HIV therapy in 2002. Up to May 2008, more than 6000 patients received combination antiretroviral therapy (cART). As HIV drug resistance is the major obstacle for effective treatment, the purpose of this study was to assess the prevalence of antiretroviral drug resistance in Honduran HIV-1-infected individuals. We collected samples from 138 individuals (97 adults and 41 children) on cART with virological, immunological or clinical signs of treatment failure. HIV-1 pol sequences were obtained using an in-house method. Resistance mutations were identified according to the 2007 International AIDS Society (IAS)-USA list and predicted susceptibility to cART was scored using the anrs algorithm. Resistance mutations were detected in 112 pat... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2665357 Mon, 03 Aug 2009 23:00:00 +0100 2665357 http://www.medworm.com/index.php?rid=2665359&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00740.x Atazanavir (ATV) has demonstrated high efficacy and safety in both treatment-naïve and treatment-experienced patients. Some comparative data are available on the durability of ritonavir-boosted (ATV/r) and unboosted formulations, but there are no data on clinicians' motivations for choosing one or another in everyday practice. The aim of this study was to evaluate the long-term efficacy of boosted and unboosted ATV in a cohort of treatment-experienced patients. All patients included in the study were enrolled in an observational cohort within the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) Project. Data on CD4 cell count, HIV viral load, metabolic parameters and adverse events of grade 3[ndash]4 are collected through an on-line system every six months. The duration of ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2665359 Sun, 02 Aug 2009 23:00:00 +0100 2665359 http://www.medworm.com/index.php?rid=2665358&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00745.x Noninvasive tests are increasingly being used for the assessment of liver fibrosis. We aimed to develop a serum index for the identification of advanced fibrosis (F[ge]3) in HIV/hepatitis C virus (HCV)-coinfected patients. We carried out a cross-sectional study on a group of 195 patients comprised of an estimation group (EG; n=127) and a validation group (VG; n=68) who all underwent liver biopsy and had not received previous interferon therapy. Liver fibrosis was estimated using the METAVIR score. We developed a new serum index (HGM-3) dependent on levels of platelets, alkaline phosphatase, hepatic growth factor, tissue inhibitor of metalloproteinase-1 and hyaluronic acid. In the EG, the area under the receiver operating characteristic curve (AUC-ROC) of HGM-3 for identification of F[ge]3 ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2665358 Sun, 02 Aug 2009 23:00:00 +0100 2665358 http://www.medworm.com/index.php?rid=2651740&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00744.x Long-term antibody responses to 23-valent pneumococcal polysaccharide vaccine (PPV) among HIV-infected patients receiving highly active antiretroviral therapy (HAART) are rarely investigated. Antibody responses to three pneumococcal capsular polysaccharides [Pneumococcal polysaccharide (PPS) 14, 19F and 23F] were assessed among 169 HIV-infected patients who received HAART and 23-valent PPV. Patients were stratified into four groups according to CD4 count at vaccination: group 1, CD4100 cells/[mu]L at vaccination and achieved better virological suppression throughout the 5-year period, while the absolute increases of CD4 cell counts after HAART were not statistically significantly different. Despite continued increases in CD4 cell counts after HAART, the proportion of HIV-infected patients ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2651740 Wed, 29 Jul 2009 23:00:00 +0100 2651740 http://www.medworm.com/index.php?rid=2651743&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00735.x Smoking is the modifiable cardiovascular (CV) risk factor that contributes most to causing premature CV disease. Prevalence of smoking in patients with HIV infection is double that of the general population. To determine the rate of patients succeeding in quitting smoking after 12 months, factors associated with this success, and the characteristics of tobacco consumption and nicotine dependence. Longitudinal descriptive study. Three hundred and sixty-eight HIV-infected patients were interviewed. Smokers in Prochaska's stage of action began a programme to quit smoking. We registered the variables related to tobacco consumption and the level of success of cessation. 63.9% of the patients were active smokers and 14% of them began the cessation programme. Average motivation for cessation was ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2651743 Tue, 28 Jul 2009 23:00:00 +0100 2651743 http://www.medworm.com/index.php?rid=2651742&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00736.x The aims of this study were to determine the predictors of CD4 count below 200 cells/[mu]L and to propose an algorithm for antiretroviral therapy initiation; and to assess the determinants of immune response to highly active antiretroviral therapy (HAART) in Côte d'Ivoire. A total of 615 consecutive patients attending an HIV/AIDS day hospital were enrolled in the study. We constructed a score system based on the results of a multivariate logistic regression analysis of the predictors of CD4 count 50 cells/[mu]L after HAART initiation. Total lymphocyte count (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2651742 Tue, 28 Jul 2009 23:00:00 +0100 2651742 http://www.medworm.com/index.php?rid=2651741&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00742.x To investigate the presence of hepatitis B virus (HBV) DNA and hepatitis C virus (HCV) RNA in HIV-infected patients initiating antiretroviral therapy in Cameroon. Baseline blood samples from 169 patients were tested retrospectively for hepatitis B surface antigens (HBsAg), anti-hepatitis B core (anti-HBc), anti-HCV and [ndash] if HBsAg or anti-HCV result was positive or indeterminate [ndash] for HBV DNA or HCV RNA, respectively, using the Cobas Ampliprep/Cobas TaqMan quantitative assay (Roche Diagnostics GmbH, Mannheim, Germany). HBV DNA was detected in 14 of the 18 patients with positive or indeterminate HBsAg results [8.3% of the total study population, 95% confidence interval (CI) 4.6[ndash]13.5]. The median HBV viral load was 2.47 × 107 IU/mL [interquartile range (IQR) 3680[ndash]1.59... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2651741 Tue, 28 Jul 2009 23:00:00 +0100 2651741 http://www.medworm.com/index.php?rid=2586152&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00741.x International studies suggesting that 20[ndash]37% of HIV-positive patients have diagnosable depression may underestimate the prevalence of this condition. The aim of this study was to investigate the prevalence of depression among HIV-positive patients in an out-patient clinic in Denmark and to detect factors of importance for the development of depression. In 2005, a population of 205 HIV-positive patients was included in a questionnaire-based study. The Beck Depression Inventory II (BDI-II) was used to assess the prevalence and severity of depressive symptoms. Patients with a BDI score of 20 or above were offered a clinical evaluation by a consultant psychiatrist. Symptoms of depression (BDI>14) were observed in 77 (38%) patients and symptoms of major depression (BDI[ge]20) in 53 (26%).... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2586152 Thu, 09 Jul 2009 23:00:00 +0100 2586152 http://www.medworm.com/index.php?rid=2586153&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00739.x The clinical implications of a failure to achieve high CD4 cell counts while receiving virally suppressive highly active antiretroviral therapy (HAART) are uncertain. We analysed data from HIV-infected men participating in the Multicenter AIDS Cohort Study (MACS) to elucidate associations between CD4 cell counts achieved during virally suppressive HAART and risks of AIDS or death. Inclusion criteria were: CD4 cell count (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2586153 Wed, 08 Jul 2009 23:00:00 +0100 2586153 http://www.medworm.com/index.php?rid=2574507&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00738.x The aim of the study was to examine the rates and predictors of treatment modification following combination antiretroviral therapy (cART) failure in Asian patients with HIV enrolled in the TREAT Asia HIV Observational Database (TAHOD). Treatment failure (immunological, virological and clinical) was defined by World Health Organization criteria. Countries were categorized as high or low income by World Bank criteria. Among 2446 patients who initiated cART, 447 were documented to have developed treatment failure over 5697 person-years (7.8 per 100 person-years). A total of 253 patients changed at least one drug after failure (51.6 per 100 person-years). There was no difference between patients from high- and low-income countries [adjusted hazard ratio (HR) 1.02; P=0.891]. Advanced disease s... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2574507 Mon, 06 Jul 2009 23:00:00 +0100 2574507 http://www.medworm.com/index.php?rid=2574509&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00734.x Genotypic algorithms used to predict the clinical efficacy of lopinavir/ritonavir (LPV/r) have included a range of mutation lists and efficacy endpoints. Normally, HIV clinical trials are powered to detect a difference between treatment arms of 10[ndash]12% for the endpoint of viral load suppression 1000 copies/mL. This analysis aimed to re-evaluate resistance algorithms for LPV/r in the TITAN trial. Baseline genotype data were classified using seven genotypic resistance algorithms: International AIDS Society USA (IAS-USA) LPV mutations (current cut-off=6), Abbott 2007 mutation list (cut-off=3), ANRS mutations (cut-off=4), FDA mutations (cut-off=3), Stanford, REGA and IAS-USA major protease inhibitor (PI) mutations. Efficacy in the TITAN trial (HIV-1 RNA (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2574509 Sun, 05 Jul 2009 23:00:00 +0100 2574509 http://www.medworm.com/index.php?rid=2574508&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00737.x Neoplasms associated with human papillomavirus (HPV) infection occur at increased frequency in patients with HIV infection/AIDS. Although laryngeal squamous cell carcinomas (LSCCs) in HIV-positive patients are uncommon, a higher incidence of this malignancy in HIV-positive patients than in the general population has been reported. As a proportion of LSCCs are associated with HPV in the general population, the clinicopathological features of a series of LSCCs developing in HIV-positive patients were evaluated to investigate the possible relationship with HPV infection, and infection with other oncogenic viruses. All HIV-positive patients with LSCC diagnosed at a single institution from 1998 to 2007 were retrospectively evaluated. The clinicopathological features were analysed and tissues we... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2574508 Sun, 05 Jul 2009 23:00:00 +0100 2574508 http://www.medworm.com/index.php?rid=2565199&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00733.x To investigate, using a longitudinal design, whether biomarkers of cardiovascular risk change after a switch to an abacavir (ABC)-containing regimen in HIV-1-infected individuals already receiving combination antiretroviral therapy (ART). Thirty-five HIV-1-infected individuals who switched ART to an ABC-containing regimen were identified. Twenty-two HIV-1-infected individuals who switched ART from and to a non-ABC-containing regimen served as controls. Plasma concentrations of soluble vascular cell adhesion molecule 1 (sVCAM-1), soluble intercellular adhesion molecule 1 (sICAM-1), matrix metallopeptidase 9 (MMP9), myeloperoxidase (MPO) and high sensitivity C-reactive protein (hs-CRP) were measured in blood samples before the switch in ART, and 3 months and 12 months afterwards. Log10-trans... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2565199 Sat, 04 Jul 2009 23:00:00 +0100 2565199 http://www.medworm.com/index.php?rid=2565204&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00724.x Tenofovir/emtricitabine (TDF/FTC) and abacavir/lamivudine (ABC/3TC) are widely used with ritonavir (RTV)-boosted protease inhibitors (PIs) as first-line highly active antiretroviral therapy (HAART), but there is conflicting evidence on their relative efficacy. The ACTG 5202 and BICOMBO trials suggested higher efficacy for TDF/FTC, whereas the HEAT trial showed no efficacy difference between the nucleoside reverse transcriptase inhibitor (NRTI) backbones. A systematic MEDLINE search identified 21 treatment arms in 12 clinical trials of 5168 antiretroviral-naïve patients, where TDF/FTC (n=3399) or ABC/3TC (n=1769) was used with RTV-boosted PI. For each NRTI backbone and RTV-boosted PI, the percentage of patients with viral load (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2565204 Tue, 30 Jun 2009 23:00:00 +0100 2565204 http://www.medworm.com/index.php?rid=2565203&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00728.x The objective of this study was to review the use of boosted PI regimens in children. Systematic literature searches of published manuscripts and conference databases using generic drug names and specific keywords were performed to ensure thorough and balanced reporting of available data. Boosted PI regimens offer multiple options across a range of ages and are efficacious in naïve and experienced children; safety and tolerability are similar to those observed in adults. Novel boosted PI simplification approaches may foster adherence and diminish resistance. Boosted PIs are key components of first- and second-line treatments in children. Identifying factors associated with the response to highly active antiretroviral therapy in children may ultimately permit individualized therapies. (Sou... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2565203 Tue, 30 Jun 2009 23:00:00 +0100 2565203 http://www.medworm.com/index.php?rid=2565202&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00729.x High serum total cholesterol and low-density lipoprotein (LDL) levels have been demonstrated to increase the probability of a sustained viral response (SVR) in chronic hepatitis C. Conversely, insulin resistance reduces SVR rates. We investigated the influence of baseline glucose and lipid values on the outcome of hepatitis C virus (HCV) treatment in HIV-1 infected subjects. We retrospectively reviewed the charts of HIV/HCV-coinfected patients treated with an interferon-based regimen from 2002 to 2008. Fasting glucose levels and total cholesterol, LDL and triglyceride levels were recorded prior to the initiation of treatment. Of the 96 patients enrolled in the study, 36 (37.5%) had genotype 1, 48 (50%) genotype 2 or 3 and 12 (12.5%) genotype 4. SVR was obtained in 25% (nine of 36) and 70% ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2565202 Tue, 30 Jun 2009 23:00:00 +0100 2565202 http://www.medworm.com/index.php?rid=2565201&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00730.x The objectives of this study were to investigate the occurrence of TB, the prevalence of LIMTb and the coverage of the TT and IT, and to estimate the number of missed opportunities to prevent TB in patients with HIV/AIDS. A random sample of patients with HIV/AIDS was selected; data from the medical files were obtained, and a TT was performed in consenting subjects. In the 203 subjects included in the study, TB occurrence was 13.3%, LIMTb prevalence was 20% and the coverage of the TT and IT was 59.2 and 55%, respectively. Patients with TB had a lower nadir CD4 cell count, but their CD4 recovery was comparable to that of non-TB patients. Patients with LIMTb always had a higher CD4 cell count. By expanding the coverage of the TT and IT to nearly 100%, we could more than double the number of p... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2565201 Tue, 30 Jun 2009 23:00:00 +0100 2565201 http://www.medworm.com/index.php?rid=2565200&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00731.x The objective of this study was to evaluate the agreement between antiretroviral treatments (ARTs) prescribed in clinical practice and the recommendations in published guidelines. A retrospective cohort study was carried out in ART-naïve adults of the Spanish Asociacion Medica Vach de Estudios Multicentricos (VACH) Cohort for the period from 2003 to 2006. A total of 945 patients initiated ART. Of these patients, 12.3% had a CD4 cell count above 350 cells/[mu]L. A 'nonrecommended' antiretroviral regimen was prescribed to 5.3, 5.1 and 7.8% of patients with CD4 counts 350 cells/[mu]L, respectively. Multivariate analyses demonstrated that only a higher viral load was associated with the selection of a combination treatment that was recommended by the guidelines. Most patients were prescribed ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2565200 Tue, 30 Jun 2009 23:00:00 +0100 2565200 http://www.medworm.com/index.php?rid=2465648&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00725.x For individuals not on antiretroviral therapy, the risk of heterosexual transmission of HIV appears negligible when blood plasma (BP) viral loads are (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2465648 Tue, 09 Jun 2009 04:00:00 +0100 2465648 http://www.medworm.com/index.php?rid=2449978&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00723.x Infection with HIV leads to progressive CD4 T-cell loss, resulting in AIDS. Apoptosis is the main mechanism for the loss of infected and bystander cells, but the complex interacting factors inducing and inhibiting apoptosis are not fully understood. Mitochondrial dysfunction is a pivotal step of the apoptotic cascade and can result in reduced mitochondrial membrane potential. The mitochondrial membrane potential of peripheral blood mononuclear cells (PBMC) was measured by flow cytometry using the dye JC-1 (Molecular Probes Inc). Apoptotic cells were identified using the Annexin V assay (Becton Dickinson GmbH). The mitochondrial membrane potential of PBMC was significantly decreased and apoptotic cell rate was increased in HIV-infected therapy-naïve patients compared with HIV-negative cont... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2449978 Tue, 02 Jun 2009 04:00:00 +0100 2449978 http://www.medworm.com/index.php?rid=2449979&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00722.x To assess the effects of chronic hepatitis C (HCV) and HIV infection on dyslipidaemia in a Hispanic population at high risk of insulin resistance. We compared serum lipids and C-reactive protein (CRP) in 257 Hispanic adults including 47 HIV- mono-infected, 43 HCV-mono-infected and 59 HIV/HCV-co-infected individuals as well as 108 healthy controls. We also assessed the effect of HCV on lipid alterations associated with antiretroviral therapy (ART), and the impact of HCV and HIV on the associations among insulin resistance, triglycerides and cholesterol. HCV infection was associated with lower total and low-density lipoprotein (LDL) cholesterol, but not high-density lipoprotein (HDL) cholesterol or triglycerides compared with healthy controls. HIV infection was associated with higher triglyc... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2449979 Mon, 01 Jun 2009 04:00:00 +0100 2449979 http://www.medworm.com/index.php?rid=2429767&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00721.x The influence of ritonavir-boosted darunavir coadministration on nevirapine pharmacokinetics was investigated in HIV-infected patients using a population-based approach. The population was composed of 51 patients (89 samples; 42 patients treated with an antiretroviral regimen containing nevirapine and nucleoside/nucleotide reverse transcriptase inhibitors and nine patients treated with a regimen containing a combination of nevirapine and darunavir). A one-compartment model with first-order absorption was fitted to the data using nonmem version V (GloboMax, Ellicott City, MD, USA). Relationships were established between nevirapine clearance (Cl) and age (Cl/F=2.42+47.2/age, where F denotes bioavailability) and between nevirapine volume of distribution (Vd) and the presence of darunavir in t... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2429767 Sat, 23 May 2009 04:00:00 +0100 2429767 http://www.medworm.com/index.php?rid=2429770&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00718.x This study aimed to develop a CYP2B6 G516T genotyping assay to identify individuals at risk of efavirenz toxicity. The frequency of this polymorphism in a UK HIV-infected population and its prevalence in individuals who had discontinued efavirenz were also to be assessed. Genomic DNA from HIV-positive patients (n=206) attending clinic at Southmead Hospital, North Bristol NHS Trust was extracted from spare blood taken for CD4 monitoring. An allele-specific polymerase chain reaction (PCR) method for the CYP2B6 G516T polymorphism was used to assign patients' genotypes. Patients' age, sex, ethnicity and drug history were also recorded. The G516T polymorphism was more prevalent in Blacks (16%; n=10/63) than Caucasians (6%; n=9/143). No significant difference in the distribution of genotypes bet... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2429770 Thu, 21 May 2009 04:00:00 +0100 2429770 http://www.medworm.com/index.php?rid=2429769&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00719.x The aim of this article is to describe the development of a dynamic French cohort of HIV-infected patients, the methodological issues and decisions made, and the characteristics of the patients currently enrolled. Data are collected during medical encounters. Data quality is ensured by automated checks during data capture, by regular controls, by annual assessments, and by ad hoc processes before any scientific analysis is performed. In September 2007, 10 458 patients representing 59 383 patient-years of follow-up were followed in our centres, including 446 with a first HIV diagnosis in the past year. Among these recently diagnosed patients, 25.6% presented with late diagnosis. Our cohort included 3017 women (28.8%). The women were less likely to be receiving highly active antiretroviral t... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2429769 Thu, 21 May 2009 04:00:00 +0100 2429769 http://www.medworm.com/index.php?rid=2429768&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00720.x Lipoatrophy and lipohypertrophy are associated with metabolic abnormalities, but little is known about their impact on hypertension. We conducted this study to determine the associations of lipoatrophy and lipohypertrophy with hypertension. A cross-sectional study of HIV-infected patients who completed a self-report body morphology assessment was performed. We defined hypertension as a clinical diagnosis, or a mean systolic blood pressure (BP)>140 mmHg or diastolic BP>90 mmHg in the previous 6 months. We used logistic regression to examine the association between hypertension and body morphology. Among 347 patients, there were 2278 BP readings in 6 months. In adjusted analyses, patients with moderate lipoatrophy [odds ratio (OR) 4.3; P=0.03] or moderate lipohypertrophy (OR 4.3; P=0.006) ha... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2429768 Thu, 21 May 2009 04:00:00 +0100 2429768 http://www.medworm.com/index.php?rid=2408095&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00709.x Zidovudine (ZDV) has been the cornerstone of antiretroviral (ARV) therapy for pregnant women infected with HIV-1 in the prevention of mother-to-child transmission (MTCT) and remains the only licensed ARV for use in pregnancy. We explored the current and future roles of tenofovir disoproxil fumarate (TDF) in the prevention of MTCT of HIV-1. We reviewed the published literature by conducting database searches of in vitro, animal and clinical studies, reported in journals and at conferences, using the search terms Tenofovir/gs4331/viread, pregnant/pregnancy, lactate, lactation, natal, reproduce/reproduction, placenta/placental, malformation, and teratogenicity/teratogenic. In a macaque model, perinatal exposure to very high dose tenofovir resulted in bone toxicity in some offspring. However, ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2408095 Fri, 15 May 2009 04:00:00 +0100 2408095 http://www.medworm.com/index.php?rid=2393016&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00717.x The aim of the study was to describe trends and risk factors for mortality and changes in antibiotic resistance, serotypes and clones among HIV-infected patients with invasive pneumococcal disease (IPD). A prospective study of 199 episodes of IPD occurring in a cohort of 4011 HIV-infected patients was carried out. Predictors of mortality included clinical and microbiological data. The 7-valent pneumococcal conjugate vaccine (PCV7) for children was introduced in late 2001. Time periods were classified for mortality studies as pre- (1986[ndash]1996), early (1997[ndash]2001) and late (2002[ndash]2007) highly active antiretroviral therapy (HAART) era, and for serotype studies as pre-PCV7 (1986[ndash]2001) and PCV7 (2002[ndash]2007) era. Of 199 IPD episodes, 71 (36%) occurred in HIV-infected pa... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2393016 Thu, 07 May 2009 04:00:00 +0100 2393016 http://www.medworm.com/index.php?rid=2393022&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00711.x To examine risk factors for sub-optimal CD4 recovery on suppressive highly active antiretroviral therapy (HAART) and assess long-term clinical and immunological outcomes. Retrospective analysis of 286 HIV-positive patients from a university clinic who initiated HAART with CD4 count (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2393022 Wed, 06 May 2009 04:00:00 +0100 2393022 http://www.medworm.com/index.php?rid=2393021&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00712.x In this study, we determined clinical factors associated with the development of cryptogenic liver disease in HIV-infected individuals. HIV-seropositive and -seronegative patients undergoing evaluation for liver transplantation were selected if they met clinical criteria for cryptogenic liver disease. Clinical data were collected retrospectively, and radiological and histological data were reviewed separately. Nine HIV-seropositive individuals were compared with 41 HIV-seronegative patients with cryptogenic liver disease. Only one HIV-seropositive patient (11%) had cirrhosis, compared to 39 HIV-seronegative patients (93%) (P (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2393021 Wed, 06 May 2009 04:00:00 +0100 2393021 http://www.medworm.com/index.php?rid=2393020&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00713.x We reviewed the safety and efficacy of nevirapine (NVP)-based therapy in all patients initiating NVP-containing combined antiretroviral therapy [cART ([ge]3 drugs)] in our clinic since 1994. Patient characteristics and laboratory values from the start of the NVP-based cART regimen to the last available follow-up or to NVP discontinuation were retrieved from an observational database. Five hundred and seventy-three patients were treated with NVP-based cART for a median of 18.4 (range 0.1[ndash]128.8) months. The 1-year cumulative estimated probability of discontinuing NVP-containing regimens for toxicity was 0.203. Only 1.9% developed a grade 3 alanine aminotransferase (ALT) elevation. Significant increases in high-density lipoprotein cholesterol were observed up to month 12 except in treat... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2393020 Wed, 06 May 2009 04:00:00 +0100 2393020 http://www.medworm.com/index.php?rid=2393019&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00714.x An article by the Swiss AIDS Commission states that patients with stably suppressed viraemia [i.e. several successive HIV-1 RNA plasma concentrations (viral loads, VL) below the limits of detection during 6 months or more of highly active antiretroviral therapy (HAART)] are unlikely to be infectious. Questions then arise: how reliable is the undetectability of the VL, given the history of measures? What factors determine reliability? We assessed the probability (henceforth termed reliability) that the n+1 VL would exceed 50 or 1000 HIV-1 RNA copies/mL when the nth one had been (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2393019 Wed, 06 May 2009 04:00:00 +0100 2393019 http://www.medworm.com/index.php?rid=2393018&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00715.x The aim of the study was to determine the modifications of the mutational archive in proviral HIV-1 DNA occurring during 24 months of intermittent or continuous highly active antiretroviral therapy (HAART). The study population included subjects enrolled in the Istituto Superiore di Sanità Pulsed Antiretroviral Therapy (ISS PART) clinical trial. All of these patients were on first-line HAART and had plasma HIV-1 RNA below 50 HIV-1 RNA copies/mL. A genotypic resistance test was performed on HIV-1 DNA extracted from peripheral blood mononuclear cells (PBMC) at baseline and after 24 months of follow-up. Resistance-associated mutations (RAMs) were defined according to the International AIDS Society (IAS) USA classification. Sixty-nine subjects were included in the study [36 enrolled in arm A ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2393018 Wed, 06 May 2009 04:00:00 +0100 2393018 http://www.medworm.com/index.php?rid=2393017&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00716.x The aims of the study were to describe the clinical presentation and renal and bone abnormalities in a case series of HIV-infected patients receiving treatment with tenofovir (TDF), and to recommend appropriate screening for toxicity related to TDF. Patients were identified from referrals to a specialist HIV renal clinic. Patients were included if treatment with TDF was assessed as the primary cause of the renal function impairment and clinical data were available prior to and following discontinuation of TDF treatment. Data were collected from case note review and clinic databases. Twenty-two patients (1.6% of all those who received TDF) were identified with TDF-associated renal toxicity. All had normal serum creatinine prior to TDF therapy. All presented with proteinuria. On stopping TDF... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2393017 Wed, 06 May 2009 04:00:00 +0100 2393017 http://www.medworm.com/index.php?rid=2393025&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00727.x (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2393025 Tue, 05 May 2009 04:00:00 +0100 2393025 http://www.medworm.com/index.php?rid=2393024&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00708.x Risk-reduction counselling is a standard preventive intervention, but behaviour change is difficult to sustain over the duration of HIV infection. However, primary HIV infection (PHI) is highly infectious and plays a key role in transmission [ndash] especially through dense sexual networks [ndash] but is short term, so even transient risk reduction can mitigate its high infectivity. Targeting behaviour-change interventions at recently infected individuals may be highly effective, particularly in higher risk groups. We explored the potential impact on HIV transmission-risk behaviour of PHI diagnosis in men who have sex with men (MSM). MSM with PHI were interviewed at diagnosis and after 3 months of follow-up about their sexual behaviour in the 12-week periods before and after diagnosis and ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2393024 Tue, 05 May 2009 04:00:00 +0100 2393024 http://www.medworm.com/index.php?rid=2393023&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00710.x We hypothesized that there may be a correlation between the interleukin-7 (IL-7)/IL-7 receptor (IL-7R) regulatory system and parameters of T-cell homeostasis in HIV-infected long-term nonprogressors (LTNPs) as compared with patients with disease progression. The possibility of a correlation between T-cell homeostatic parameters and IL-7/IL-7R was investigated in 22 LTNPs (CD4 count [ge]500 cells/[mu]L for >10 years) vs. HIV-positive patients at different disease stages [12 early: CD4 count [ge]400 cells/[mu]L; 15 late (AIDS-presenters): CD4 count [le]150 cells/[mu]L]. Compared with early-stage HIV-positive patients, LTNPs displayed a higher circulating IL-7 concentration (P=0.05), which was positively associated with higher IL-7R[alpha] expression and a higher T-cell receptor excision circ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2393023 Tue, 05 May 2009 04:00:00 +0100 2393023 http://www.medworm.com/index.php?rid=2309893&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00702.x The frequency and significance of, and liver biopsy findings associated with, a persistently normal alanine aminotransferase (ALT) level in HIV/hepatitis C virus (HCV)-coinfected patients are poorly characterized. We analysed factors associated with persistently normal ALT levels, defined as at least three consecutive normal ALT values over a 6-month period, in a group of 381 HIV/HCV-coinfected patients. Patients were categorized into two groups according to ALT values: group 1, patients with persistently normal ALT levels; and group 2, patients with elevated ALT values. Possible interactions with host factors, HIV and HCV viral factors, antiretroviral treatment and histological features were examined. Thirty-six patients (9.4%) had persistently normal ALT levels. None of the 36 patients h... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2309893 Wed, 08 Apr 2009 04:00:00 +0100 2309893 http://www.medworm.com/index.php?rid=2309898&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00697.x The prevalence of metabolic syndrome (MS) in HIV-infected patients on highly active antiretroviral therapy (HAART) is a subject of debate. We investigated the prevalence of MS in a cohort of Danish HIV-infected patients and estimated the effect of the various classes of antiretroviral therapies on the prevalence of MS and its components. A cross-sectional study was performed in which data were obtained from fasting blood tests, anthropometry, an interview questionnaire and whole-body dual-energy X-ray absorptiometry (DEXA) scans. MS was defined using the National Cholesterol Education Programme (NCEP) Adult Treatment Panel (ATP) III diagnostic criteria. Five hundred and sixty-six patients were included in the study, of whom 27% were diagnosed with MS. In univariate analysis, the duration o... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2309898 Thu, 26 Mar 2009 04:00:00 +0100 2309898 http://www.medworm.com/index.php?rid=2309897&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00698.x The aim of the study was to elucidate primary drug resistance and transmission of HIV-1 in acute and recent drug-naïve seroconverters in Singapore. Acute and recent HIV-1 seroconverters were enrolled in the study. The HIV-1 polymerase (pol) gene was sequenced and used for genotypic drug resistance analysis and phylogenetic analysis. HIV-1 transmission clusters were inferred from phylogenetic clustering analysis. Of the 60 subjects analysed, 95% were men, and 73.3% were men who have sex with men (MSM). Six HIV-1 subtypes were identified, including CRF01_AE (46.7%), subtypes B (30%), B' (15%) and G (1.7%), CRF33_01B (1.7%) and CRF34_01B (5%). Primary genotypic resistance was detected in only one (1.7%) subtype B variant. Thirty-one patients (51.7%) were phylogenetically clustered, of whom 9... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2309897 Thu, 26 Mar 2009 04:00:00 +0100 2309897 http://www.medworm.com/index.php?rid=2309896&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00699.x The objective of this study was to explore the associations among blood pressure, HIV status and two predefined highly active antiretroviral therapy (HAART) regimens: treatment with and without nonnucleoside reverse transcriptase inhibitors (NNRTIs) (NNRTI- and non-NNRTI-based HAART). A cross-sectional survey was conducted among 612 adults attending the Sexual Health Outpatient Department at St Mary's NHS Hospital Trust, London. HIV-infected patients treated with NNRTIs had a blood pressure that was 4.6/4.2 mmHg higher than those who were HIV positive but treatment naïve. The diastolic difference remained statistically significant after adjusting for potential confounders of this association (2.4 mmHg; P=0.03). There was no difference in blood pressure between those treated with non-NNRTI... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2309896 Thu, 26 Mar 2009 04:00:00 +0100 2309896 http://www.medworm.com/index.php?rid=2309895&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00700.x The aim of the study was to determine whether immune reconstitution inflammatory syndrome (IRIS) associated with herpes zoster occurs on a different time frame from other instances of IRIS. Statistical analysis of onset times of herpes zoster-associated IRIS and other cases of IRIS was carried out in a retrospective cohort starting antiretroviral therapy at advanced stages of HIV infection. Herpes zoster-associated IRIS was significantly more frequent after the first 3 months of successful highly active antiretroviral therapy (HAART), than other instances of IRIS (IRIS associated with tuberculosis, Mycobacterium avium complex, Kaposi's sarcoma, etc.) which mainly occurred during the first 3 months of treatment. The characteristic onset time pattern of herpes zoster-associated IRIS, coincid... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2309895 Thu, 26 Mar 2009 04:00:00 +0100 2309895 http://www.medworm.com/index.php?rid=2309894&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00701.x The aim of the study was to investigate the influence of continued injecting drug use, enrolment in an opiate substitution treatment programme (OSTP), or cessation of injecting drug use on the uptake and course of antiretroviral therapy (ART). A prospective observational study of all participants in the Swiss HIV Cohort Study followed between 1997 and 2006 was carried out. We distinguished four groups of former or current injecting drug users (IDUs): (i) abstinent former IDUs; (ii) persons in OSTPs without concomitant injecting drug use; (iii) persons in OSTPs with concomitant injecting drug use; (vi) current IDUs. These groups were compared with a group of patients who had never been IDUs. Factors related to ART uptake and virological endpoints were analysed using logistic generalized est... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2309894 Thu, 26 Mar 2009 04:00:00 +0100 2309894 http://www.medworm.com/index.php?rid=2252113&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00692.x The aim of this work was to audit the extent to which routine HIV care in the UK conforms with British HIV Association (BHIVA) guidelines and specifically the proportion of patients starting highly active antiretroviral therapy (HAART) who achieve the outcome of virological suppression below 50 HIV-1 RNA copies/mL within 6 months. A prospective cohort review of adults with HIV infection who started antiretroviral therapy (ART) for the first time between April and September 2006 was carried out using structured questionnaire forms. A total of 1170 adults from 122 clinical sites participated in the review. Of these patients, 699 (59.7%) started ART at CD4 counts (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2252113 Wed, 11 Mar 2009 04:00:00 +0100 2252113 http://www.medworm.com/index.php?rid=2252111&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00693.x Kidney disease remains a prevalent problem in HIV care. The contribution of highly active antiretroviral therapy (HAART), HIV disease factors and traditional factors needs further evaluation. A cross-sectional study of all patients seen at an HIV outpatient clinic during 2005 was performed. All data were collected from medical record review. Multivariate regression modelling was used to identify independent predictors of lower glomerular filtration rate (eGFR) and chronic renal failure (CRF) from factors significant in univariate analysis. eGFR was calculated using the simplified modification of diet in renal disease equation. Results were compared with those for persons from the National Health and Nutrition Examination Survey (NHANES) matched for age, race and gender. Of 845 HIV-infected... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2252111 Wed, 11 Mar 2009 04:00:00 +0100 2252111 http://www.medworm.com/index.php?rid=2252109&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00694.x Thymidine nucleoside reverse transcriptase inhibitors (NRTIs) are associated with subcutaneous fat loss. Facial changes cannot be assessed by dual-energy X-ray absorptiometry (DEXA) scans. There are limited objective data on the reversibility of facial lipoatrophy. We performed a facial volume substudy of a randomized thymidine NRTI replacement study carried out in HIV-infected subjects with moderate to severe lipoatrophy. Facial volume changes were assessed using validated 3D laser imaging. Changes in body composition were measured using DEXA scans. The association between changes in facial volume and body composition parameters at 48 weeks was measured using Spearman's rank correlation. Forty-seven individuals (46 male), 11 receiving zidovudine and 36 receiving stavudine, switched to eit... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2252109 Wed, 11 Mar 2009 04:00:00 +0100 2252109 http://www.medworm.com/index.php?rid=2252107&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00695.x Recent studies in hospitalized patients with community-acquired pneumonia have found a lower risk of bacteraemia and better clinical outcomes in patients who had previously received the 23-valent pneumococcal polysaccharide vaccine (PPV) in comparison with unvaccinated individuals. The aim of this study was to assess the influence of prior PPV on clinical outcomes in HIV-infected adult patients hospitalized with invasive pneumococcal disease (IPD). This was an observational study of all consecutive HIV-infected adults hospitalized with IPD from January 1996 to October 2007 in three hospitals in Spain. Baseline characteristics and clinical outcome-related variables were compared according to prior PPV vaccination status. A total of 162 episodes of IPD were studied. In 23 of these (14.2%), p... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2252107 Wed, 11 Mar 2009 04:00:00 +0100 2252107 http://www.medworm.com/index.php?rid=2252105&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2009.00696.x The aim of the study was to evaluate the impact of different patterns of nonadherence on treatment outcomes in patients with long-term follow-up. This cohort study included patients who began highly active antiretroviral therapy during 1996[ndash]1999, with the last follow-up in 2007. Adherence was evaluated every 2 months by monitoring of pharmacy refills and by using self-reports. Patients were considered nonadherent at a specific visit when less than 90% of the prescribed drugs had been taken. Adherence was categorized as follows. (A) Continuous adherence: a patient had to be adherent in all of the evaluations throughout the period of follow-up. (B) Treatment interruption: drugs were not taken for more than 3 days, for any reason. Treatment failure was defined as viral load >500 HIV-1 R... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2252105 Wed, 11 Mar 2009 04:00:00 +0100 2252105 http://www.medworm.com/index.php?rid=2193853&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00689.x The aim of the study was to characterize the impact of the cytochrome P450 2B6 (CYP2B6), CYP3A4, CYP3A5 and ATP-binding cassette sub-family B member 1 (ABCB1) polymorphisms on nevirapine plasma concentrations. A total of 104 patients (82% male; 26% non-Caucasian) were genotyped for eight single nucleotide polymorphisms at four loci (CYP2B6, CYP3A4, CYP3A5 and MDR1). Nevirapine plasma concentrations were determined using high-performance liquid chromatography. Non-Caucasian ethnicity [5609 ng/mL (n=27) for non-Caucasians vs. 3771 ng/mL (n=77) for Caucasians; P (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2193853 Wed, 18 Feb 2009 05:00:00 +0100 2193853 http://www.medworm.com/index.php?rid=2189942&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00691.x The aim of the study was to investigate the prevalence and aetiology of chronic kidney disease (CKD) and trends in estimated glomerular filtration rate (eGFR) in HIV-infected patients. Ascertainment and review of CKD cases among patients attending King's College and Brighton Hospitals, UK were carried out. CKD was defined as eGFR (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2189942 Tue, 17 Feb 2009 05:00:00 +0100 2189942 http://www.medworm.com/index.php?rid=2189943&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00686.x More than 10 years after the introduction of combination antiretroviral therapy (cART), we examined the trend in the proportion of deaths caused by end-stage liver disease (ESLD) in HIV-infected adults in France between 1995 and 2005. In 2005, 34 departments prospectively recorded all deaths in HIV-infected patients who were followed in those departments (around 24 000). Results were compared with those of four previous cross-sectional surveys conducted since 1995 using the same methodology. Among 287 reported deaths in 2005, 100 (35%) were related to AIDS, and 48 (17%) to ESLD. Three out of four patients who died from ESLD-related causes had chronic hepatitis C. Excessive alcohol consumption was reported in approximately half of the patients (48%). At death, 62% of patients had undetectab... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2189943 Sun, 15 Feb 2009 05:00:00 +0100 2189943 http://www.medworm.com/index.php?rid=2169637&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00687.x Recent studies suggest that patients with HIV infection are at increased risk for incident diabetes mellitus (DM). We investigated the incidence and risk factors of DM among HIV-infected patients receiving combination antiretroviral therapy (CART) in Taiwan. Incident cases of DM were identified among HIV-infected patients at the National Taiwan University Hospital between 1993 and 2006. A retrospective case[ndash]control study was conducted after matching cases with controls for sex, age at HIV diagnosis, year of HIV diagnosis, mode of HIV transmission and baseline CD4 lymphocyte count. A multivariate analysis was performed to identify risk factors for incident DM among HIV-infected patients. In 824 HIV-infected patients eligible for analysis, 50 cases of incident DM were diagnosed, result... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2169637 Mon, 09 Feb 2009 05:00:00 +0100 2169637 http://www.medworm.com/index.php?rid=2169638&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00685.x The aim of the study was to evaluate long-term changes in lipids and to assess other coronary heart disease (CHD) risk factors in highly experienced AIDS patients with immune reconstitution, and to examine their association with antiretroviral therapy (ART). We evaluated 433 AIDS patients with prior severe immunosuppression and ART-based immune reconstitution, followed in a multicentre prospective observational study between 2000 and 2006. We estimated the prevalence at entry of hypercholesterolaemia and metabolic syndrome, and 10-year CHD risks. Trends in total cholesterol (TC), triglycerides (TG) and high-density lipoprotein (HDL) cholesterol were evaluated over time, and use of specific ART drugs at each study visit was assessed using mixed effect models, adjusting for CHD risk factors ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2169638 Sun, 08 Feb 2009 05:00:00 +0100 2169638 http://www.medworm.com/index.php?rid=2166368&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00690.x Darunavir (TMC114) is a new HIV protease inhibitor (PI). This Phase I, randomized, open-label trial compared the effects of darunavir plus low-dose ritonavir (RTV) (darunavir/RTV) with those of atazanavir/RTV on lipid and glucose parameters. Forty-nine HIV-negative, healthy male volunteers received RTV 100 mg once a day (qd) for 7 days, followed by either darunavir/RTV 800/100 mg qd (n=25) or atazanavir/RTV 300/100 mg qd (n=24) for 21 days. Mean changes in fasting lipid and glucose parameters at day 28 were calculated using post-RTV alone (day 7) and baseline (day [minus]1) values as references. Short-term safety, tolerability and RTV pharmacokinetic parameters were evaluated. After 7 days of RTV treatment, the mean triglyceride concentration increased by approximately 30 mg/dL in both gro... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2166368 Sun, 08 Feb 2009 05:00:00 +0100 2166368 http://www.medworm.com/index.php?rid=2166370&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00683.x Tenofovir disoproxil fumarate (TDF) is active against hepatitis B virus (HBV) and HIV. However, the long-term efficacy of tenofovir disoproxil fumarate (TDF) is not well known and the appearance of resistance is a major concern. We have studied the efficacy of TDF against HBV in patients treated at an Infectious Diseases Unit. We carried out a retrospective observational study of the efficacy of TDF against HBV replication in a cohort of 52 HIV-coinfected patients who received TDF for at least 6 months. The median duration of follow-up of TDF treatment was 34 months. Forty-one patients (79%) were positive for HBV envelope antigen (HBeAg) and 35 had received previous lamivudine monotherapy for a median duration of 32 months. Virological breakthrough was observed in nine cases (17%). At the ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2166370 Thu, 05 Feb 2009 05:00:00 +0100 2166370 http://www.medworm.com/index.php?rid=2166369&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00684.x The aim of the study was to compare the risks of death among HIV-infected patients on highly active antiretroviral therapy (HAART) in two proximate, yet distinct neighbourhoods: a neighbourhood with a high concentration of gay men, and a neighbourhood with a high concentration of injecting drug users. We compared the clinical and socioeconomic characteristics of HIV-infected patients from the two neighbourhoods entering the British Columbia Centre for Excellence in HIV/AIDS Drug Treatment Program from 1 September 1997 to 30 November 2005, using contingency table statistics. Cox survival models and Kaplan[ndash]Meier methods were used to estimate the cumulative mortality rates. We found significant differences between patients from the two neighbourhoods for all socioeconomic variables. Pat... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2166369 Thu, 05 Feb 2009 05:00:00 +0100 2166369 http://www.medworm.com/index.php?rid=2140429&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00682.x We report the results of plastic surgery using autologous fat transplants (Coleman's Lipostructure[trade]) in six HIV-infected adolescents with facial lipoatrophy: three boys and three girls, aged 14[ndash]19 years. The quantity of reinjected fat on each side of the face varied from 5 to 12 mL within a single procedure. All the patients reported being satisfied or very satisfied with the cosmetic results and reported a positive impact on their daily life. With well-trained surgeons and carefully selected indications, corrective surgery of facial lipoatrophy in HIV-infected adolescents can provide immediate and long-lasting benefits in terms of physical appearance and psychological wellbeing, and should be considered as a component of comprehensive care. (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2140429 Thu, 29 Jan 2009 05:00:00 +0100 2140429 http://www.medworm.com/index.php?rid=2140435&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00673.x Guidelines for kidney function monitoring and antiretroviral drug dosing are available and respectively refer to glomerular filtration rate and creatinine clearance (CrCl). The aim of the study was to compare kidney function estimates vs. measured 24-h CrCl in HIV-infected subjects. A cross-sectional design was used, with comparison of Cockcroft[ndash]Gault (CG), original and simplified modification of diet in renal disease (MDRD) equations vs. measured 24-h CrCl. Subjects were HIV-infected, 18[ndash]70 years old, without pre-existing kidney disease. Results are presented as mean (±standard deviation), unless otherwise stated. The study population consisted of 90 patients, of whom 71% were male, with a mean age of 45 years (±6.5 years). At the time of evaluation, the mean body mass index... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2140435 Wed, 28 Jan 2009 05:00:00 +0100 2140435 http://www.medworm.com/index.php?rid=2140434&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00676.x The aim of the study was to describe the characteristics of young people with vertically acquired HIV diagnosed aged [ge]13 years. A retrospective review of HIV diagnoses reported to well-established national paediatric and adult HIV surveillance systems in the United Kingdom/Ireland was conducted. Forty-two young people with vertically acquired HIV diagnosed aged [ge]13 years were identified; 23 (55%) were female, 40 (95%) were black African and 36 (86%) were born in sub-Saharan Africa. The median age at HIV diagnosis was 14 years (range, 13[ndash]20 years). Half of the patients presented with symptoms; the remainder were screened for HIV following diagnosis of a relative. The median CD4 count at diagnosis was 210 cells/[mu]L (range, 0[ndash]689 cells/[mu]L), 12 patients (29%) were diagno... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2140434 Wed, 28 Jan 2009 05:00:00 +0100 2140434 http://www.medworm.com/index.php?rid=2140433&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00679.x The aim of the study was to compare the performance of several bedside neuropsychological tools for detection of HIV-associated neurocognitive disorder (HAND) in antiretroviral drug-exposed persons. We analysed the relative performance of the HIV Dementia Scale (HDS), International HIV Dementia Scale (IHDS) and the Mini-Mental Status Exam (MMSE) together with neuropsychological tests (Symbol-Digit, Grooved Pegboard and Trail Making) in HIV-1-seronegative subjects (HIV[minus]; n=13) and in HIV-1-seropositive subjects with HAND (HIV+HAND; n=13) and other neurological disorders (HIV+OND; n=20). Established neuropsychological tests consistently showed significantly poorer performance by HIV+HAND subjects compared with the other two groups. Similarly, the mean HDS and IHDS scores were lower in ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2140433 Wed, 28 Jan 2009 05:00:00 +0100 2140433 http://www.medworm.com/index.php?rid=2140432&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00680.x The relationship between the subjective diagnosis of lipoatrophy and the objective amount of limb fat loss in HIV-infected adults is unclear. Using Medline, we identified published articles reporting the amount of arm, leg or limb fat measured by dual X-ray absorptiometry in HIV-infected patients with moderate-severe lipoatrophy and in healthy non-HIV-infected adults. We calculated the relative content of fat in the limbs, arms and legs of lipoatrophic patients with regard to the weighted arithmetic means of those fat values in healthy controls. We found 799 patients from 10 articles, and 73 healthy controls from two articles. Limb fat ranged from 2.6 to 4.4 kg in patients, and from 7.1 to 7.2 kg in controls. Both patients and controls were almost exclusively men, of white race, and in the... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2140432 Wed, 28 Jan 2009 05:00:00 +0100 2140432 http://www.medworm.com/index.php?rid=2140431&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00675.x The aim of the study was to identify and characterize hepatitis B virus (HBV) polymerase gene mutations associated with ongoing HBV replication in HIV/HBV-coinfected individuals receiving tenofovir (TDF). This retrospective cross-sectional study identified 28 HIV/HBV-coinfected individuals who had received TDF for at least 3 months. All patients had samples available while receiving TDF (on-TDF), and 24 also had samples available prior to treatment (pre-TDF). Case records were reviewed to obtain clinical and virological data at the times of sampling (±3 months). The HBV DNA of all samples was amplified using polymerase chain reaction (PCR), and the polymerase region of PCR-positive samples was sequenced and compared with reference HBV data. Of the pre-TDF samples, 15 of 24 (63%) were HBV ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2140431 Wed, 28 Jan 2009 05:00:00 +0100 2140431 http://www.medworm.com/index.php?rid=2140430&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00678.x We aimed to retrieve the vital status of patients lost to follow-up (LFU), with no further visits for at least 12 months, for the 34 835 patients in the Agence Nationale de Recherche sur le SIDA CO4 French Hospital Database on HIV (ANRS CO4 FHDH) seen in 1999 and to examine how loss to follow-up might influence estimates of survival and the impact of delayed access to care (DAC) on survival. The status of LFU patients was established by using the mid-2006 update of the FHDH in which their status 12 months after loss to follow-up was added when available and by matching with the Mortalité 2000-Epidemiological Centre for Medical Causes of Death (CépiDc) database, which included HIV-infected patients dying in 2000. We compared Kaplan[ndash]Meier and hazard ratio (HR) estimates before and af... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2140430 Wed, 28 Jan 2009 05:00:00 +0100 2140430 http://www.medworm.com/index.php?rid=2127768&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00672.x This cross-sectional study was designed to pilot the analysis of clinical data, knowledge about and attitudes towards HIV/AIDS, and prevention and risk behaviour in persons recently infected with HIV. Blood samples and demographic, laboratory, clinical and behavioural data were collected from patients with newly diagnosed HIV infections. The BED IgG-capture ELISA (BED-CEIA) was used to determine the recency of infection. Recent HIV infections contributed 54% [95% confidence interval (CI) 45; 64%] of infections in men who have sex with men (MSM) and 16% (95% CI 0; 39%) of infections in patients with other transmission risks (P=0.041). Recently infected MSM were characterized by younger age and higher viral load as compared with MSM who had longstanding infections (P=0.011 and 0.005, respect... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2127768 Fri, 23 Jan 2009 05:00:00 +0100 2127768 http://www.medworm.com/index.php?rid=2127769&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00670.x The aim of the study was to determine the cost-effectiveness of HIV nonoccupational post-exposure prophylaxis (NPEP) in Australia. A retrospective cost analysis of a population-based observational cohort of 1601 participants eligible for NPEP in Australia between 1998 and 2004 was carried out. We modelled NPEP treatment costs and combined them with effectiveness outcomes to calculate the cost per seroconversion avoided. We estimated the cost-utility of the programme, and sensitivity and threshold analysis was performed on key variables. The average NPEP cost per patient was A$1616, of which A$848 (52%) was for drugs, A$331 (21%) for consultations, A$225 (14%) for pathology and A$212 (13%) for other costs. The cost per seroconversion avoided in the cohort was A$1 647 476 in our base case an... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2127769 Thu, 22 Jan 2009 05:00:00 +0100 2127769 http://www.medworm.com/index.php?rid=2091800&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00668.x Two open-label, randomized, cross-over trials in healthy volunteers were conducted to investigate the pharmacokinetic interaction between etravirine and tenofovir disoproxil fumarate. Etravirine was administered as either 800 mg twice a day (bid) (phase II formulation in Study 1) or 200 mg bid (phase III formulation in Study 2) for 8 days followed by a 12 h pharmacokinetic evaluation. After a minimum of 14 days washout, tenofovir disoproxil fumarate 300 mg once a day was administered for 16 days. Volunteers were randomized to receive co-administration of etravirine with tenofovir disoproxil fumarate on either days 1[ndash]8 or days 9[ndash]16 followed by a 12 h pharmacokinetic evaluation for etravirine on day 8 or 16, respectively. Plasma and urine tenofovir concentrations were determined ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2091800 Fri, 09 Jan 2009 05:00:00 +0100 2091800 http://www.medworm.com/index.php?rid=2091802&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00674.x Although many studies have been carried out on pulmonary diseases in HIV-infected patients, studies specifically investigating the aetiologies of cavitary lung lesions are rare. HIV-infected patients enrolled in a cohort study who presented with cavitary lung lesions by radiography were identified between June 1994 and March 2008. Medical records and radiological and microbiological data for these patients were retrospectively reviewed using a standardized case collection form. During the 14-year study period, 73 episodes of cavitary lung lesions were diagnosed in 66 of 1790 (3.7%) HIV-infected patients. At the diagnosis of cavitary lung lesions, the median CD4 count was 25 cells/[mu]L (range 1[ndash]575 cells/[mu]L). Eighty-one pathogens were considered causative, with fungi being the mos... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2091802 Thu, 08 Jan 2009 05:00:00 +0100 2091802 http://www.medworm.com/index.php?rid=2091801&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00669.x A prospective study was carried out to assess HIV-1 and HIV-2 mother-to-child transmission (MTCT) rates in Portugal between 1999 and 2005 by analysing the proportion of diagnosed infected children born to HIV-positive mothers. Serial blood samples were collected from 1315 children at risk of HIV-1 infection, 131 children at risk of HIV-2 infection and six children at risk of both HIV-1 and HIV-2 infections attending 25 Health Institutions. HIV proviral DNA was detected by nested polymerase chain reaction (PCR) and statistical analysis was performed using spss. DNA PCR using HIV-1 and HIV-2 long terminal repeat (LTR) primers amplified 92.5% and 75% of maternal HIV infections, respectively. Overall, MTCT occurred in 3.4% [95% confidence interval (CI) 2.5[ndash]4.6%] of HIV-1 and 1.5% (95% CI... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2091801 Thu, 08 Jan 2009 05:00:00 +0100 2091801 http://www.medworm.com/index.php?rid=2086205&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00665.x The objective of this study was to assess the effect on CD4 cell counts and viral load dynamics the withdrawal of START after birth could generate. This was a 5-year cohort study involving HIV-1-infected pregnant women who presented with CD4 counts >300 cells/[mu]L and had received START to prevent MTCT. Seventy-five pregnancies were assessed. In 24 cases, there was a history of antiretroviral therapy prior to prophylaxis. The median baseline CD4 count was 573 cells/[mu]L. In 75% of cases, prophylaxis was started after 26.6 weeks of gestation. The median CD4 cell count increase over baseline during prophylaxis was 24.5%. In only five cases did HIV-1 viral load remain detectable during prophylaxis. After START, CD4 cell counts did not drop significantly, and the HIV-1 viral load plateau was... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2086205 Wed, 07 Jan 2009 05:00:00 +0100 2086205 http://www.medworm.com/index.php?rid=2080299&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00664.x This study explores whether viral load measurements can be used in resource-limited settings to target those in need of adherence assistance. It was hypothesized that high plasma viral loads (pVLs) ([ge]500 HIV-1 RNA copies/mL) were the result of poor antiretroviral therapy adherence and amenable to improvement with adherence assistance. A single-arm, multicentre pilot study was conducted from November 2003 to March 2004 on 606 treatment-experienced patients who had initiated an antiretroviral regimen in Mali and Burkina Faso [ge]6 months before study enrolment. In these patients, those whose pVL was [ge]500 copies/mL were offered 1 month of modified directly administered antiretroviral treatment (mDAART) with weekly follow-up visits from pharmacists or adherence counsellors. An adherence ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2080299 Mon, 05 Jan 2009 05:00:00 +0100 2080299 http://www.medworm.com/index.php?rid=2080300&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00667.x Poly-l-lactic acid (PLA) injections modestly increase objectively assessed facial thickness but not facial soft tissue volume (FSTV) over 24 weeks. The durability of this response has not been well defined objectively. HIV-infected lipoatrophic adults were randomized to four open-label PLA treatments administered every 2 weeks from week 0 (immediate group, n=50) or from week 24 (deferred group, n=50). Endpoints included FSTV assessed by computed tomography, facial lipoatrophy severity, quality of life (QoL) and safety. Analyses were by intention to treat. Between weeks 24 and 48, soft tissue thickness increased modestly in injection planes, at the maxillary [mean 0.9 mm; 95% confidence interval (CI) 0.3[ndash]1.5 mm; P=0.007] and base of nasal septum levels (mean 0.4 mm; 95% CI 0.1[ndash]0... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2080300 Sun, 04 Jan 2009 05:00:00 +0100 2080300 http://www.medworm.com/index.php?rid=2058893&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00663.x The aim of the study was to determine the effect of nucleoside reverse transcriptase inhibitors (NRTIs) on CD4 recovery in HIV-1-infected individuals receiving long-term suppressive combination antiretroviral therapy (cART). A retrospective cohort study was carried out. The mean time-weighted CD4 change from baseline was determined at weeks 48, 96 and 144: its associations with exposure to NRTIs were assessed using linear regression. One hundred and five patients were included. Their median baseline CD4 count was 225 (interquartile range 91[ndash]362) cells/[mu]L. A trend of greater CD4 change from baseline was observed for individuals who at baseline had CD4 counts >200 cells/[mu]L (138 vs. 113, 176 vs. 134 and 204 vs. 173 cells/[mu]L), or were [le]40 years old (136 vs. 118, 182 vs. 150, ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2058893 Tue, 23 Dec 2008 05:00:00 +0100 2058893 http://www.medworm.com/index.php?rid=2058894&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00662.x The aim of the study was to determine the relationship between alcohol consumption and liver fibrosis as assessed by aspartate aminotransferase to platelet ratio index (APRI) in HIV-infected adults and to explore the relative contributions of alcohol and hepatitis C virus (HCV) to APRI among HIV/HCV-coinfected adults. We performed a cross-sectional analysis of data from an observational clinical cohort. Alcohol consumption was categorized according to National Institute on Alcohol Abuse and Alcoholism guidelines. We defined significant liver disease as APRI>1.5, and used multinomial logistic regression to identify correlates of increased APRI. Among 1358 participants, 10.4% reported hazardous drinking. It was found that 11.6% had APRI>1.5, indicating liver fibrosis. Hazardous drinking was ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=2058894 Mon, 22 Dec 2008 05:00:00 +0100 2058894 http://www.medworm.com/index.php?rid=1950760&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00655.x Hypertensive cardiovascular complications are more closely associated with ambulatory blood pressure (ABP), particularly the attenuated diurnal blood pressure (BP) rhythm (i.e. a fall in systolic blood pressure (Source: HIV Medicine) HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1950760 Wed, 12 Nov 2008 05:00:00 +0100 1950760 http://www.medworm.com/index.php?rid=1950765&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00653.x Highly active antiretroviral therapy (HAART) is reported to cause insulin resistance among adults, but effects on children are less clear. We attempted to describe the prevalence of insulin resistance among HIV-infected children receiving HAART. Insulin resistance was assessed at 96 weeks of treatment with nonnucleoside reverse transcriptase inhibitor (NNRTI)-based HAART (nevirapine or efavirenz with stavudine and lamivudine) among children in Chiang Mai, Thailand. Insulin resistance was defined as homeostasis model assessment for insulin resistance (HOMA-IR) [ge]3.16, fasting c-peptide [ge]4.40 ng/mL or fasting insulin [ge]25.0 [mu]U/mL. Impaired fasting glucose (IFG) was defined as glucose [ge]110 mg/dL. Measurements were analysed for associations with age, lipodystrophy, treatment regim... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1950765 Mon, 10 Nov 2008 05:00:00 +0100 1950765 http://www.medworm.com/index.php?rid=1950764&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00652.x To investigate the impact of HIV co-infection on mortality in patients infected with hepatitis C virus (HCV). From a nationwide Danish database of HCV-infected patients, we identified individuals diagnosed with HCV subsequent to an HIV diagnosis. For each co-infected patient, four control HCV patients without HIV were matched on age, gender and year of HCV diagnosis. Data on comorbidity, drug abuse, alcoholism and date of death were extracted from two healthcare databases. We constructed Kaplan[ndash]Meier curves and used Cox regression analyses to estimate mortality rate ratios (MRRs), controlling for comorbidity. We identified 483 HCV[ndash]HIV co-infected and 1932 HCV mono-infected patients, yielding 2192 and 9894 person-years of observation with 129 and 271 deaths, respectively. The 5-... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1950764 Mon, 10 Nov 2008 05:00:00 +0100 1950764 http://www.medworm.com/index.php?rid=1950763&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00651.x Multiple factors may lead to hepatic steatosis (HS) in HIV-positive patients. HS may result in severe liver damage on its own and/or by accelerating the progression of chronic viral hepatitis B or C. The sensitivity/specificity of liver ultrasound (US) to recognize severe HS is above 85%. A cross-sectional case[ndash]control study of all HIV out-patients who underwent liver US since 2004 was conducted at our institution. Eight hundred and thirty (36.1%) out of 2300 HIV-positive patients on regular follow-up underwent liver US during the study period. Severe HS was diagnosed in 108 (13%) patients. A total of 117 matched HIV controls lacking HS were selected randomly. In patients with severe HS, we found significantly higher values of body mass index (BMI), plasma viral load, serum glucose, ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1950763 Mon, 10 Nov 2008 05:00:00 +0100 1950763 http://www.medworm.com/index.php?rid=1950762&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00650.x More and more highly treatment-experienced patients are achieving viral suppression. However, the durability of suppression remains unclear. Patients from Royal Free Hospital (London, UK) and JW Goethe University Hospital (Frankfurt, Germany) who had failed [ge]1 antiretroviral (ARV) regimen in all three main drug classes and [ge]3 previous ARV regimens and subsequently achieved viral load 400 copies/mL). Two hundred and forty-seven patients contributed 723 person-years and 114 viral rebounds [rate=15.8 per 100 person-years; 95% confidence interval (CI) 12.9[ndash]18.7]. More recent calendar years of viral suppression [relative risk (RR)=0.90 per year later; 95% CI 0.81[ndash]1.00; P=0.05] and greater number of ARVs in the regimen not previously failed (RR=0.78 per 1 ARV more; 95% CI 0.65[... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1950762 Mon, 10 Nov 2008 05:00:00 +0100 1950762 http://www.medworm.com/index.php?rid=1950761&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00654.x The aim of this study was to describe the relationship between age and the time to treatment discontinuation in the absence of virological failure as well as the development of specific laboratory abnormalities, in patients starting highly active antiretroviral therapy (HAART) for the first time. Analyses included 8708 antiretroviral-naïve patients from the UK Collaborative HIV Cohort (CHIC) study who started HAART from 1998 onwards. We considered time to the first discontinuation of any drug in the initial HAART regimen for reasons other than virological failure; the association between this and age at the start of HAART was determined using proportional hazards regression after adjustment for potential confounders. The incidence of specific laboratory abnormalities in the first year aft... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1950761 Mon, 10 Nov 2008 05:00:00 +0100 1950761 http://www.medworm.com/index.php?rid=1855189&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00645.x To assess the prevalence, clinical and immunological characteristics, risk factors and survival of patients with AIDS-related cryptococcosis in the era of highly active antiretroviral therapy (HAART). All newly diagnosed cryptococcosis cases identified retrospectively from among a series of AIDS patients hospitalized consecutively at a single institution in Italy in 1985[ndash]1996 (pre-HAART period, n=165) and 1997[ndash]2006 (post-HAART period, n=40) were analysed comparatively. The prevalence of cryptococcosis decreased from 4.7% (165/3543) to 2.2% (40/1805) between the pre- and post-HAART periods (P=0.0001). There were no differences in the clinical features or immunological status of the patients between the two cohorts. The variables associated with the occurrence of cryptococcosis i... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1855189 Tue, 07 Oct 2008 04:00:00 +0100 1855189 http://www.medworm.com/index.php?rid=1791363&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00640.x Our objective was to evaluate the pharmacokinetics of nelfinavir (NFV) (625 mg tablets) 1250 mg twice daily during pregnancy and postpartum. The participants were HIV-1-infected pregnant women enrolled in P1026s and receiving NFV (625 mg tablets) 1250 mg twice daily as part of routine clinical care. Intensive steady-state 12-h NFV pharmacokinetic profiles were performed during pregnancy and postpartum. The target NFV area under the plasma concentration[ndash]time curve (AUC0[ndash]12) was [ge]10th percentile NFV AUC0[ndash]12 in non-pregnant historical controls (18.5 [mu]g h/mL). Of 27 patients receiving NFV, pharmacokinetic data were available for four (second trimester), 27 (third trimester) and 22 (postpartum) patients. The NFV maximum concentration (Cmax), 12-h post-dose concentration ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1791363 Sun, 14 Sep 2008 04:00:00 +0100 1791363 http://www.medworm.com/index.php?rid=1791362&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00638.x To study the relationship between antiretroviral (ARV) treatment and abnormal ankle-branch index (ABI) and to compare the risk factors for altered ABI. Patients coming to the office from April 2007 until July 2007 were offered to take part in the study. ABI was obtained with standard technique. Those [le]0.9 or [ge]1.3 were considered altered ABI. Clinical reports were reviewed to examine traditional vascular risk factors, coinfection with hepatitis C virus and/or hepatitis B virus, tobacco use, highly active antiretroviral therapy use and its components and length of use of each ARV drug. ABI was measured in 147 patients, 82.3% males. Thirty-three patients (22.45%) had an altered ABI, and it was in relationship with CD4 cell nadir, dyslipidaemia and protease inhibitors (PI) use. When logi... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1791362 Sun, 14 Sep 2008 04:00:00 +0100 1791362 http://www.medworm.com/index.php?rid=1791361&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00641.x Whether pregnancy has an impact on the evolution of CD4 cell counts in women treated with highly potent antiretrovirals before conception remains largely unknown. Among patients enrolled in the ANRS CO8 (APROCO/COPILOTE) cohort, we selected all women aged between 18 and 50 years at initiation of combination antiretroviral therapy (cART). Slopes of CD4 cell counts during follow-up were estimated using mixed longitudinal models with time-dependent indicators for pregnancy and delivery. Of the 260 selected HIV-infected women, a pregnancy occurred in 39 women in a median follow-up time of 66 months. Women who became pregnant had higher CD4 cell count at baseline but this difference progressively lessened during follow-up because they had a slower increase than women who did not become pregnant... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1791361 Sun, 14 Sep 2008 04:00:00 +0100 1791361 http://www.medworm.com/index.php?rid=1791360&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00644.x TMC125-C227, an exploratory phase II, randomized, controlled, open-label trial, compared the efficacy and safety of TMC125 (etravirine) with an investigator-selected protease inhibitor (PI) in nonnucleoside reverse transcriptase inhibitor (NNRTI)-resistant, protease inhibitor-naïve, HIV-1-infected patients. Patients were randomized to TMC125 800 mg twice a day (bid) (phase II formulation; n=59) or the control PI (n=57), plus two nucleoside reverse transcriptase inhibitors (NRTIs). In an unplanned interim analysis, patients receiving TMC125 demonstrated suboptimal virological responses relative to the control PI. Therefore, trial enrolment was stopped prematurely and TMC125 treatment discontinued after a median of 14.3 weeks. In this first-line NNRTI-failure population, baseline NRTI and N... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1791360 Sun, 14 Sep 2008 04:00:00 +0100 1791360 http://www.medworm.com/index.php?rid=1791359&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00642.x The British HIV Association (BHIVA) audit subcommittee aimed to survey UK clinic policy and practice regarding baseline assessment and immunization of newly diagnosed HIV-positive patients, and frequency of follow-up and testing in established patients in the UK. UK centres providing HIV care were requested to complete an online survey between October 2006 and March 2007. 111 centres participated in the survey. 89.2% of centres routinely performed baseline HIV resistance testing. 99% of centres had a policy of routine screening for hepatitis B. Only 91% of centres were routinely offering a sexual health screen at diagnosis. Frequency of routine follow-up for patients not requiring antiretroviral therapy (ART) and stable on ART varied between three and six months. This review showed variati... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1791359 Sun, 14 Sep 2008 04:00:00 +0100 1791359 http://www.medworm.com/index.php?rid=1791358&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00643.x Governments, clinicians and drug-licensing bodies have adopted changes in CD4 cell counts and HIV-1 RNA levels as evidence of effectiveness for new therapeutic interventions. We aimed to determine the strength of the association between the magnitude of the effect of changes in CD4 cell count and HIV-1 RNA and progression to AIDS or death in the highly active antiretroviral therapy (HAART) era. We identified all randomized clinical trials (RCTs) evaluating the effect of HAART on both clinical and surrogate endpoints (1994 to September 2006). We performed a meta-regression and weighted linear regression. We additionally estimated potential RCT sample sizes that would be required to assess the effectiveness of new interventions in terms of clinical endpoints. We included data from 178 RCTs. ... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1791358 Sun, 14 Sep 2008 04:00:00 +0100 1791358 http://www.medworm.com/index.php?rid=1791357&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00646.x The principal causes of liver enzyme elevation among HIV[ndash]hepatitis B virus (HBV) co-infected patients are the hepatotoxic effects of antiretroviral therapy (ART), alcohol abuse, ART-induced immune reconstitution and the exacerbation of chronic HBV infection. To investigate the incidence and severity of liver enzyme elevation, liver failure and death following lamivudine (3TC) withdrawal in HIV[ndash]HBV co-infected patients. Retrospective analysis of the Swiss HIV Cohort Study database to assess the clinical and biological consequences of the discontinuation of 3TC. Variables considered for analysis included liver enzyme, HIV virological and immunological parameters, and medication prescribed during a 6-month period following 3TC withdrawal. 3TC was discontinued in 255 patients on 36... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1791357 Sun, 14 Sep 2008 04:00:00 +0100 1791357 http://www.medworm.com/index.php?rid=1738009&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00629.x To define the incidence and risk factors for methicillin resistant Staphylococcus aureus (MRSA) bacteraemia in an HIV-infected population. From January 1, 2000 to December 31, 2004, we conducted a retrospective cohort study. We identified all cases of Staphylococcus aureus bacteraemia (SAB), including MRSA, among patients enrolled in the Johns Hopkins Hospital out-patient HIV clinic. A conditional logistic regression model was used to identify risk factors for MRSA bacteraemia compared with methicillin-sensitive SAB and no bacteraemia in unmatched (1:1) and matched (1:4) nested case-control analyses, respectively. Of 4607 patients followed for a total of 11 020 person-years (PY) of follow-up, 216 episodes of SAB occurred (incidence: 19.6 cases per 1000 PY), including 94 cases (43.5%) which... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1738009 Wed, 27 Aug 2008 04:00:00 +0100 1738009 http://www.medworm.com/index.php?rid=1738008&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00630.x The aim of this study was to explore the effects of cholecalciferol supplementation on vitamin D levels, bone mineral density (BMD), body fat distribution and insulin sensitivity in vitamin D-deficient HIV-1-infected patients. Twenty vitamin D-deficient HIV-1-infected patients were prospectively treated with 2000 IU cholecalciferol/day for 14 weeks, whereafter treatment was continued with half this dosage until 48 weeks. BMD, body fat distribution, 1,25-dihydroxy vitamin D3 (1,25(OH)2D3), fasting glucose, insulin, adiponectin, leptin, interleukin (IL)-6 and tumour necrosis factor (TNF)-[alpha] were measured at baseline, and at 24 and 48 weeks. Parathyroid hormone (PTH), 25-hydroxy vitamin D3 [25(OH)D3], cholesterol and triglycerides were measured at baseline, and at 12, 24 and 48 weeks. Af... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1738008 Wed, 27 Aug 2008 04:00:00 +0100 1738008 http://www.medworm.com/index.php?rid=1738007&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00632.x In resource-limited countries, HIV-1 RNA quantification is usually performed in reference laboratories. Samples from remote areas are transported under suboptimal conditions. Here we evaluated HIV-1 RNA stability in plasma stored at different temperatures for 1 week. Blood samples collected in ethylenediaminetetraacetic acid (EDTA) and processed within 6 h of collection were tested by HIV-1 RNA quantification using Roche Cobas Ampliprep-Cobas TaqMan® (Roche Diagnostics). The results were compared with matched HIV-1 RNA concentrations determined from plasma stored for 1 week at 4, 22, 30 or 37 °C. A total of 51 samples were evaluated: 10 stored at 4 °C, 15 at 22 °C, 16 at 30 °C and 10 at 37 °C. Keeping plasma at 4, 22 or 30 °C for 1 week did not affect HIV RNA measurement. Compared w... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1738007 Wed, 27 Aug 2008 04:00:00 +0100 1738007 http://www.medworm.com/index.php?rid=1738006&cid=s_33106_20_f&fid=33106&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1468-1293.2008.00631.x We sought to determine the association between body morphology abnormalities and depression, examining lipoatrophy and lipohypertrophy separately. An observational cross-sectional study of 250 patients from the University of Washington HIV Cohort was carried out. Patients completed an assessment including measures of depression and body morphology. We used linear regression analysis to examine the association between lipoatrophy or lipohypertrophy and depression. Analysis of variance was used to examine the relationship between mean depression scores and lipoatrophy and lipohypertrophy in 10 body regions. Of 250 patients, 76 had lipoatrophy and 128 had lipohypertrophy. Mean depression scores were highest among patients with moderate-to-severe lipoatrophy (16.4), intermediate among those wi... HIV Medicine journals http://www.medworm.com/rss/comments.php?id=1738006 Wed, 27 Aug 2008 04:00:00 +0100 1738006