Comparison of the rate and size of HIV-1 viral load blips with Roche COBAS TaqMan HIV-1 versions 1.0 and 2.0 and implications for patient management.

Background: The Roche COBAS TaqMan HIV-1 version 1.0 (v1.0) real-time PCR test detects more low level viral loads (VL) compared to the previous Roche Amplicor version 1.

The cost-effectiveness of early access to HIV services and starting cART in the UK 1996-2008.

Aim: To calculate use, cost and cost-effectiveness of people living with HIV (PLHIV) starting routine treatment and care before starting combination antiretroviral therapy (cART) and PLHIV starting first-line 2NRTIs+NNRTI or 2NRTIs+PI(boosted), comparing PLHIV with CD4≤200 cells/mm3 and CD4>200 cells/mm3. Few studies have calculated the use, cost and cost-effectiveness of routine treatment and care before starting cART and starting cART above and below CD4 200 cells/mm3.

Methods: Use, costs and cost-effectiveness were calculated for PLHIV in routine pre-cART and starting first-line cART, comparing CD4≤200 cells/mm3 with CD4>200 cells/mm3 (2008 UK prices).

Successful treatment of acute hepatitis C virus in HIV positive patients using the European AIDS Treatment Network guidelines for treatment duration.

Background: The incidence of acute hepatitis C virus (HCV) in HIV-positive patients is rising. Recent studies summarized by the European AIDS Treatment Network (NEAT)(1) show that pegylated interferon alpha (PEG-IFNα) and ribavirin can lead to a sustained virological response (SVR) in approximately 60-80% of patients. Controversy remains on when to start treatment and whether 24 or 48 weeks of treatment lead to better outcomes.

Cost-effectiveness of early treatment with first-line NNRTI-based HAART regimens in the UK, 1996-2006.

Aim: Calculate time to first-line treatment failure, annual cost and cost-effectiveness of NNRTI versus PIboosted first-line HAART regimens in the UK, 1996-2006.

Background: Population costs for HIV services are increasing in the UK and interventions need to be effective and efficient to reduce or stabilize costs. 2NRTIs + NNRTI regimens are cost-effective regimens for first-line HAART, but these regimens have not been compared with first-line PI(boosted) regimens.

Rising population cost for treating people living with HIV in the UK, 1997-2013.

Background: The number of people living with HIV (PLHIV) is increasing in the UK. This study estimated the annual population cost of providing HIV services in the UK, 1997-2006 and projected them 2007-2013.

Methods: Annual cost of HIV treatment for PLHIV by stage of HIV infection and type of ART was calculated (UK pounds, 2006 prices).

Predictors of renal outcome in HIV-associated nephropathy.

Background: Human immunodeficiency virus (HIV)-associated nephropathy (HIVAN) is an important cause of end-stage renal disease among African American patients. This study was performed to study the epidemiology of HIVAN in a predominantly black African population and the impact of highly active antiretroviral therapy and other factors on the development of end-stage renal disease.

Methods: We retrospectively identified all patients with HIVAN, defined by biopsy or strict clinical criteria, in 8 clinics in the United Kingdom.

Symptomatic HIV viraemia during a drug holiday: an argument against treatment interruption?

An HIV-positive African woman developed severe constitutional symptoms associated with rebound viraemia during a planned antiretroviral treatment interruption, requiring reinitiation of highly active antiretroviral therapy.

Variation in morphotype, karyotype and DNA type of fluconazole resistant Candida albicans from an AIDS patient.

Azole-resistant oropharyngeal and oesophageal candidiasis is a recent phenomenon observed in patients with AIDS usually previously treated with fluconazole. Some variation has been observed in antifungal susceptibility testing among separate colonies of Candida albicans from the same patient. This raises the question of whether there are multiple clones present or simply phenotypic variation in expression of azole resistance.

Azole resistance in Candida.

Resistance of Candida to azoles is an increasing problem. Susceptibility testing of Candida against fluconazole and ketoconazole is now feasible and desirable. Good correlation of resistance in vitro with clinical failure of fluconazole therapy has now been shown in mucosal candidiasis.

Karyotyping of fluconazole-resistant yeasts with phenotype reported as Candida krusei or Candida inconspicua.

The yeasts Candida krusei and Candida inconspicua have similar phenotypes, which may make discrimination of these organisms difficult. In this study we determined the karyotypes of 51 isolates of these two yeast species by contour-clamped homogeneous electric field electrophoresis. We found that the 43 isolates that had the C.

Recurrent transient neurological deficits in advanced HIV infection.

Objectives: To report the occurrence of a syndrome of recurrent neurological deficits in advanced HIV disease and to discuss its management and prognosis.

Design: Retrospective case study.

Setting: A regional treatment centre for HIV-infected individuals in northwest England.

Fluconazole-resistant candidosis in an HIV cohort.

Objectives: To report the occurrence of HIV-related mucosal candidosis that fails to respond to fluconazole, to establish the correlation between in vitro susceptibility testing and clinical failure, and to assess the efficacy of alternative treatments.

Design: Chart review of all patients with fluconazole failure and all patients with CD4 counts < 50 x 10(6)/l continuing to respond to fluconazole, and prospective in vitro susceptibility testing of Candida.

Setting: A regional treatment centre for HIV-infected individuals in north-west England.

Leishmaniasis of the tongue treated with liposomal amphotericin B.

A 66-year-old man, immunosuppressed because of a lymphoma and with severe ischaemic heart disease and proteinuria, presented with a swelling on the tongue due to leishmaniasis. His travel history suggested that he had acquired the infection in the Mediterranean area some years earlier. He was treated with liposomal amphotericin B for 21 days and made a good recovery despite a temporary deterioration in renal function.