Variable uptake of recommended interventions to reduce mother-to-child transmission of HIV in Australia, 1982-2005.

Objective: To analyse the uptake of interventions known to reduce the risk of perinatal HIV transmission among Australian women with HIV infection (who knew their HIV status before delivery), and identify predictors of uptake.

Design: Retrospective analysis of perinatal HIV surveillance data in Australia.

Patients: Women reported as having HIV infection and having given birth to a child (1982-2005) were identified through three mechanisms: an informal network of clinicians (1982-1993); an active surveillance program through paediatricians (since 1993); and state health department reports of children born to women newly diagnosed with HIV (since 1995).

Relation between HIV viral load and infectiousness: a model-based analysis.

Background: A consensus statement released on behalf of the Swiss Federal Commission for HIV/AIDS suggests that people receiving effective antiretroviral therapy-ie, those with undetectable plasma HIV RNA (<40 copies per mL)-are sexually non-infectious. We analysed the implications of this statement at a population level.

Methods: We used a simple mathematical model to estimate the cumulative risk of HIV transmission from effectively treated HIV-infected patients (HIV RNA <10 copies per mL) over a prolonged period.

Serological evidence for infection with Campylobacter jejuni/coli in patients with multifocal motor neuropathy.

Campylobacter jejuni/coli (CJC) infection has been implicated in the immunopathogenesis of Guillain-Barré syndrome (GBS), acute motor axonal neuropathy (AMAN), and Miller Fisher syndrome (MFS). However, its role in chronic immune mediated neuropathies such as multifocal motor neuropathy (MMN) or chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is less clear. Anti-ganglioside antibodies are associated with chronic motor neuropathies such as MMN and IgM anti-GM1, and IgM anti-asialo GM1 antibodies have been shown to cross-react with CJC lipopolysaccharides.

Marked epitope- and allele-specific differences in rates of mutation in human immunodeficiency type 1 (HIV-1) Gag, Pol, and Nef cytotoxic T-lymphocyte epitopes in acute/early HIV-1 infection.

During acute human immunodeficiency virus type 1 (HIV-1) infection, early host cellular immune responses drive viral evolution. The rates and extent of these mutations, however, remain incompletely characterized. In a cohort of 98 individuals newly infected with HIV-1 subtype B, we longitudinally characterized the rates and extent of HLA-mediated escape and reversion in Gag, Pol, and Nef using a rational definition of HLA-attributable mutation based on the analysis of a large independent subtype B data set.

Prevalence, incidence and risk factors for pharyngeal chlamydia in the community based Health in Men (HIM) cohort of homosexual men in Sydney, Australia.

Objectives: To determine the prevalence, incidence and risk factors for pharyngeal Chlamydia trachomatis in the community based Health in Men (HIM) cohort of HIV negative homosexual men in Sydney, Australia.

Methods: From January 2003, all HIM participants were offered annual screening for pharyngeal chlamydia using BD ProbeTec nucleic acid amplification testing (NAAT). Detailed sexual behavioural data were collected every 6 months, and risk factors for infection and hazard ratios were calculated using Cox regression.

Could sexually transmissible infections be contributing to the increase in HIV infections among men who have sex with men in Australia?

Background: To review existing data on sexually transmissible infections (STI) in men who have sex with men in Australia in order to determine the possible contribution of STI to diverging trends in HIV notifications in different states.

Methods: We reviewed data from multiple sources, including routine national surveillance data, laboratory surveillance data, self-reported information on STI testing in men who have sex with men and ad hoc reports of STI prevalence.

Results: We found increasing rates of gonorrhoea and infectious syphilis notifications in urban men in Australia between 1997 and 2006, and increasing rates of chlamydia notifications in men aged 30-49 years.

Trends in HIV incidence in homosexual men in developed countries.

Objectives: To describe trends in HIV notifications and in other measures of HIV incidence in homosexual men in developed countries.

Methods: A literature search was conducted using PubMed. In addition to the peer-reviewed literature, data on HIV surveillance trends were sought by searching websites of surveillance authorities in developed countries.

Trend in HIV incidence in a cohort of homosexual men in Sydney: data from the Health in Men Study.

Objectives: To determine the incidence of HIV seroconversion in a community-based cohort of homosexual men in Sydney from 2002 to 2006.

Methods: Participants were recruited between 2001 and 2004 from community-based events and venues. They were tested for HIV annually at follow-up interviews.

Trends in HIV prevalence among homosexual and bisexual men in eastern Australian states.

Objectives: In Australia, HIV notification rates in homosexual men, previously much higher in New South Wales, have become similar across the eastern states. We examined whether trends in HIV prevalence in community-based samples of homosexual men were consistent with the trends in HIV notifications.

Methods: We examined data on self-reported HIV status from annual cross-sectional, self-completed anonymous surveys of homosexual men conducted between 1998 and 2006 in Sydney, Melbourne and Brisbane.

Characteristics of HIV diagnoses in Australia, 1993-2006.

Objective: To describe recent trends in the diagnosis of HIV infection in Australia.

Methods: National HIV surveillance data from 1993 to 2006 were analysed with a focus on geographic differences by HIV exposure route and late presentation (HIV within 3 months of a first AIDS-defining illness or a CD4 count of less than 200 cells muL(-1)).

Results: In 1993-99, the number of HIV diagnoses declined by 32%, and then increased by 39% from 1999 to 2006.

Establishment of a surveillance system (utilising Midwifes Data Collection Systems) for monitoring the impact of hepatitis B vaccination on the population prevalence of chronic hepatitis B virus infection in Australia.

Objective: To examine how routine hepatitis B surface antigen (HBsAg) testing of antenatal women (as identified on the NT Midwifes Data Collection System) can be used to track the impact of hepatitis B (HBV) vaccination on the prevalence of chronic HBV infection in the Northern Territory (NT).

Methods: Women who gave birth between 01 July 2002 and 30 June 2004 were identified from the NT Midwives Data Collection System (MDCS). For each woman, the unique hospital record number (HRN) was linked to the information system of the NT Government pathology service to obtain the results of serological tests for hepatitis B.

Representativeness of injecting drug users who participate in HIV surveillance: results from Australia's Needle and Syringe Program Survey.

Objective: Australia's annual Needle and Syringe Program (NSP) Survey forms the basis of HIV surveillance among injecting drug users (IDUs) by providing serial point prevalence estimates of patterns of infection and risk behaviors. This study examined the representativeness of NSP Survey samples.

Design: National cross-sectional survey of 3920 NSP clients.

Does circumcision make a difference to the sexual experience of gay men? Findings from the Health in Men (HIM) cohort.

Introduction: The relevance of circumcision in preventing male-to-male sexual transmission of HIV is poorly understood, in particular because any potential beneficial effect could be diminished by the impact of circumcision on sexual behavior.

Aim: We examined the impact of circumcision on sexual experience.

Methods: Univariate and multivariate logistic regressions were performed on data from 1,426 HIV-negative homosexually active men.

Self-report is a valid measure of circumcision status in homosexual men.

Objective: Misreporting of circumcision status may affect observed relationships between circumcision status and HIV or other sexually transmissible infections. As no data exist on the validity of self-reported circumcision status among homosexual men, we investigated the agreement between self-report and examination findings in a subgroup of participants in the Health in Men (HIM) study in Sydney, Australia.

Methods: A subgroup of 240 participants in the community based HIM cohort study attending annual interview agreed to a brief genital examination by a trained study nurse who was unaware of their previous self-reported circumcision status.

Estimating the risk of blood donation associated with HIV risk behaviours.

A blood donor questionnaire and declaration, with deferral of potential donors at a higher risk of blood-borne infections, was introduced in Australia in the mid-1980s to reduce the risk of donation of HIV-infected blood. However, the absolute risk of HIV transmission through blood donation from high-HIV-risk donors has not been estimated. This study presents a new method of assessing the risk posed to the blood supply by selected HIV risk behaviours.

Trends in agreements between regular partners among gay men in Sydney, Melbourne and Brisbane, Australia.

Between 1998 and 2007, 51,449 Gay Community Periodic Survey questionnaires were completed in Sydney, Melbourne and Brisbane, Australia. These included 23,424 where the respondents reported currently being in a relationship with a regular male partner. About 90% of men with a regular partner had been tested for HIV, and about three quarters had tested HIV-negative.

Epidemiology of primary HIV-1 infection.

Purpose Of Review: To review recent studies reporting epidemiological and public health aspects of primary and recently acquired HIV infection, with a particular emphasis on patterns of occurrence, relationship to onward transmission, diagnostic strategies and risk factors.

Recent Findings: Diagnosis of primary HIV infection remains a relatively infrequent occurrence. Clinical and demographic characteristics may be helpful indicators to guide the decision to offer testing.

Improved cognitive function as a consequence of hepatitis C virus treatment.

Objective: The aim of the study was to investigate the impact of treatment-related clearance of hepatitis C virus (HCV) on cognitive function.

Methods: A prospective study was conducted in 19 HCV-monoinfected and 15 HIV/HCV-coinfected individuals undergoing pegylated interferon alpha-2a and ribavirin therapy between April 2003 and August 2005. Neuropsychological, mood, and health-related quality of life (HRQOL) effects were assessed using computer-based battery, Trail Making Tests, Depression Anxiety Stress Scales and the Short Form-36 health survey.

HIV diagnoses in Australia: diverging epidemics within a low-prevalence country.

Objective: To describe recent trends in the diagnosis of HIV infection in Australia.

Design And Setting: Analysis of national surveillance system data for 1993-2006.

Main Outcome Measures: Number and population rate of new HIV diagnoses by year, exposure route and demographic characteristics.

Liver cancer and hepatitis B and C in New South Wales, 1990-2002: a linkage study.

Background/aims: Hepatocellular carcinoma (HCC) incidence has increased in Australia in the past 20-30 years. We conducted a community-based linkage study to examine the characteristics of hepatocellular carcinoma with particular reference to hepatitis B and C infections.

Methods: Hepatocellular carcinoma cases (n=2,072) notified to the New South Wales (NSW) Central Cancer Registry from 1990 to 2002 were probabilistically linked to HBV and HCV diagnoses notified to NSW Health.

Transmission of hepatitis C virus by needle-stick injury in community settings.

Background: Hepatitis C virus (HCV) is predominantly transmitted by blood-to-blood contact, typically by sharing of needles by injecting drug users. Discarded needles could act as a vector for transmission of this infection.

Methods: Two cases of HCV seroconversion following a needle-stick injury in a community setting were identified.