Publications by authors named "Paul Benn"

Article Synopsis
  • People living with HIV have a higher chance of reactivating Chagas disease, which is often overlooked.
  • There was previously no data on Chagas disease prevalence in UK HIV clinics, prompting a screening initiative.
  • In a screening of 86 patients, no positive cases were found, but clinician awareness led to the identification of one seropositive patient, demonstrating the feasibility of routine screening despite its labor-intensive nature.
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We report the safety and pharmacokinetic properties of the HIV-1 maturation inhibitor GSK3739937 (GSK'937) in healthy participants. This was a phase I, first-in-human, double-blind, randomized, placebo-controlled, single- (part 1) and multiple- (part 2) dose escalation study with an additional open-label relative bioavailability and food effect study (part 3). Participants received oral ascending single doses (10-800 mg) in part 1, up to 18 once-daily 25- to 100-mg or 3 once-weekly 500-mg doses in part 2, and single 100-mg doses as powder-in-bottle or tablet (in fed and fasted states) formulations in part 3.

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Article Synopsis
  • - Cabotegravir + rilpivirine is a new long-acting antiretroviral therapy given monthly or every two months, but the COVID-19 pandemic disrupted many patients' clinic visits for injections.
  • - A study evaluated how well the treatment was maintained during the pandemic across various clinical trials, finding that 94% of participants continued their planned dosing without major issues despite some visits being affected.
  • - Most of the 130 affected participants switched to oral therapy to ensure continued treatment, with 98% maintaining effective viral suppression, highlighting the flexibility of the treatment approach during the pandemic.
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Article Synopsis
  • The study aimed to analyze the pharmacokinetics of cabotegravir, focusing on how different factors (both intrinsic and extrinsic) affect the drug's variability in the body using data from various clinical trials.
  • Researchers utilized advanced statistical tools like NONMEM and R to evaluate a large dataset of plasma concentrations from HIV-1-infected and uninfected subjects, testing different dosing methods and identifying trends related to demographics and health metrics.
  • The findings suggest a population pharmacokinetic model that can guide dosing strategies without necessitating adjustments based on individual factors like race or age, highlighting certain influences from smoking and body metrics on drug absorption and clearance.
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Background: Long-acting cabotegravir and rilpivirine administered monthly or every 2 months might address the challenges associated with daily oral antiretroviral therapy. The ATLAS-2M week 48 results showed non-inferiority of long-acting cabotegravir and rilpivirine administered every 8 weeks compared with that of every 4 weeks. In this study, we report the efficacy, safety, and tolerability results from the week 96 analysis.

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Background: ATLAS (NCT02951052), a phase 3, multicenter, open-label study, demonstrated that switching to injectable cabotegravir (CAB) with rilpivirine (RPV) long-acting dosed every 4 weeks was noninferior at week (W) 48 to continuing three-drug daily oral current antiretroviral therapy (CAR). Results from the W 96 analysis are presented.

Methods And Design: Participants completing W 52 of ATLAS were given the option to withdraw, transition to ATLAS-2M (NCT03299049), or enter an Extension Phase to continue long-acting therapy (Long-acting arm) or switch from CAR to long-acting therapy (Switch arm).

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Objectives: The objective of this study was to describe the real-world use and effectiveness of dolutegravir-based regimens (DBRs) in routine clinical practice in the United Kingdom.

Methods: Retrospective analysis was conducted using data from four National Health Service trusts using Climate-HIV, an electronic case record system. Eligible patients were aged ≥18 years with HIV-1 infection who were prescribed a DBR from December 2012 to March 2018.

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Background: Advances in HIV-1 therapeutics have led to the development of a range of daily oral treatment regimens, which share similar high efficacy rates. Consequently, more emphasis is being placed upon the individual's experience of treatment and impact on quality of life. The first long-acting injectable antiretroviral therapy for HIV-1 (long-acting cabotegravir + rilpivirine [CAB + RPV LA]) may address challenges associated with oral treatment for HIV-1, such as stigma, pill burden/fatigue, drug-food interactions, and adherence.

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Background: Phase 3 clinical studies showed non-inferiority of long-acting intramuscular cabotegravir and rilpivirine dosed every 4 weeks to oral antiretroviral therapy. Important phase 2 results of every 8 weeks dosing, and supportive modelling, underpin further evaluation of every 8 weeks dosing in this trial, which has the potential to offer greater convenience. Our objective was to compare the week 48 antiviral efficacy of cabotegravir plus rilpivirine long-acting dosed every 8 weeks with that of every 4 weeks dosing.

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Objectives: Test of cure (TOC) for (NG) and (CT) infection is an important tool in the public health management of STIs. However, there are limited data about the optimal time to perform TOC using nucleic acid amplification tests (NAATs) for NG and CT infections. A study was performed to assess the feasibility of a larger study to determine the optimal time to TOC using NAATS.

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Objectives: Post-exposure prophylaxis (PEP) for HIV is often poorly tolerated and not completed. Alternative PEP regimens may improve adherence and completion, aiding HIV prevention. We conducted a randomized controlled trial of a maraviroc-based PEP regimen compared with a standard-of-care regimen using ritonavir-boosted lopinavir.

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The incidence of human immunodeficiency virus (HIV) infection continues to rise among core groups and efforts to reduce the numbers of new infections are being redoubled. Post-exposure prophylaxis (PEP) is the use of short-term antiretroviral therapy (ART) to reduce the risk of acquisition of HIV infection following exposure. Current guidelines recommend a 28-day course of ART within 36-72 hours of exposure to HIV.

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Article Synopsis
  • * Out of 253 patients, 58.5% were found to be deficient in 25-hydroxycholecalciferol, with the highest deficiency rates among non-white patients (73.5%).
  • * The research indicated no link between vitamin D deficiency and factors like gender, CD4 count, or viral load, but suggested that low serum calcium levels could signal a need to check vitamin D status.
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Objectives: To evaluate the performance and patient acceptability of the PIMA point-of-care (POCT) CD4 test.

Methods: Parallel POCT and laboratory CD4 testing were performed in newly diagnosed HIV patients and those with chronic infection attending routine or emergency clinics. Demographics, clinical status and time taken for CD4 results to be available were recorded.

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Background: Post-exposure prophylaxis (PEP) following sexual exposure to HIV has been recommended as a method of preventing HIV infection in the UK. Men who have sex with men (MSM) are the group most affected by HIV in the UK and their sexual risk taking behaviour is reported to be increasing. One-to-one behavioural interventions, such as motivational interviewing (MI) have been recommended to reduce HIV in high risk groups.

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Objectives: To assess the feasibility and outcomes of recalling men who have sex with men (MSM) diagnosed as having a bacterial sexually transmitted infection (STI) for re-screening.

Methods: This evaluation was conducted from December 2008 for a 9-month period. MSM diagnosed as having a bacterial STI in that period were offered recall for re-screening 3 months after their diagnosis.

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Purpose Of Review: Postexposure prophylaxis (PEP) has become an important part of combined approaches to the prevention of onward HIV transmission. As PEP becomes more widely available after sexual as well as occupational exposure, there are ongoing debates about cost-effectiveness and utility. Different regions have adopted different PEP strategies and the availability of new antiretroviral drugs and classes means that options for PEP regimens are increasing.

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There is an ongoing need for potent antiretroviral therapies to deal with the increasing pool of treatment-experienced patients with multiple drug resistance. The last few years have seen the arrival of 2 new and very potent protease inhibitors - darunavir and tipranavir - alongside 2 whole new classes of anti-HIV agents - the integrase inhibitors and chemokine receptor CCR5 antagonists. This review focuses on the role of darunavir in managing HIV infection, with an emphasis on darunavir's exceptional resistance profile and related clinical effectiveness, pharmacokinetics, tolerability and toxicity data.

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This audit compared sexual histories taken by self-completed questionnaires (SQ) versus the 'gold-standard' of 'traditional' face-to-face interviews by health-care professionals (HP). It compared reporting of symptoms and sexual behaviour and looked at outcomes in terms of diagnoses of sexually transmitted infections. SQ were at least equal to HP and might therefore be a valuable tool in streamlining services.

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We present the British Association for Sexual Health and HIV (BASHH) guidelines for post-exposure prophylaxis after sexual exposure (PEPSE) to HIV. This document includes a review of the current data to support the use of PEPSE, considers how to calculate the risks of HIV infection after a potential exposure, and provides recommendations on when PEPSE would and would not be considered. Other areas included are the possible impact on sexual behaviour, cost-effectiveness, and issues relating to service provision.

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