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HIV Care (hiv + care)

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Medical Sciences100%

Selected Abstracts

British HIV Association (BHIVA) national cohort outcomes audit of patients commencing antiretrovirals from naïve

HIV MEDICINE, Issue 6 2009
E Street
Objectives 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. Methods 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. Results A total of 1170 adults from 122 clinical sites participated in the review. Of these patients, 699 (59.7%) started ART at CD4 counts <200 cells/,L and 193 (16.5%) had not been tested for HIV drug resistance. Excluding patients with valid reasons for stopping short-term ART, 795 (73.5%) of 1081 patients had an undetectable viral load (VL) at follow-up. Detectable VL was strongly associated with pretreatment CD4 count below 50 cells/,L and pretreatment VL above 100 000 copies/mL, and was not associated with clinic location or case load. About a quarter of patients did not have a VL measurement during the first 6 weeks after starting ART. Conclusions The majority of patients who initiated ART at sites participating in this UK national audit were managed within the BHIVA guidelines and achieved virological suppression below 50 copies/mL around 6 months after commencing treatment. Poor VL outcomes were associated with very low CD4 cell count and/or high VL at baseline but not with clinic case load or location. There is an urgent need to diagnose patients at an earlier stage of their HIV disease. [source]

National review of maternity care for women with HIV infection

HIV MEDICINE, Issue 5 2006
C McDonald
Objective To assess adherence to the British HIV Association (BHIVA) 2001 guidelines for the management of HIV-infected pregnant women. Methods A survey and a case note review were carried out using structured questionnaires sent to providers of adult HIV care in the UK and Ireland. Participants were women with HIV infection who delivered a live or stillborn infant between October 2002 and September 2003. The main outcome measures were the appropriate use of antiretroviral therapy, the use and timing of elective Caesarean section, and support for the avoidance of breast-feeding. Results Of 186 centres, 100 (54%) responded with data on 501 eligible pregnancies. Conclusions In general, practice was in accordance with the BHIVA 2001 guidelines. However, in a number of cases Caesarean sections were planned later than the recommended 38 weeks. [source]

Current status of HIV infection: a review for non-HIV-treating physicians

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 12 2007
Bettina Knoll MD
An estimated 40 million people live with human immunodeficiency virus (HIV) globally, and over four million people were newly diagnosed with HIV infection in 2006. Twenty-five million people have died as a result of HIV since its recognition in 1981. Where available, highly active antiretroviral therapy has resulted in significant decreases in HIV-associated morbidity and mortality. Nevertheless, opportunistic infections and conditions continue to occur, and their recognition and management continue to be an important component of HIV care. [source]

Sexual behaviour and diagnosis of people over the age of 50 attending a sexual health clinic

AUSTRALASIAN JOURNAL ON AGEING, Issue 1 2009
Chris Bourne
Objectives:,To investigate the sexual health and behaviour of older Australians attending a sexual health clinic. Methods:,A retrospective patient record of people aged 50 years and over attending the clinic. Results:,2438 people aged 50 years and over attending. The main reasons for attending were assessment of genital symptoms (40%), testing for sexually transmitted infections (STIs) (23%), and HIV testing/care (13%); more than 50% of the clients had a previous sexual health problem and more than 50% had not been tested for HIV. Men reported more lifetime sexual partners than women and were significantly more likely to report using condoms (P < 0.05), although condom use was variable. Genital herpes (10% women, 6% men) and non-gonococcal urethritis (9% men) were the most commonly diagnosed STIs. Conclusions:,High levels of unsafe sex and many important sexual health problems were identified which provide direction for public health interventions for older sexually active Australians. [source]