A5042807166- HIV/AIDS Research and Interventions
- Poxvirus research and outbreaks
- HIV/AIDS drug development and treatment
- Bacillus and Francisella bacterial research
- HIV Research and Treatment
- Pneumocystis jirovecii pneumonia detection and treatment
- Herpesvirus Infections and Treatments
- HIV, Drug Use, Sexual Risk
- Reproductive tract infections research
- Syphilis Diagnosis and Treatment
- Sex work and related issues
- HIV-related health complications and treatments
- Diagnosis and treatment of tuberculosis
- Tuberculosis Research and Epidemiology
- Antibiotic Use and Resistance
- Antibiotic Resistance in Bacteria
- Sexual function and dysfunction studies
- Virology and Viral Diseases
- Abdominal vascular conditions and treatments
- Female Genital Mutilation/Cutting Issues
- Chronic Disease Management Strategies
- Sexuality, Behavior, and Technology
- Adolescent and Pediatric Healthcare
- Reproductive Health and Contraception
- Frailty in Older Adults
Chelsea and Westminster Hospital NHS Foundation Trust
2016-2025
Chelsea and Westminster Hospital
2016-2024
Dean College
2021-2022
National Health Service
2020-2022
Government of the United Kingdom
2022
GTx (United States)
2021
University of Bologna
2014-2017
Policlinico S.Orsola-Malpighi
2014-2017
May Institute
2016
Medical Research Council
2016
The COVID-19 pandemic and its related restrictions have affected attendance to delivery of UK sexual healthcare services (SHS). We surveyed the impact on behaviour men having sex with (MSM) inform future SHS provision.We conducted a cross-sectional, anonymous, web-based survey among HIV-negative MSM at high risk HIV infection who attended 56 Dean Street, health clinic. was over 7-day period in August 2020. Data sociodemographic characteristics, mental well-being experienced during lockdown...
Background Diagnosis of pulmonary (PTB) and extra-pulmonary tuberculosis (EPTB) in smear-negative patients can be difficult. We assessed retrospectively the performance Xpert MTB/RIF system (Xpert, Cepheid) diagnosing (TB), which represents most common form TB a low incidence setting. Methods Performance was compared to acid-fast microscopic examination using Ziehl-Neelsen (ZN) stain with culture-confirmed TB. Results 386 Mycobacterium (MTB) culture-positive samples were detected out 5170...
We describe 2 cases of infectious proctitis secondary to human monkeypox in patients presenting with rectal pain. These highlight the importance multidisciplinary management and expanding case definitions enabling clinical recognition without skin rash.
This retrospective service evaluation reviews practical measures for pre-exposure prophylaxis (PrEP) users with estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m 2 . Of 35 724 PrEP users, 361 had an eGFR , of whom 16% required non-tenofovir disoproxil/emtricitabine formulations. Majority cases simple and conservative management, repeat sampling and/or stopping the supplements recreational drugs.
Introduction: Preexposure prophylaxis (PrEP) is contributing to achieve a reduction in HIV diagnoses men having sex with (MSM). Albeit infrequent, infections the context of recent PrEP exposure represent clinical challenge. Methods: Data on use and possible reasons leading infection were analysed individuals newly diagnosed at 56 Dean Street clinic 2016–2020. Demographics, immune-virological parameters, genotypic resistance test results treatment management this group compared those not...
Mpox was declared a Public Health Emergency of International Concern by the World Organization on 23 July 2022 [1], following rapid increase in cases beginning Europe May 2022. By 2 November 2022, 77,264 had been confirmed 109 countries, including 102 with no previously reported mpox infections [2]. Historically, largely self-limited zoonotic illness, affecting mostly children rural rainforest areas West and Central Africa [3]. However, risk factors, demographics clinical features disease...
Introduction A key part of the response to mpox (monkeypox) epidemic has been vaccination campaign targeted at gay, bisexual and other men who have sex with (GBM), including people living HIV (PLWH). Methods We undertook a single-site, retrospective analysis individuals received single dose modified vaccinia Ankara (MVA-BN) prior onset symptoms. Demographics, clinical characteristics patient management were analysed. Results Of 10 068 first MVA-BN vaccination, 15 (0.15%) developed...
Few data exist on the benefits and acceptability of rapid initiation antiretroviral treatment in acute HIV infection (AHI). We analysed a large cohort acutely infected patients starting therapy (ART) to determine uptake, linkage into care time achieve viral suppression.Case notes all individuals diagnosed with AHI between May 2014 October 2015 at 56 Dean Street, sexual health clinic London, UK were reviewed. was defined through documentation plasma RNA positivity only, p24 antigen negative...
Screening and treatment of sexually transmissible infections, including HIV, are free in the UK nations; pre-exposure prophylaxis (PrEP) became England October 2017 through PrEP Impact trial. Doctor-led clinics started at 56 Dean Street September 2015, with drug purchased privately full price. The service was expanded to other staff support initiation monitoring increasing numbers attendees purchasing from online pharmacies. Nonetheless, when clinic given a target 1700 for trial, it clear...
Penicillin-based antibiotic treatment for syphilis infection with CNS involvement (early neurosyphilis) is not always a suitable option. We compared outcomes of patients diagnosed early neurosyphilis and treated doxycycline or procaine G penicillin.Serological clinical were analysed in between January 2015 October 2019 at 56 Dean Street, combined sexual health HIV service based London, UK. Acute onset CNS, ocular and/or otic symptomatology documented seroconverting serology >4-fold increase...
Background: Human monkeypox virus (MPXV) cases in UK have been mainly due to imported infections from West Africa. and several other countries are now reporting increasing number of individuals with no apparent epidemiological links areas where the is endemic.Methods: We report clinical features patients confirmed MPVX infection via MPXV viral PCR detection who attended open-access sexual health clinics London, UK. hospitalization rates concurrent STI we describe our response...
HIV pre-exposure prophylaxis (PrEP) is becoming a pivotal strategy for prevention. Understanding the impact of risk factors transmission to identify those at highest would favour implementation PrEP, currently limited by costs. In this service evaluation, we estimated incidence bacterial STIs in men who have sex with (MSM) diagnosed early syphilis attending London sexual health clinic according their status. addition, infection HIV-negative MSM, following diagnosis syphilis.We undertook...
Successful management of HIV infection as a chronic condition has resulted in demographic shift where the proportion people living with (PLWH) older than 50 years is steadily increasing. A dedicated clinic to PLWH was established at Chelsea and Westminster Hospital January 2009 then extended services across directorate. We report results service evaluation reviewing 10 activities this between 2019. aimed estimate prevalence major noninfectious comorbidities, polypharmacy (≥5 medications),...
HIV-1 pre-exposure prophylaxis (PrEP) has been available in England since March 2020 on the National Health Service using generic emtricitabine and tenofovir disoproxil. 56 Dean Street (56DS) provided PrEP through (1) additional private care from September 2015, estimated to be providing 11% of England's 2019; (2) IMPACT trial, as well monitoring those self-sourcing PrEP. Providing at scale a nurse-led service required safety net for complex individuals. 56DS introduced consultant-led...
Increasingly, people attending HIV services are requesting long-acting injectable (LAI) antiretroviral treatment (ART). However, without RNA resistance-associated mutation results, individuals considered unsuitable for LAI ART. We present our experience of sequencing proviral DNA in 30 to inform suitability ART, whom 23 were suitable. In conclusion, optimization diagnostic tools such as confirm ART would be a welcome addition.
To evaluate the frequency of myopathy and serum creatine kinase (CK) elevation associated with use integrase inhibitor raltegravir we conducted a retrospective, cohort analysis assessing incidence skeletal muscle toxicity among HIV-infected patients treated raltegravir. Adult who started raltegravir-containing therapy were enrolled into study. The was defined by presence one or more following parameters: (1) isolated significant CK without signs symptoms; (2) diffuse myalgia weakness; (3)...
The 56 Dean Street combination prevention model, a strong engagement with the LGBTQI community and flexible services adapted to users' changing needs led an 80% drop in HIV diagnoses gay, bisexual other men who have sex (GBMSM) from 2015 2017. We describe service changes at since 2012 which resulted increase frequency of testing, introduction pre-exposure prophylaxis, earlier diagnosis shorter time viral suppression those living HIV. This model could be deliver similar results settings high...
Objectives Rapid antiretroviral therapy (ART) initiation is recommended in early HIV infection (EHI), even the absence of baseline viral resistance test result. We analysed time to suppression according ART regimen started a cohort patients diagnosed with EHI. Methods Clinical records individuals consecutively EHI between July 2016‐June 2018 were reviewed. The distribution clinical, virological and immunological factors was compared treatment groups using Mann–Whitney U‐test. Results 262...