Objectives Many questionnaires on adherence to antiretroviral therapy are in use, but the validity of patients' responses has not been tested. The Medication Adherence Self-Report Inventory (MASRI) developed and tested for its against objective measures treatment outcome. Design Prospective study comparing questionnaire with MEMS TrackCap (MC, a medication event monitoring system), pill count (PC) plasma HIV viraemia publicly funded specialist clinic. Participants Patients self-medicating...

A proportion of patients with HIV infection who subsequently receive highly active antiretroviral therapy (HAART) exhibit a deterioration in their clinical status, despite control virologic and immunologic parameters. This response, known as the immune reconstitution inflammatory syndrome (IRIS), occurs secondary to an response against previously diagnosed pathogens.From our cohort 5,832 treated HAART era, we identified 150 therapy-naive first presentation Kaposi's sarcoma (KS). Their...

Background Polylactic acid (PLA, New‐Fill ® ; Medifill, London, UK and Dermic Labs, a division of Eventis, Strasbourg, France) injections into the deep dermis increase fibroblast numbers collagen production. The substance is widely used in medical applications including cosmetic procedures. Methods HIV‐positive individuals with facial lipoatrophy (based on physician assessment) were randomized to immediate (weeks 0, 2 4) or delayed 12, 14 16) PLA given as three bilateral weeks apart...

CXCR4-using virus is associated with higher viral load and accelerated human immunodeficiency (HIV) disease progression. Additionally, CCR5 antagonists may not reduce the HIV-1 RNA when mixed/dual-tropic or present. The determination of coreceptor tropism be required before CXCR4 are initiated, unless reliable predictive markers use established.Samples from treatment-naive -experienced HIV-1-positive individuals date-matched CD4 CD8 cell counts RNA, clade, pol sequences were assessed for...

<h3>Objective:</h3> To determine the prevalence of rectal chlamydia infection in a cohort men who have sex with (MSM) and proportion that would be missed without routine screening. <h3>Methods:</h3> MSM presenting to four HIV/GUM outpatient clinics at Chelsea &amp; Westminster Hospital NHS Foundation Trust between 1 November 2005 29 September 2006 were offered testing for addition their screen sexually transmitted infections (STIs). <i>Chlamydia trachomatis</i> (CT) tests performed using...

Background: HAART dramatically reduces mother-to-child transmission of HIV allowing vaginal delivery if the viral load is low. This study provides data for optimum timing short-term in pregnancy. Methods: Retrospective multicentre cohort pregnant women commencing London and Brighton, UK. Demographics, gestation, drug class, CD4 cell count, results were collated. Survival curves reaching a less than 50 copies/ml stratified by initial load. Cox's proportional hazards regression model was...

Objective: To determine the incidence of Kaposi's sarcoma (KS) in a prospective longitudinal cohort HIV-1-infected individuals before during and after introduction highly active antiretroviral therapy (HAART) to compare KS between specific HAART regimens. Design: Univariate multivariate analysis 8640 individuals. Methods: The protective effect regimens based on either protease inhibitors (PI) or non-nucleoside reverse transcriptase (NNRTI) development was examined prospectively recorded data...

Objective To evaluate the prevalence, outcome and possible risk factors for hyperlactataemia lactic acidosis in HIV-positive persons receiving antiretroviral therapy. Methods Cross-sectional longitudinal data from a prospectively collected clinical database. Associations with regimen, laboratory parameters were assessed using univariate multivariate Cox's proportional hazards model. Results Patients naive to therapy patients on current minimum of 4 months assessed. Median lactate was 1.1...

Background Some patients with HIV/tuberculosis (TB) coinfection who are on anti-TB treatment and highly active antiretroviral therapy (HAART) will develop an exacerbation of symptoms, signs or radiological manifestations TB that not due to relapse recurrence their TB. The aetiology these immune reconstitution inflammatory syndrome (IRIS) reactions is unknown but it presumed they occur, at least in part, as a consequence HAART-related immunity. Methods Patients were diagnosed first episode...

Background: Tenofovir disoproxil fumarate (tenofovir DF), the first nucleotide analogue reverse transcriptase inhibitor approved for treatment of HIV infection, has been associated with renal dysfunction in isolated cases. We investigated overall incidence and risk individuals receiving tenofovir DF compared this other antiretrovirals. Methods: Data from Chelsea Westminster cohort were analyzed to reveal HIV-positive a creatinine value greater than 120 μmol/L at any time, upper limit normal...

Background Little information exists on the impact of highly active antiretroviral therapy (HAART) health-care provision in South Africa despite increasing scale-up access to HAART and gradual reduction prices. Methods Findings Use cost services for 265 HIV-infected adults without AIDS (World Health Organization [WHO] stage 1, 2, or 3) 27 with (WHO 4) receiving between 1995 2000 Cape Town were compared controls matched baseline WHO stage, CD4 count, age, socioeconomic status, who did not...

Objectives To develop methods to maximize the accuracy of reporting HIV risk behaviours in a general population survey. We assessed feasibility using computer-assisted self-completion interview (CASI) comparison with pen-and-paper (PAPI). Design A probability sample survey residents aged 16–44 years Britain, alternate assignment addresses by CASI (462) or PAPI (439). Methods Personal interviews exploring demographic and sexual behaviour variables. Principal outcome measures were impact...

OBJECTIVE--To describe the characteristics of patients attending their general practitioners and complaining fatigue or being "tired all time." DESIGN--Prospective study cohort aged 16 years older with follow up at two weeks by questionnaires six months. SUBJECTS--220 (164 women) mean age 43 an age-sex matched comparison group. SETTINGS--Doctors in four practices Lancashire, Mid Glamorgan, Suffolk, Surrey. MAIN OUTCOME MEASURES--General clinical data, results from standard group laboratory...

To evaluate treatment outcome of acute hepatitis C virus (HCV) in HIV-positive individuals.Open-label, prospective study conducted London, January 1997-December 2003.Patients whom HCV infection had been diagnosed sequential RNA levels measured at 0, 4, 12, 24, 32, and 48 weeks. If positive 12 weeks, patients were offered pegylated interferon alpha-2b 1.5 microg/kg/wk ribavirin 800-1200 mg/d for 24 Patients with increasing titers earlier.Fifty male homosexuals a mean age 37 years identified:...

Background: The established International Prognostic Index for lymphomas has not included patients with systemic AIDS-related non-Hodgkin lymphoma. Objective: To establish the most appropriate prognostic index use in Design: A prospective study involving univariate and multivariable analyses of lymphoma whose data were used to examine standard new criteria survival after diagnosis. Setting: Chelsea Westminster cohort HIV-1–infected persons. Patients: 9621 HIV-positive patients, 111 whom was...

Human immunodeficiency virus (HIV) uses 2 distinct chemokine receptors, CCR5 (R5) or CXCR4 (X4), during entry. Viruses may be R5 tropic, X4 dual/mixed (D/M) tropic. R5-tropic predominates at high CD4 cell counts, with the number of X4-tropic strains increasing as count decreases.We investigated relationship between tropism and decreases in before antiretroviral therapy initiation, frequency clinical events, responses to a cohort treatment-naive patients.Four hundred two patients underwent...

Abstract To establish the prevalence of sexual dysfunction amongst HIV-positive men and to determine factors associated with we conducted a cross-sectional study in seven European HIV treatment centres. Data on medical history, antiretroviral laboratory results were collected by interview case record review. Sexual function was evaluated participant self-completion questionnaire based International Index Erectile Function (IIEF) 711/929. Seventy-seven percent participants returned...

Background UK guidelines recommend routine HIV testing in healthcare settings if the local diagnosed prevalence >2/1000 persons. This prospective study assessed feasibility and acceptability, to patients staff, of routinely offering tests four settings: Emergency Department, Acute Care Unit, Dermatology Outpatients Primary Care. Modelling suggested estimated undiagnosed infection attendees would exceed 1/1000 The identified prospectively was not a primary outcome. Methods Permanent staff...

There have been no data presented on the relative rates of development renal stones in those receiving ritonavir-boosted atazanavir (ATZ/r) when compared with other commonly used antiretrovirals (ARVs). We rate a cohort HIV-infected individuals attending Chelsea and Westminster Hospital Foundation Trust exposed to ATZ/r efavirenz (EFV)/ritonavir-boosted lopinavir (LPV/r) darunavir (DRV/r) over 45-month study period. The group (n = 1206) EFV/LPV/r/DRV/r combined 4449) was 7.3 [95% confidence...

Background: The mechanisms by which dyslipidemia and lipoatrophy develop during antiretroviral therapy are not clear. No treatment of is currently established. Methods: This was an open-label randomized study HIV-positive individuals on a first-line containing stavudine (d4T) with either protease inhibitor (PI) or nonnucleoside reverse transcriptase (NNRTI) hypercholesterolemia (defined as total cholesterol >5.2 mmol/L >180 mg/dL) and/or viral load <50 copies/mL. Patients switched d4T to...