The aim of the study was to investigate the efficacy and safety of first-line antiretroviral therapy (ART) with integrase inhibitor (INI) or protease inhibitor (PI)-based regimens in patients with low CD4 cell counts and/or an AIDS-defining disease. Methods We conducted a retrospective, multicentre analysis to investigate discontinuation proportions and virological response in patients with CD4 cell counts < 200 cells/µL and/or AIDS-defining disease when starting first-line ART. Proportions of those discontinuing ART were compared using univariate analysis. Virological response was analysed using the Food & Drug Administration (FDA) snapshot analysis (HIV-1 RNA < 50 HIV-1 RNA copies/mL at week 48). Results Two hundred and eighteen late presenters were included in the study: 13.8% were women and 23.8% were of non-European ethnicity, and the mean baseline CD4 count was 91 cells/µL (standard deviation 112 cells/µL). A total of 131 late presenters started on INI-and 87 on PI-based treatment. It was found that 86.1% of patients treated with INIs and 81.1% of patients treated with PIs had a viral load < 50 copies/mL at week 48; proportions of discontinuation because of adverse events were 6.1% in the INI group and 11.5% in the PI group. No significant differences in discontinuation proportions were observed at week 12 or 48 between INI-and PI-based regimens (P = 0.76 and 0.52, respectively). Virological response was equally good in those receiving INIs and those receiving PIs (86.1% vs. 81.1%, respectively; P = 0.36). Conclusions In a European cohort of late presenters starting first-line INI or PI-based ART regimens, there were no significant differences in discontinuation proportions or virological response at week 48.
Previously, spectra of certain weighted composition operators W ψ,ϕ on H 2 were discovered under one of two hypotheses: either ϕ converges under iteration to the Denjoy-Wolff point on all of D rather than compact subsets, or ϕ is "essentially linear fractional". We show that if ϕ is a quadratic self-map of D of parabolic type, then the spectrum of W ψ,ϕ can be found when these maps exhibit both of the aforementioned properties, as most of them do.
Objectives
Disruption to sexual health services during the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2; coronavirus disease 2019 [COVID‐19]) pandemic may have adversely affected the provision of HIV post‐exposure prophylaxis (PEP), possibly leading to increased HIV transmission. Globally, services have reported a reduction in the number of PEP prescriptions dispensed during lockdowns, although it is unclear why. Our primary objective was to describe the temporal change in weekly HIV PEP dispensed at six English sexual health clinics in 2020.
Methods
We performed a cross‐sectional review of PEP prescriptions from six English centres during 2020.
Results
During 2020, 2884 PEP prescriptions were dispensed across the six centres studied, a fall of 34.5% from the 4403 PEP prescriptions in 2019. Before the COVID‐related lockdown in 2020, the PEP dispensed was stable at 82.5 per week. Following the first lockdown, this fell to a nadir of 13 in week 14 (Figure 1). Prescriptions rose to a peak of 79 in week 37 and then declined to 32 prescriptions in the last week of 2020. There was no difference in the following characteristics of PEP recipients before and during the first lockdown: age, ethnicity, country of birth or the service the recipient attended.
Conclusion
Whatever the reason for the fall in PEP seen in England over 2020, it is essential that HIV testing and access to HIV prevention is maintained for those in need.
showed HIV positive. A positive CSF-VDRL test was shown in seven patients, three had HIV positive. 3) Peripheral blood CD4 + T cell count The peripheral blood CD4 + T cell count was low (<550 cells/mL) in fifteen out of 26 malignant syphilis, of those seven cases were HIV seropositive. Six out of 26 patients suffered from both malignant syphilis and neurosyphilis but without HIV infection. Conclusion There is no direct association between HIV infection and malignant syphilis or neurosyphilis. Additionally, we found a new unusual combination of malignant syphilis and neurosyphillis in the absence of HIV infection. Disclosure No significant relationships.
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