HIV Seropositivity: Gilson R

Brook MG, Gilson R, Wilkins EL, Anonymous00075. · Central Middlesex Hospital, London, UK. · HIV Med. · Pubmed #14511247 No free full text.

This publication has no abstract.

Ewings FM, Bhaskaran K, McLean K, Hawkins D, Fisher M, Fidler S, Gilson R, Nock D, Brettle R, Johnson M, Phillips A, Porter K, Anonymous00018. · MRC Clinical Trials Unit, London, UK. · AIDS. · Pubmed #18090396 No free full text.

Abstract: OBJECTIVES: To estimate changes over calendar time in survival following HIV seroconversion in the era of HAART and to provide updated survival estimates. METHODS: Using data from a UK cohort of persons with well estimated dates of HIV seroconversion, we analysed time from seroconversion to death from any cause using Cox models, adjusted for prognostic factors. Kaplan-Meier methods were then used to determine the expected survival in each calendar period. RESULTS: 2275 seroconverters were included with 18 695 person-years of follow up. A total of 444 (20%) died. The relative risk of death, compared with pre-1996, decreased over time to 0.63 [95% confidence interval (CI), 0.48-0.81], 0.24 (0.17-0.34), 0.14 (0.10-0.21), 0.08 (0.05-0.13) and 0.03 (0.02-0.06) in 1996-1997, 1998-1999, 2000-2001, 2002-2003 and 2004-2006, respectively. An elevated risk of death was associated with older age at seroconversion [hazard ratio (HR), 1.49; 95% CI, 1.34-1.66 per 10-year increase] and HIV infection through injecting drug use (HR, 1.53; 95% CI, 1.17-2.00). In 2000-2006, the proportion of individuals expected to survive 5, 10 and 15 years following seroconversion was 99%, 94% and 89%, respectively. CONCLUSIONS: Survival following HIV seroconversion has continued to improve over calendar time in our cohort, even in the more recent years of HAART availability. HIV seroconverters, by definition identified early in their infection, are likely to have the greatest opportunity for intervention; if similar high survival expectations are to be seen in the wider HIV-infected population, early diagnosis is likely to be crucial.

Giraudon I, Ruf M, Maguire H, Charlett A, Ncube F, Turner J, Gilson R, Fisher M, Bhagani S, Johnson M, Barton S. · Health Protection Agency, Regional Epidemiology Unit London, 7th Floor, Holborn Gate, 330 High Holborn, London WC1V 7PP, UK. · Sex Transm Infect. · Pubmed #17932125 No free full text.

Abstract: OBJECTIVES: To determine the incidence of diagnosed newly acquired hepatitis C virus (HCV) in HIV-positive men who have sex with men (MSM) across London and Brighton in order to inform public health interventions. METHODS: Cases were defined as MSM attending London and Brighton HIV/genitourinary medicine clinics from January 2002 to June 2006, with HCV PCR RNA or antibody positive, and a negative HCV test in the previous three years. The yearly number of cases and HCV screening policy in MSM were examined. A negative binomial regression model was used to estimate HCV incidence density rate ratio and 95% CI. RESULTS: 20 out of 38 clinics provided information, covering 84% of the HIV-positive MSM workload in London and 100% in Brighton. The estimated overall incidence was 9.05 per 1000 HIV-positive MSM patient-years. It increased from 6.86 per 1000 in 2002 to 11.58 per 1000 during January-June 2006. Incidence at clinics ranged from 0 to 15.4 (median 6.52) per 1000 HIV-positive MSM patient-years. There was some evidence of difference in the incidence and trend (p = 0.02) in each clinic. The average annual rise in incidence of HCV was 20% (95% CI 4% to 39%, p = 0.001). There was little evidence of such transmission among MSM with negative or unknown HIV status. CONCLUSIONS: HCV incidence clearly increased among HIV-positive MSM in London and Brighton during January 2002 to June 2006. Prospective enhanced surveillance of HCV in MSM, including HIV status and behavioural risk factors, is recommended to help inform control measures and better determine the frequency of transmission in all MSM.

Bhaskaran K, Pillay D, Walker AS, Fisher M, Hawkins D, Gilson R, McLean K, Porter K, Anonymous00258. · Medical Research Council Clinical Trials Unit, London, UK. · AIDS. · Pubmed #15199326 No free full text.

Abstract: Using data from the UK Register of HIV Sero-converters, we compared the rate of CD4 cell decline in antiretroviral-naive individuals with and without evidence of transmitted drug resistance (TDR). Although there was a suggestion that CD4 cell decline in the first year after seroconversion was faster in those with TDR,there was no evidence of a difference in the rate of decline thereafter. The virological and host determinants of this possible phenomenon are worth further exploration.