Use this URL to cite or link to this record in EThOS: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.406056
Title: Issues in HIV in the era of Highly Active Antiretroviral Therapy
Author: Moore, Antonia Louise
ISNI:       0000 0001 3415 6984
Awarding Body: University of London
Current Institution: University College London (University of London)
Date of Award: 2004
Availability of Full Text:
Access from EThOS:
Full text unavailable from EThOS. Please try the link below.
Access from Institution:
Abstract:
The topics presented reflect the changing and diverse nature of HIV in the era of HAART. Changing characteristics at the Royal Free Hospital (RFH) Between 1992 & 2000 the proportion HIV cases that are in heterosexuals and in black Africans (women in particular) has increased. There has been evidence of improving survival after HAART (in terms of increasing age and CD4 counts and decreasing viral loads over time). However, the CD4 count at diagnosis has fallen and the proportion of patients presenting with AIDS at HIV diagnosis remains high. Gender and response to HAART The possible influence of gender on response to HAART was examined in the RFH and EuroSIDA cohorts. Virological outcomes were similar in males and females although the results suggest a possible disadvantage for women in terms of virological rebound and failure. Immunological and clinical outcomes were, however, similar. The clinical relevance of a potential virological gender difference is uncertain, particularly if this does not translate into a clinical difference. Cervical abnormality and HIV The prevalence of cervical abnormality in women attending for a first cervical screen at the RFH is 60%. Those with a higher baseline CD4 count were less likely, and those who were smokers more likely, to have an abnormality. Fifty-five percent of women starting HAART had cervical abnormalities and this had risen to 62% at the time of a follow-up visit six months later. Those with the largest increases in CD4 count on treatment were those most likely to experience regression of a lesion. Bone Mineral Density (BMD) and HIV In a cross sectional study the prevalence of reduced BMD was found to be greater in those who had ever been exposed to PIs than other individuals. The value of serum markers of bone turnover as screening tools to detect abnormal BMD was assessed. Neither marker was effective for screening for reduced BMD but the methods used may provide a useful model for future work.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.406056  DOI: Not available
Share: