European Journal of Medical Research - Deutsche AIDS ...

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June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH 71 of HIV/HCV co-infected patients. Carriers of the IL6 high producer (HP) genotype had significantly higher SVR rates than patients with a IL6 low producer genotype (70.1% vs. 52%; P
72 EUROPEAN JOURNAL OF MEDICAL RESEARCH June 27, 2007 Table 1 (C.6). tent, generally well-tolerated, QD protease inhibitor with a relatively low rate of ALT/AST elevations similar to comparators. Patients with co-infection from 4 ATV clinical development studies were analyzed. Methods: This post-hoc analysis of studies in ARV-naïve (BMS 034, 089) and experienced (BMS 043, 045) patients using ATV, with/without RTV, was performed to assess the rate of ALT, AST, total bilirubin elevations and AEs in the presence or absence of hepatitis co-infection. Results: 866 subjects received ATV-based regimens (214 ATV/r; 652 ATV) for a median of 48 to 95 weeks (1100 subject-years of treatment exposure). 134 (15%) had baseline HBV and/or HCV co-infection (Table 1). Grade 3-4 total bilirubin elevation rates were comparable in subjects with/without co-infection. Subjects who received ATV/r or ATV, with/without co-infection, had similar rates of Grade 2-4 treatment-related AEs (including jaundice and scleral icterus) and liver-related AEs. Conclusions: Similar to other ARVs, patients with HBV and/or HCV co-infection had a higher rate of G3/4 ALT/AST elevations. In contrast, G3/4 bilirubin elevations, overall AEs and liver-related AEs, had a comparable frequency in patients with/without co-infection, suggesting that ATV and ATV/r are safe treatment alternatives in this population. C.7 (Poster) Ocular syphilis prefers different anatomical structures in HIV–negative and -positive patients Kunkel J. 1 , Schürmann D. 2 , Kneifel C. 3 , Zeitz M. 1 , Pleyer U. 4 , Krause L. 3 , Schneider T. 1 1 Charité Campus Benjamin Franklin, Med. Klinik I, Gastroenterologie, Infektiologie, Rheumatologie, Berlin, Germany, 2 Charité Campus Virchow Klinikum, Med. Klinik m. S. Infektiologie, Berlin, Germany, 3 Charité Campus Benjamin Franklin, Klinik für Augenheilkunde, Berlin, Germany, 4 Charité Campus Virchow Klinikum, Klinik für Augenheilkunde, Berlin, Germany Objective: To evaluate differences in ocular syphilis between HIV-negative and –positive patients. Methods: All patients with ocular syphilis treated in our institutions at the Charite between 1998 and 2006 were reviewed. The diagnosis of ocular syphilis was made on the criteria: (1)inflammatory or noninflammatory ocular disease; (2)serological evidence for syphilis with a positive Treponema pallidum particle agglutination (TPPA) titer and fluorescent treponemal antibody absorption test (FTA-Abs) result or positive venereal disease research laboratory (VDRL) titer; (3)improvement following antimicrobial therapy. Major opthalmological finding, patients´ characteristics, laboratory features including HIV status, CSF examination and data on treatment were collected. Results: We identified 22 cases (37 eyes) of ocular syphilis nine of which were HIV-positive. One patient´s HIV status remained unknown because testing was refused, the patient (1 eye) was therefore excluded from the study. The mean case load was 2,75 cases/year. Presenting complaints were generally similar, comprising loss of vision, foggy vision, feeling of pressure and ocular pain (data not shown). 8 of 12 HIV-negative patients (67%) and 7 of 9 HIV-positive patients (78%) had a bilateral manifestation. Optic neuritis was most common in HIV-negative patients (6 of 12 patients/ 9 of 20 eyes), panuveitis was most common in HIV-positive patients (4 of 9 patients/ 8 of 16 eyes). For six patients the ocular symptoms led to the diagnosis of a previously undetected HIV-infection. Age, CRP, TPPA and VDRL titers, CSF-cells and -VDRL titers and intrathecal Treponema pallidum antibody index (ITPA) were not different in the two groups. 13 of 21 patients had skin or mucosa alterations like palmoplantar exanthema or enoral ulcerations (9 of 12 HIV-negative and 4 of 9 HIV-positive). After treatment with iv betalactame antibiotics for at least 10 days all patients improved except one patient who had concommitant vitreous opacity not connected to syphilis infection (Table 1). Conclusions: Ocular syphilis prefers optic nerve in HIV-negative patients and uvea in HIV-positive patients. It should be considered in any patient with unclear ocular lesions and screening for HIV-coinfection is essential. Table 1 (C.7).
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