June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH 71 <strong>of</strong> HIV/HCV co-infected patients. Carriers <strong>of</strong> 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 tent, generally well-tolerated, QD protease inhibitor with a relatively low rate <strong>of</strong> ALT/AST elevations similar to comparators. Patients with co-infection from 4 ATV clinical development studies were analyzed. Methods: This post-hoc analysis <strong>of</strong> studies in ARV-naïve (BMS 034, 089) and experienced (BMS 043, 045) patients using ATV, with/without RTV, was performed to assess the rate <strong>of</strong> ALT, AST, total bilirubin elevations and AEs in the presence or absence <strong>of</strong> hepatitis co-infection. Results: 866 subjects received ATV-based regimens (214 ATV/r; 652 ATV) for a median <strong>of</strong> 48 to 95 weeks (1100 subject-years <strong>of</strong> 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 <strong>of</strong> 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 <strong>of</strong> 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. Table 1 (C.7). Table 1 (C.6). Methods: All patients with ocular syphilis treated in our institutions at the Charite between 1998 and 2006 were reviewed. The diagnosis <strong>of</strong> 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) <strong>of</strong> ocular syphilis nine <strong>of</strong> 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 <strong>of</strong> vision, foggy vision, feeling <strong>of</strong> pressure and ocular pain (data not shown). 8 <strong>of</strong> 12 HIV-negative patients (67%) and 7 <strong>of</strong> 9 HIV-positive patients (78%) had a bilateral manifestation. Optic neuritis was most common in HIV-negative patients (6 <strong>of</strong> 12 patients/ 9 <strong>of</strong> 20 eyes), panuveitis was most common in HIV-positive patients (4 <strong>of</strong> 9 patients/ 8 <strong>of</strong> 16 eyes). For six patients the ocular symptoms led to the diagnosis <strong>of</strong> 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 <strong>of</strong> 21 patients had skin or mucosa alterations like palmoplantar exanthema or enoral ulcerations (9 <strong>of</strong> 12 HIV-negative and 4 <strong>of</strong> 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.
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