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Prevalence of CSF Alzheimer’s disease-like in middle-aged HIV+ individuals

Prevalence of CSF Alzheimer’s disease-like in middle-aged HIV+ individuals

To provide external CSF references, we tested 3 HIV-negative controls aged 64±2 and 5 AD patients aged 63±6 years. CSF was examined blind to the AD or HIV-associated neurocognitive disorder (HAND) status and vice versa. Risk for AD was evaluated using published cut-offs, which combines the three CSF biomarkers.

Based on the cut-offs: no elderly controls had a CSF-AD profile; all AD patients had at least one CSF-AD profile. Of the HIV+ individuals, 11.4% had a CSF-AD profile. Logistic regressions showed that APOE ε4/ε4 (p=0.03), having previously diagnosed severe HAND (p<0.03) and having lower current neurocognition (p<.002) were associated with a CSF-AD like profile.

Some patients with chronic HIV disease have 10-fold higher risk for AD based on CSF biomarkers, relative to the general population of the same age. However, it is not clear if this finding has the same clinical significance as in the general population. Known genetic factors for this age group were associated with a CSF-AD like profile, as well as past HAND and lower current neurocognition. Our research argues for renewed research effort to understand the consequences of brain ageing in HIV+ persons.


AIDS 2014

Immune Control of the HIV reservoirs

Prevalence of Sexually Transmitted Infections (STIs) and patient characteristics of older men over 60 years of age attending a public STD clinic in South Australia

Background: STI prevalence is changing. With society aging, life expectancy increasing and changes in sexual practices, STIs in senior citizens are of interest from economic, health related and social burden perspectives. Few studies on STIs in older men greater than 60 years of age exist, hence, a need to obtain further information about this subpopulation.

Conducting clinical audits to improve sexual health service delivery in primary health care services: Successes, challenges and lessons learnt

Conducting clinical audits in the context of continuous quality improvement (CQI) programs in Aboriginal Community Controlled Health Services (ACCHS) has provided valuable information regarding what factors facilitate or create challenges to improving outcomes in sexual health service delivery.

High prevalence, incidence and clearance of anal high-grade squamous intraepithelial lesions (HSIL) in homosexual men: early evidence from the Study of the Prevention of Anal Cancer (SPANC)

Homosexual men are at increased risk of anal cancer. Screening and treatment of the precursor, HSIL, has been advocated by some, but screening is not recommended in widely-accepted guidelines. We aimed to describe the prevalence, incidence, and clearance rates of anal HSIL, and association with human papillomavirus (HPV) status, in a community-recruited cohort of homosexual men.

The conscience clause in relation to termination of pregnancy service

Background: Medical termination of pregnancy (MTOP) has been available and successfully used as an option for women internationally since 1988. The regimen for MTOP results in abortion in 99% of cases. Since Mifepristone’s recent availability in Australia, Marie Stopes International has performed more than 10,000 MTOP procedures in Australia since 2009. In Victoria, the Law Reform Commission removed pregnancy termination (“abortion”) from the criminal statutes in August 2008, which provided women and health care professionals with protection from criminal prosecution for their legal involvement in termination of pregnancy (TOP).

HIV and syphilis co-infections and re-infections: trends from Victoria

Since 2009, the Victorian syphilis enhanced surveillance system has been collecting HIV status and syphilis re-infection status for infectious syphilis cases. Baseline data from 2009 showed that 31% of the infectious syphilis cases were HIV positive and 18% reported were re-infections. This suggested that syphilis transmission among a pool of HIV positive MSM was making a considerable contribution to the syphilis epidemic in Victoria. We analysed the data from 2009 to 2012 to determine whether this pattern of transmission is continuing. Notification data for infectious syphilis between 2009 and 2012 were reviewed by HIV infection status, syphilis re-infection status and risk factor exposures.

Efficacy and acceptability of a combination intervention for smoking cessation in HIV positive individuals: a pilot study

HIV positive gay men have high rates of cigarette smoking. The risks of smoking in addition to the elevated risk of cardiovascular disease and some malignancies in people with HIV means smoking cessation interventions should be prioritised.