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S Limb

Publications and source records attributed to S Limb.

3 recordsLinked to original sources

HIV post-exposure prophylaxis after sexual assault: the experience of a sexual assault service in London.

OBJECTIVES: To review the provision, uptake and outcome of HIV post-exposure prophylaxis (HIV-PEP) after sexual assault. METHODS: A retrospective case note review of patients attending a sexual assault service in London during 1999. RESULTS: Ten out of 150 patients were considered eligible for PEP after a careful risk assessment. Eight patients accepted HIV-PEP. Highly active antiretroviral therapy (HAART) consisted of Combivir/indinavir in six patients and Combivir/nelfinavir in two patients. Two patients changed their combination due to adverse events. Five patients completed the recommended 28 days of treatment. Three patients discontinued therapy due to adverse events. Two patients who completed HIV-PEP were noted to have raised cholesterol at follow-up. All patients who took PEP were HIV-1 and -2 antibody negative at six months. CONCLUSIONS: Compared with other published studies the completion rate of HIV-PEP in our study was high. The uptake and adverse events of HAART in this scenario were similar to previously published studies. A multidisciplinary approach to the management of this patient group will improve adherence to PEP.

Antiretroviral Therapy, Highly Active↗

Changing trends in cytomegalovirus retinitis with triple therapy.

PURPOSE: Cytomegalovirus retinitis (CMVR) has been the most common cause of visual loss in AIDS patients. We investigate whether the pattern of disease has changed since the introduction of triple therapy. METHODS: We reviewed the records of all patients with CMVR in one teaching hospital HIV unit over a 2 year period (n = 24). This included the opthalmic and systemic findings, HIV and CMV treatment, survival after diagnosis and CD4 results. RESULTS: There has been a marked decrease in the number of patients developing new CMVR: from 21 eyes (15 patients) to 4 eyes (4 patients) in two consecutive 12 month periods between January 1996 and December 1997, coinciding with the introduction of triple therapy in October 1996. Median survival has increased from 376 days in the deceased patients to 598 days in the survivors on triple therapy. Median time to CMVR relapse has lengthened from 79 to 179 days in the triple therapy cohort. The pattern of ocular morbidity in the 11 eyes of the 7 surviving patients is also changing, with no new zone 1 disease, and a marked rise in the incidence of uveitis, maculopathy and cataracts. CONCLUSION: Results suggest that triple therapy is associated with an increase in survival, a decrease in CMVR relapse and changes in ocular features. This transition has implications for current screening and treatment protocols.

AIDS-Related Opportunistic Infections↗

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Evaluation Studies as Topic↗