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Background Spondylodiscitis is an infectious disease of the vertebral body and intervertebral space, the early diagnosis and treatment are essential to give the patient the best chance of a good outcome, but these are often delayed because it tends to present nonspecific manifestations. Objectives To analyse cases of Spondylodiscitis and identify poor prognosis variables. Methods A retrospective observational study, included all adult patients with confirmed infectious spondylodiscitis between January 2010 and December 2017. Demographic features, concurrent disease, clinical history, laboratory findings, microbiological diagnosis, radiological data and clinical outcome were compiled from the clinical history management software. Statistical analysis was performed with the software R (version 3.3.2). Results We included 87 patients with a mean age of 62.05 (16.94) years old. Males predominated (69%). Almost 31% patients presented of a level of immunosuppression (immunosuppression treatment, cirrhosis, HIV infection, solid organ transplantation). The average time with axial pain was 74 (87.65) days. Mean length of hospital stay was 34.24 (34.3) days and readmission rate was 34.9%. Most of patients showed high CRP levels at their admission, with an average value of 88.92 (84.58) mg/L, it was not correlated with worse prognosis. Underlying endocarditis proportion was 11.5%. Blood cultures were positive in 29 patients (33,3%), it was correlated with hospital stay (p=0,03). 51 patients had puntion-aspiration and intervertebral biopsy with microbiologic findings diagnosis in 30 patients (58.8%): 42.5% patients had an identifiable gram +bacteria (37,8% Streptococcus genere), 13.7% a Gram- bacteria, Mycobacterium tuberculosis in 8% and fungi infection (all Candida spp.) in 3.4%. 38% of patients showed vertebral destruction on MRI; 17.4% cord compression and developed neurological complications (8 of them paraparesis). 18.4% of patients required further surgical procedures. Furthermore, vertebral destruction was statistically correlated with epidural abscess (p=0,006). Almost 6% of patients died in the following year after diagnostic. Conclusions Delay in diagnosis is an important issue in Spondylodiscitis patients. Higher complications rates are mainly in relation to greater vertebral destruction. Underlying infectious endocarditis was described in a small proportion of patients in contrast to other studies. Presence of epidural abscess was also correlated with vertebral destruction, for this reason, patients with this finding should be more carefully follow-up. Disclosure of Interest None declared

Background Spondylodiscitis is an infectious disease of the intervertebral space, often caused by hematological spreading from a distance septic focus, especially Endocarditis. Because of its low incidence combined with an ambiguous symptoms, delay diagnosis and treatment of this condition, raising probability of an undesirable outcome. Objectives To identify poor prognosis variables in patients with Spondylodiscitis Methods Observational retrospective study with non-quirurgic spondylodiscitis patients from 2010 to 2016 was performed. Demographic information, clinical history, laboratory test and radiological data were compiled from the clinical history management software. Statistical analysis was performed with the software R (version 3.3.2). Results We included 55 patients, with a mean age of 63.47 (16.11) years old. Males predominated (69%). The average time with axial pain was 64.44 (80.63) days. Mean length of hospital stay was 64.44 (80.63) days and readmission rate was 32.7%. 20% of patients required further surgical procedures. Most of patients showed high CRP levels at their admission, with an average value of 112.97 (83.64) mg/L. Underlying endocarditis proportion was 16.4% and in this patients hospital stay was significative higher; nevertheless, it was not correlated with worse prognosis. 50% of patients showed vertebral destruction on MRI; 14.8% cord compression and 20.4% of patients developed neurological complications (7 of them paraparesis). Furthermore, vertebral destruction was statistically correlated with epidural abscess (P=0.026). Isolation and microbiological identification in blood cultures was possible in 83.6% of patients. Most frequent bacteria was Gram positive (50.09%), then Gram negative (18.2%), mycobacteria (10,9%) and fungi (3.6%). Conclusions Delay in diagnosis is an important issue in Spondylodiscitis patients. Higher complications rates are mainly in relation to greater vertebral destruction. Underlying infectious endocarditis was described in a small proportion of patients in contrast to other studies. Presence of epidural abscess was also correlated with vertebral destruction, for this reason, patients with this finding should be more carefully follow-up. Disclosure of Interest None declared

Objectives: Primary - evaluate the improvement in psychiatric symptoms attributable to changing the antiretroviral drug responsible for such symptoms to nevirapine (NVP). The tools used were a sleep test (the Pittsburgh Sleep Quality Index [PSQI]) and the Hospital Anxiety and Depression Scale (HADS). Secondary - determine the neuropsychiatric disorders and evaluate adherence to treatment and quality of life. Methods : Prospective, observational post-authorisation study that included HIV-1 patients from 36 Spanish hospitals who satisfied the following criteria: age over 18 years; change of antiretroviral treatment to NVP due to CNS side-effects; a PSQI score >5 (significant sleep disturbance); a HADS score ≥10 on the day of starting NVP treatment; and no psychoactive drug treatment initiated during the 6 weeks prior to starting treatment with NVP. Other data gathered from the patients included clinical and demographic details and administration of the Epworth somnolence scale, the Medical Outcomes Study-short form 30 items (MOS-SF-30) quality of life scale and the Simplified Medication Adherence Questionnaire (SMAQ). Evaluations were performed at baseline, 1 and 3 months after the change. Results : 129 patients were included (73.6% men; mean age, 43.2 ± 9.8 years; 36.5% homosexual, 30.2% heterosexual; 28.7% drug users; 38% AIDS; 33.3% co-infection). The drug changed was efavirenz in 89.9% of cases. The reason for the change was sleep disturbances in 75.2%, anxiety in 65.1%, other psychiatric disturbances in 38.7%, attention disturbances in 31%, and other reasons in 31%; a mean of 2.4 neuropsychiatric disturbances were detected in each patient. CD4 rose from 582 ± 261 to 619 ± 299 (non-significant difference). Only three patients had developed an HIV viral load at the end of the study. The differences produced by the change are shown in Table 1. 29 patients withdrew from the study, for the following reasons: 9 for NVP-related toxicity (7 cases of rash and 2 of hepatitis); 7 for loss to follow-up; 4 for voluntary withdrawal; 9 for other reasons. Discussion : The study shows that the change to NVP from a drug that is causing neuropsychiatric disturbances (principally, efavirenz) is effective in resolving those disturbances, with an improvement in all the parameters studied (quality of sleep, anxiety/depression and somnolence). This leads to better adherence and a better quality of life with no detriment to their immunological and virological control. (Published: 11 November 2012) Citation: Abstracts of the Eleventh International Congress on Drug Therapy in HIV Infection Pedrol E et al. Journal of the International AIDS Society 2012, 15 (Suppl 4):18347 http://www.jiasociety.org/index.php/jias/article/view/18347 | http://dx.doi.org/10.7448/IAS.15.6.18347

The new European Guidelines of Dislipidemia Management of the European Societies of Cardiology and Arteriosclerosis consider HIV+ as patients at high risk of developing cardiovascular events and deaths. The objective of the study was to evaluate cardiovascular events and deaths in a series of HIV+ patients. Observational, cross-sectional study, including a cohort of HIV+ and HIV- patients from 2008. CVR was calculated using the SCORE-CVR chart. Variation on lipid profile and incidence of cardiovascular events, cardiovascular death or death related to any cause were recorded. Data was analyzed using SPSS version 20.0 for MAC. 154 HIV+ and 155 HIV- patients were included. Mean age: 44.8±9.5 vs 55.2±14.3 y and 69.5% vs 49% males respectively (p

Background : Until the past decade, immune/viral failure was the main reason for antiretroviral treatment changes. After HAART generalization the management of antiretroviral treatment toxicities was the most prevalent reason for treatment modification. Today, with the advent of new more potent and less toxic drugs as well as more convenient combinations may have changed the situation. We aim to describe the main reasons that today leads to ART changes in HIV+ patients in Spain in the current clinical practice. Methods : Multicentre, national, cross-sectional epidemiological study. Eligible patients had to be HIV+, >18 years old and under current ART that was going to be changed by any reason. Patients did sign inform consent. The study consisted in a single visit (change of treatment) in which data on social and demographic characteristics, HIV disease and ARV treatment were collected. Results : 349 patients were included; mean age: 43.7±8.9 y, 70.5% male and 89.1% Caucasian. Main transmission categories were IVDU (36.4%) and heterosexual (36.4%). Mean time from HIV diagnosis was 11.3±7.6 y. 59.5% were CDC C category. Median CD4 nadir was: 155 cells/mm 3 and median CD4 at the time of switching was 467 cells/mm 3 . 64.1% had undetectable viral load (