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Introduction: Long‐acting injectable cabotegravir + rilpivirine (CAB + RPV LAI) was approved for use in virally suppressed adults in the England and Wales national health service in November 2021. We describe a service evaluation of delivery processes and outcomes in 12 clinics. Methods: Centres populated a database using information from local policies and clinical records. Services were asked to describe approval processes, clinic pathways, and adherence to national guidelines. Additional data were collected on reasons for regimen choice, treatment discontinuations, and management of viraemia. Results: In total, 518 adults from 12 clinics were approved for CAB + RPV LAI between February 2022 and December 2023. Of the 518 people approved for CAB + RPV LAI, 423 received at least one injection. Median duration on CAB + RPV was 7.5 months (interquartile range 3.7–11.3). In total, 97% of injections were administered within the ±7‐day window. Virological failure occurred in 0.7%, and 6% discontinued CAB + RPV. Conclusion: In this large UK‐based cohort, robust approval processes and clinic protocols facilitated on‐time injections and low rates of both discontinuation and virological failure. [ABSTRACT FROM AUTHOR]

The article presents guidelines given by the British HIV Association (BHIVA) on best clinical practice for antiretroviral therapy (ART) and management of adults living with human immunodeficiency virus (HIV). Topics discussed include involvement of people living with HIV, primary aim of ART, and considerations when managing people with spontaneous HIV viral control.

Background: There is currently little evidence exploring menopausal status, age at last menstrual period (LMP) and management of menopause among women living with HIV aged 45–60 years in England. Methods: Socio‐demographic, lifestyle and clinical data were collected through a self‐completed cross‐sectional survey. Longitudinal CD4 count and viral load data were available from linkage to clinical records, if consent was provided. Women were categorised as pre‐, peri‐ or post‐menopausal. Factors associated with menopausal stage were examined using ordinal logistic regression adjusting for age. Age at LMP was estimated using Kaplan–Meier survival analysis. Results: The 847 women had a median age of 49 [interquartile range (IQR): 47–52] years. Most were of black ethnicity (81.3%), were born outside the UK (85.0%) and had completed secondary education (88.7%); 177 (20.4%), 373 (43.0%) and 297 (34.2%) were pre‐, peri‐ or post‐menopausal, respectively. After adjusting for age, associations of menopausal status with non‐cohabiting relationship [adjusted odds ratio = 0.63 (95% confidence interval: 0.43–0.91)], baseline viral load ≥ 100 000 copies/mL [2.67 (1.20–5.94)] and unemployment [1.34 (0.97–1.84)] remained significant. Median (IQR) age at LMP was 54 (51–55) years in the group. In total, 27.9% (233/836) of women reported severe menopausal symptoms; 45.6% of those with somatic symptoms had heard of hormone replacement therapy and 8.7% had used it. Only 5.6% of women with urogenital symptoms had used topical oestrogen. Conclusions: Our findings highlight the importance of educating both women and their healthcare providers about menopausal symptoms and management options. [ABSTRACT FROM AUTHOR]

The article informs about of British Infection Association adult HIV testing guidelines 2020 about in areas of high seroprevalence to increase testing uptake and frequency. Topics include target all individuals living with undiagnosed HIV will need to be offered testing and commenced on antiretroviral therapy (ART); and elimination of human immunodeficiency virus (HIV) transmission in the Great Britain.

The article offers information on the guidelines from the British HIV Association concerning the use of antiretroviral therapy for the treatment of adults with HIV-1 positive in 2015. Topics discussed include the areas of treatment and care identified by the guidelines, the factors affecting the outcomes of treatment and adverse effects, and the direct impact of the socio-economic status of an individual on adherence.

This study characterized the prevalence and patterns of antiretroviral- drug-resistance mutations according to plasma human immunodeficiency virus type 1 (HIV-1) RNA load in a large population of patients with HIV-1 infection who underwent testing for resistance mutations in routine clinical practice. HIV-1 genotypic resistance test results with linked clinical data were obtained from national resistance and clinical databases in the United Kingdom. Among 7861 tests, detection of ⩾1 resistance mutation was most frequent at viral loads of 300-10,000 copies/mL and decreased statistically significantly at viral loads of >10,000 copies/mL. Major resistance mutations were commonly detected in the subset of tests that were performed among patients with viral loads of <1000 copies/mL (1001 [12.7%] of 7861 tests).We conclude that HIV-1 genotypic resistance testing is informative for patients with low viral loads. [ABSTRACT FROM AUTHOR]