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Asymptomatic hyperuricaemia is associated with ritonavir therapy, but gout has rarely been reported. We present a retrospective cohort study of 1825 HIV-positive patients seen at one inner London HIV clinic over a two-year period. In all, 18 patients had gout, of whom 15 were receiving antiretroviral therapy. Seven had predisposing risk factors for gout (e.g.pyrazinamide therapy, haematological malignancy). Of the remaining 11 patients, two were on no medication and eight (73%) were receiving ritonavir as a boosted protease inhibitor (PI). By comparison, 11% of HIV-positive patients without gout were receiving ritonavir (odds ratio = 22; confidence interval = 5–104). Seven of the 18 patients had documented features of lipodystrophy and dyslipidaemia. Gout was seen in patients with known risk factors for gout or who were receiving ritonavir as a boosted PI and who also had lipodystrophy. [ABSTRACT FROM AUTHOR]

Background: Female sex workers are a heterogeneous group and recent reports of declining incidence of sexually transmitted infections (STIs) do not apply to all populations. This is an observational study of street-based sex workers attending an inner-London genitourinary (GU) clinic between 1 July 2006 and 31 January 2007. Methods: In July 2006 the local sex worker outreach project developed a weekly drop-in for street-based sex workers. From the drop-in, sex workers were fast tracked to attend a range of dedicated health services, including the GUM clinic. Results: The outreach team made contact with 120 street-based sex workers in the borough. 40 of these attended the drop-in and 25 attended the GU clinic. 8 had tuberculosis. There were frequent reports of recent recreational drug use, unprotected sex with clients and no reliable contraception. 7 were pregnant, 6 were HIV positive and 12 had positive syphilis serology. A further 17 STIs were identified. Conclusions: There was a high frequency of HIV, syphilis, other bacterial STIs and unwanted pregnancy among sex workers attending this clinic. There were considerable amounts of other physical ill health in this group, with frequently reported risky sexual behaviour. This study demonstrates the need for targeted development work to meet the multifactorial needs of these women. [ABSTRACT FROM AUTHOR]