OBJECTIVE:To assess the HIV prevalence in patients diagnosed with gestational trophoblastic neoplasia (GTN). DESIGN:A retrospective single centre cohort study. METHODS:A database from the Sheffield Trophoblastic Disease Centre (STDC), Sheffield, UK was searched between 1st January 2015 and 31st December 2021. A total of 3,591 patients were referred to STDC with a diagnosis of gestational trophoblastic disease (GTD), of which 221 (6.2%) were treated for GTN. The prevalence of HIV-positive tests in GTN patients was assessed. RESULTS:HIV testing was performed in 93% GTN patients ( n  = 205/221). Overall, 1.3% of GTN patients ( n  = 3/221) were HIV-positive, involving two known HIV-positive patients and one new diagnosis. This equates to a HIV prevalence of 14 : 1000, which is ∼7 to 9× higher than the HIV prevalence in Sheffield (1.9 per 1000) and Yorkshire and Humber (1.5 per 1000). CONCLUSION:Given the extremely high HIV prevalence in our population, 'opt out' HIV testing is recommended within our specialist trophoblastic centre for all referred GTD and GTN patients. There is little reason to suspect that the prevalence of HIV-positive patients is any lower in the cohort of GTD patients referred to specialist trophoblastic centres for hCG screening alone, without requiring chemotherapy, particularly considering that most GTN arises from GTD.

3.5% of the global population.1 In highprevalence areas, new infections occur mainly at birth or in childhood. Most HBV in the UK is among migrant populations from areas with high prevalence, such as SubHealth care is increasingly reliant on immune-modulating drugs that can exacerbate a chronic infection or allow a past, 'cleared' infection to reactivate. Clinicians may not appreciate the high burden of HBV among certain minority migrant groups, who may themselves have misconceptions regarding personal risk and modes of transmission, and who experience barriers to accessing health care.3 The busy GP needs to know who to test for HBV, how to tell if someone has chronic or past HBV infection, and when past

Overall prevalence of hepatitis B (HBV) in the UK is low. However, among migrants from endemic areas, prevalence has been shown to be high. Furthermore, timely diagnosis and/or referral are required prevent serious health consequences through early institution of treatment.Methods: We identified locations that would be familiar to Chinese members of the community with the objective of facilitating testing. Dried blood spot samples were collected from 229 Chinese subjects and tested for HBV and also for hepatitis C virus (HCV) infection - offering complete chronic viral hepatitis screening. Results: HBsAg was positive in 20/229 (8.7%) participants, (10 F, 10 M). Five women and one man were aware of their condition, but only one man and none of the women were under specialist care. The average length of residence in the UK for positive patients was 15 years (range 2-40).Evidence of HBV past infection, HBcAb(+)/HBsAg(-), was seen in 28/229 participants (12.2%). HCV antibody testing produced negative results in all participants.The methodology of testing was well accepted, 139/144 (95%) responded to a feedback questionnaire declaring no discomfort and 100% finding the information session useful.Conclusion: This model of outreach testing is helpful for addressing health inequalities afflicting the UK's Chinese community. (C) 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Advances in management have resulted in a dramatic decline in mortality for individuals infected with human immunodeficiency virus (HIV). This decrease in mortality, initially the result of improved prophylaxis and treatment of opportunistic infections but later mediated by the use of highly-active antiretroviral therapy (HAART) has led to the need to consider long-term complications of the disease itself, or its treatment. Bone disease is increasingly recognised as a concern. The prevalence of reduced BMD and possibly also fracture incidence are increased in HIV-positive individuals compared with HIV-negative controls. There are many potential explanations for this - an increased prevalence of established osteoporosis risk factors in the HIV-positive population, a likely direct effect of HIV infection itself and a possible contributory role of ARV therapy. At present, the assessment of bone disease and fracture risk remains patchy, with little or no guidance on identifying those at increased risk of reduced BMD or fragility fracture. Preventative and therapeutic strategies with bone specific treatments need to be developed. Limited data suggest bisphosphonates may be beneficial in conjunction with vitamin D and calcium supplementation in the treatment of reduced BMD in HIV-infected patients but larger studies of longer duration are needed. The safety and cost-effectiveness of these and other treatments needs to be evaluated.