patients still get transient side-effects especially at the beginning of taking this regimen due to efavirenz as such, regular monitoring and thorough counselling of all patients on the side effects of tenofovir-based regimen and transient nature of side effects is needed. A large scale study to be done to obtain data on longterm side-effects of tenofovir-based regimen most possibly renal impairment due to tenofovir or efavirenz-induced gynecomastia.

patients still get transient side-effects especially at the beginning of taking this regimen due to efavirenz as such, regular monitoring and thorough counselling of all patients on the side effects of tenofovir-based regimen and transient nature of side effects is needed. A large scale study to be done to obtain data on longterm side-effects of tenofovir-based regimen most possibly renal impairment due to tenofovir or efavirenz-induced gynecomastia. The findings and conclusions in this report are those of the authors and do not necessarily represent views of the Centres for Disease Control and Prevention. Background Incident syphilis among HIV-infected persons indicates ongoing behavioural risk for HIV transmission. Detectable viral loads among co-infected cases may amplify this risk. Methods Primary and secondary (P&S) cases reported during 2009-2010 from four US sites were cross-matched to local HIV surveillance registries to identify syphilis case-persons infected with HIV prior to or shortly after the syphilis diagnosis. We examined HIV viral load and CD4 results collected within 6 months before or after syphilis diagnosis for the co-infected cases identified. Independent correlates of detectable viral loads ( ‡200 copies/mL) were determined. Results We identified 1675 cases of incident primary or secondary syphilis among persons with HIV. Median age was 37 years, 99.5% were male, 41.1% were African American, 24.5% Hispanic, and 79.9% of the HIV diagnoses were made at least one year prior to syphilis diagnosis. Among those co-infected, there were no viral load results reported for 188 (11.2%); of the 1487 (88.8%) with reported viral load results, 809 (54.4%) had a detectable viral load (median 25,101 copies/mL, range 206-3,590,000 copies/mL). Detectable viral loads were independently correlated with syphilis diagnosed at younger age, at an STD clinic, and closer in time to HIV diagnosis. Conclusion More than half of syphilis case-persons identified with HIV had a detectable viral load collected within 6 months of the syphilis diagnosis. This suggests virologic as well as active behavioural risk for transmitting HIV. Despite the increase of HIV patient throughput in Morocco, follow up testing (HIV Viral load VL) is still centralised in the National referral laboratory (NRL) as the activity required trained staff and specialised infrastructure. P17.26Patients were often lost due to great distances between testing centre and home as well as delays in returning results.To follow the dynamic of decentralising HIV treatment and care in Morocco, the NRLH launched a process of strengthening regional laboratory capacities.In this framework, we assessed factors associated with lab capacities to offer HIV viral load testing, and followed their performance after implementation.On site visits were performed to the laboratory of the regional laboratory of the Hassan II hospital of Agadir in southern Morocco; this region that accounts the greatest number of HIV positive cases. Using Laboratory assessment tool, the labora...

serum HCV VL >5 log 10 IU/mL (p = 0.011). The magnitude of paired rectal and serum HCV VLs were strongly correlated (correlation coefficient 0.688, p < 0.001). Based on the median quantifiable rectal VL in the absence of visible blood, the surface of an average human penis would be exposed to 2,496 IU of HCV for the duration of anal intercourse. Conclusion This study provides the first documentation of the presence of HCV in non-blood rectal fluid. It is plausible that the combination of bathing of an inserted penis in rectal HCV, with the attendant friction of anal intercourse, could result in penetration of HCV into the inserted penis. The protection to the penis afforded by a condom would logically mitigate the risk of transmission by this mechanism. This study should inform public health policy concerning the primary prevention of sexually transmitted HCV.