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As it has happened with other wild ungulates in Europe, the roe deer (Capreolus capreolus) population in Aragon has suffered a considerable expansion during the last two decades. In the Iberian Mountains of Zaragoza (SIZ) this process come along with an increasing sporting interest in the species and the raising of conflicts due to crop damage, mainly on fruit trees and vineyards. The Government of Aragon is responsible of managing big game populations and fixes the hunting quotas. During the elaboration of hunting plans it has to consider different and even opposite interests and points of view, so availability of reliable population trends it is essential for the management of these populations. It has been developed a scheme for monitoring roe deer population in Aragon based on strip transect counts of pellet groups. This information is complemented by the sightings of roe deer during a fox and lagomorph monitoring scheme based on spotlight counts from car. In the Iberian Mountain System of Zaragoza, between 2005 and 2009, the survey results point that the roe deer abundance has doubled, and the mean density reaches 5.4 ± 0.33 roe deer/km2. Initially, management plans followed a conservative criterion in order to keep the population growing, with a moderate extraction rate, still hunt and a balanced sex-specific quota. Due to the positive trend of the species and the necessity of reducing damage caused to agriculture, mainly fruit trees, the management goals change to population control and it was decided to increase hunting pressure: hunting season was extended, hunting drives with dogs are authorized and the extraction rate is raised. Although the hunting quota fulfillment is close to 80%, and the number of shot deer has increased from 193 in 2005 to 1.084 in 2009, until now there is no reduction in the population growth. ; Al igual que ha ocurrido con otros ungulados en el resto de Europa, durante las dos últimas décadas la población de corzo (Capreolus capreolus) ha experimentado una considerable expansión en Aragón. En el Sistema Ibérico zaragozano (SIZ) este proceso se ha visto acompañado por un incremento del interés cinegético hacia la especie y por una creciente conflictividad asociada a los daños en cultivos de leñosas. En Aragón es la Administración la responsable de planificar el aprovechamiento cinegético de la caza, asignando los cupos de captura a los cotos de caza. Durante la elaboración de los planes de caza se debe atender a posiciones e intereses muchas veces contrapuestos, por lo que para gestionar estas poblaciones es imprescindible contar con datos objetivos sobre su estado. Para ello se ha desarrollado un plan de seguimiento del corzo en Aragón basado en la realización periódica de transectos de recuento de grupos fecales sobre recorridos fijos. Esta información se complementa con las observaciones de corzo registradas en una red de fareos nocturnos diseñada originalmente para el seguimiento de lagomorfos y zorro. Los datos obtenidos en el SIZ indican que entre 2005 y 2009 la abundancia media de corzo se ha duplicado y que su densidad media alcanza 5,4 ± 0,33 corzos/km2. Inicialmente los planes de caza seguían criterios conservadores que permitiesen mantener la población en crecimiento, con una tasa de extracción moderada, un cupo equilibrado entre machos y hembras y una caza selectiva a rececho. Ante la evolución positiva de la especie y la necesidad de atenuar las protestas por daños en cultivos, fundamentalmente frutales, se ha cambiado a una estrategia de control poblacional con un notable incremento de la presión cinegética: se amplía el periodo hábil de caza, se autoriza la caza en batidas y se aumenta la tasa de extracción, aunque se ha mantenido la sex-ratio equilibrada en los cupos. A pesar de que el cumplimiento del cupo se sitúa en torno al 80%, y se ha pasado de 193 capturas en 2005 a 1.084 en 2009, hasta ahora no se ha conseguido frenar el crecimiento poblacional.

Purpose of the studyGood penetration of antiretroviral drugs to the seminal plasma may be associated with a decrease in viral replication and play an important role in the prevention of sexual transmission of HIV. We present data from a series of HIV‐infected ARV‐experienced patients receiving etravirine‐containing regimens, in whom etravirine concentrations and viral loads were determined in blood plasma and seminal plasma. The objective was to determine etravirine concentrations and HIV‐1 viral load (VL) in blood plasma (BP) and seminal plasma (SP) of HIV‐infected patients.MethodsTen HIV‐1 adult antiretroviral‐experienced patients receiving an etravirine‐containing regimen for at least 1 month were enrolled. Semen and blood samples were both collected around 12–24 h after the last etravirine dose, depending on once‐daily or twice‐daily dosing, respectively. HPLC/MS/MS was used to determine etravirine concentrations, and HIV‐1 VL was determined by real‐time PCR (limit of detection, VL 40 copies/mL).ResultsTen blood and twenty semen samples were collected. Median (range) CD4 count was 502 cells/mm3 (252–817) and median (range) BP VL was<40 copies/mL (40–362). Median (range) time on etravirine was 52 weeks (12–124). Median (range) BP etravirine concentration was 452.5 ng/mL (258–751). Median (range) SP etravirine concentration was 62.9 ng/mL (31.2–166), and values were above the protein‐free IC50 range (0.39–2.4 ng/mL) in all cases. Median (range) etravirine SP:BP ratio was 0.16 (0.07–0.26). SP VL was<40 copies/mL in all patients, whereas BP VL was detectable in one patient with poor adherence to treatment.












Patient
SP (ng/ml)
BP (ng/ml)
SP VL (copies/ml)
BP VL (copies/ml)
SP:BP
Concomitant ARV




1
31.2
375
<40
<40
0.08
DRVr/TDF


2*
57.1
307
<40
<40
0.18
3TC/ABC


3*
36.9
506
<40
<40
0.07
TDF/FTC


4*
60.6
399
<40
<40
0.15
3TC/ABC


5
68.1
258
<40
<40
0.26
LPVr/TDF


6*
104
414
<40
<40
0.25
3TC/ABC


7
107
491
<40
362
0.21
DRVr/TDF/FTC


8*
65.3
592
<40
<40
0.11
TDF/FTC


9
52.2
518
<40
<40
0.1
DRVr


10
166
751
<40
<40
0.22
TDF/FTC


Median
62.9
452.5
<40
<40
0.16






Patients taking ETR once a day.

ConclusionsTotal etravirine concentrations in male genital secretion are modest, reaching only 16% of the BP concentration, but nevertheless, more than 10 times above the wild type IC50 range.

Purpose of the studyOur aim was to evaluate factors associated with progression to AIDS/death in HIV‐infected naïve pts initiating cART with low CD4 counts.MethodsAdult HIV‐infected ARV‐naïve pts with CD4 <200 who initiated NNRTI or PI‐containing regimens between 1998 and 2009, were included. Primary end point was progression to AIDS (a first episode or a new AIDS‐defining condition in pts with prior AIDS) or death. Kaplan‐Meier curves were used to determine progression‐free survival and multivariate Cox regression models were used to identify independent predictive factors of progression to AIDS/death.Summary of resultsWe included 1427 patients (80% men, median age 38 years, 25% IDU, 37% AIDS, 20% HCV) between 1998 and 2009. At baseline (BL), median (range) CD4 and viral load (VL) was 77 (1–199) cells/µL and 170,000 (19–8,750,000) copies/mL, respectively. After a median follow‐up 4.6 years, 70% of pts reached CD4>200/µL, 65.2% reached undetectable VL and 268 (19%) pts progressed to AIDS/death during follow‐up. The probability of AIDS/death at 5 years was 76%, 34%, 3% and 3%, in pts with BL CD4<100/VL>5 log and CD4<200/VL detectable during FU, BL CD4<100/ VL>5 log and CD4<200/VL undetectable during FU, BL CD4<100 and/or VL>5 log and CD4>200/VL undetectable during FU and BL CD4>100/ VL<5 log and CD4>200/VL undetectable during FU, respectively. In the multivariate analysis, several variables were associated with AIDS/death: CD4< 200 during FU (HR 10.89, p<0.001), detectable VL during FU (HR 3.49, p<0.001), age>50 years (HR 1.75, p=0.001), prior AIDS (HR 1.71, p<0.001) and BL VL>5 log (HR 1.45, p=0.011). If only pts without prior AIDS (n=895) were analyzed, the variables independently associated with AIDS/death were: CD4<200 during FU (HR 9.90, p<0.001), detectable VL during FU (HR 2.78, p<0.001) and BL VL>5 log (HR 1.62, p=0.016).ConclusionsIn immunosuppressed patients initiating cARV therapy, not reaching CD4>200/µL during FU was the strongest variable associated with progression to AIDS/death. VL at BL and mainly at follow up also played a role in patient outcome.

Purpose of the studyFew clinical trials have compared non‐nucleoside reverse transcriptase inhibitors (NNRTI) and ritonavir‐boosted protease inhibitors (PI/r) as initial combined antiretroviral therapy (cART) for HIV‐1‐infected patients with high plasma viral load (pVL), and non‐conclusive results have been reported. We compared the effectiveness between NNRTI and PI/r as first‐line cART for HIV‐1‐infected patients with high pVL.MethodsObservational retrospective study of 664 consecutive treatment‐naïve HIV‐1‐infected patients with pVL (HIV‐1 RNA) >100,000 copies/mL who initiated NNRTI or PI/r‐based cART between 2000–2010 in three University hospitals. Only currently preferred or alternative regimens in clinical guidelines were included. Primary endpoint: percentage of therapeutic failures at week 48. Virologic failure was defined as: a) lack of virologic response (<1 log RNA HIV‐1 decrease in first 3 months); b) RNA HIV‐1 >50 c/mL at week 48; c) confirmed rebound >50 c/ml after a previous value <50 c/mL. Intent‐to‐treat (ITT noncompleter=failure) and on‐treatment (OT) analyses were performed.Results62% of patients initiated NNRTI‐regimens (83% efavirenz) and 38% PI/r‐regimens (62% lopinavir/). Baseline characteristics: male 83%; median age 39 yrs; median CD4 count: 212/µL (NNRTI 232 vs PI/r 177, p=0.028); pVL 5.83 log10 c/mL (NNRTI 5.43 vs PI/r 5.55, p=0.007); AIDS 24% (NNRTI 21% vs PI/r 29%, p=0.015). NRTI backbones were tenofovir plus 3TC or FTC in 72%. The percentage of therapeutic failure was higher in the PI/r group (ITT NC=F 26% vs 18%, p=0.012) with no differences in virologic failures (PI/r 5%, NNRTI 6%, p=0.688). The rate of treatment changes due to toxicity and/or voluntary discontinuations was higher in the PI/r group (15% vs 8%, p=0.008). A multivariate analysis adjusted for age, gender, CD4 count, VL and AIDS showed NNRTI vs PI/r as the only variable associated with treatment response (OR 0.61, 95% CI 0.41–0.88). Median pVL and rate of resistance at virologic failure were higher in patients receiving NNRTI (3.97 vs 2.49 log copies/mL, p<0.001 and 62% vs 12%, p=0.004, respectively).ConclusionsInitial NNRTI‐regimens showed higher effectiveness compared with PI/r‐regimens in HIV‐1‐infected patients with high pVL, although virologic failure rates were low and comparable. Resistance emergence was more frequent and pVL higher in patients failing NNRTI. However, more patients initiating PI/r‐based regimens changed or discontinued therapy.

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK