Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Mo.B. 1244 - Mo.B. 1249

Monday, July 8, 1996

D. Costaghiola, BE INSERM SC4, Fa culte de Medecine Saint-Antolne, 27 rue (hang, / n
571 Paris Cedex 12, France.Tel [phone] Fax 33 I 43 07 39 57
F cmail: cotagHi1b3e.ussieu.frMo.B.1244
EPIDEMIOLOGY AND PATHOGENESIS OF PLANTAR WARTS IN HIV-INFECTED
PATIENTS
Peter Barbosa Lacey I oveland. Richmond Kilpatrick, Efrk Kenyon. Cahlfornia College of
Podiatric Medirne, I210 Scott Street, Sain Francisco, C-A 941 1', USA
As the nmanaremert of some of the more seious complcaitions of ItIV disease continues
to imp rove, the podiatnc manifestations become of greater significance for patient care.
Plantar verrurae caused by human papilomnvirus have been reported to be among the
most conmmonly observed conditions in this patient population (1,2). However, the inci
dence, prevalence, and other epiderniological parameters of plantar verrucae amrong HIV
infected individuals have not been ascertained. In order to establish and define the epidemiological parameters of plantar warts among HIV seropositive individuals we have conducted
a preiminary screening of over 400 individuals. A survey form was completed by all partici
pants regarding their HIV status, presence of warts and demographics. Individuals who
claimed to have plantar- warts were examined by a clinican to verify the diagnosis and
detail the pathology of the lesions. Plantar warts were observed in 17% of the HIV-positive
popuiator, while only a 2% incidence rate was observed in the imrnunocompetent group.
For this samrDic size the Xz value equals 25.5 (degree of freedom -: I), and the probability
(p) value s < 0.0 1, which represents a striking statistically significant value. These studies suggest that plantar warts are becorming more important in clinical management of HIV infection. Further studies are bein conducted to study mechanisrns of pathogenicity in the HIV
infected population.
Peter Barbosa, PhD, C ifornia College of Podiatric Medicine, 1210 Scott Street. Sanr
Francisco. California 94 I 5, tel. (4 5) 2920'152, fax [phone]
Mo.B. 1245
PREVALENCE OF HIV AND HTLV INFECTIONS IN SELECTIVE ETHNIC GROUPS IN
HONDURAS
**Dubon M, Garcia Saiz A*, Klaskala W"' Baum MK'". Regional Hospital IHSS, San
Pedro Sulr, Honduras: '"Centro de Biologica Celula, Madnrd,*Fogarty International
Training Program, University of Miami, USA
Objective: to determine the prevalence of HIV and HTIV infections in two different ethnic
groups in Honduras: black Ciarribs (ia rif lunasdescendants of the African slaves and mestizo
women.
Methods: A total of I 4 serumn samnples were tested for h HTLV antibodies using particle
agglutinatio n and ELISA: then confirmed by modifed Western Blot (HTLV, Blot 2.3,
Diagnostic Biotechnology) in order to distinguish between both HTLV types. Samples were
also 'creened for antibodies to HIV using EFLISA and Western Blot In addition, syphilis serology was done and gonorrhea culture were taken.
Results: Duning two m onths ( Feb March, 994), 62 blood samples were obtained from
black iCarnbs / Garifunas(66% women),ivrtng in a renmote rural area on the Atlantic coast,
and from 52 mestizo women, comnmerial sex workers(CSW), operating in San Pedro Sula,
the most industnalized city i n Htonduras. Overall HIV prevalence rate was 13.4% among
CSW and 0.3% in black Cairribs. Slightly higher was HTLV seropositivity rate; 17.7% for
HTLV- in black iarribs i2 males and 9 temales) and t.9% for HTLV-2 among mestizo,
conorerial sex workers (one person positive). Among H FLV- I infected black Carbs two
women werie co- infected with HIV and one in addition, with syphilis.
Conclusions: The results indicate relatively high HITTI V prevalence in black
Ca ibs(arifinas)on the Atlantic tcoast of Honduras. It is important to continue this study
in order toi assess the trenrd in prevalence and mode of transrmission oft the HTLV in other
ethnic and risk behavior roups in Htonduras in relation to HIV infection.
Jo(,e Marria Dubon, U of Miami, Dept. Epidemiology & Public Health, PO. Box 016069, Miami,
Ft 33101 [phone]
Mo.B. 1246
PARVOVIRUS B19 INFECTION IN AIDS PATIENTS
Bair. (gGuitavo A., CastliN N. P Hospital de infecrtolog a. Centro Medico La Raza ", I.M.S.S.
Mexico riy, Mexico
Objective: To determine the preivalence and the influence of Parvovirus B I9 infection in the
cinical oicomre in AIDS and non AIDS patients.
Methods: 1I 6 persons with chinical syndromes suggestive of Parvovirus B19 infection, 100
AIDS ipa tients and 1 00 healthy persons were studied using two EIA methods (PV-B 19 G;
PV-B1i9 IgM 3rd g.) one confirmatory test (PV-B19 IG-1 gM IFA) Biotrin InternationalT. In
the AIDS patients we determined to antibodies to other oportunistic pathogens; RBC.
WBC, platelets and CD4- CD8 counts.
Results: 82% of AIDS patients show antibodies to PV-B 9,.,n contrast with: healthy- perons who show 2%, patients with mononucleisc syndrome: 5.2%, history of foetal
deaths: 65%. haeriotolo cal disorders 36.5%; exposed to exanthematic persons: 35.7/. All
the AIDS pasents with antibodies to PVBI 9 has severe,nemii, plaquetopeny CD4 ounts
below 200 ceils, and 8 hcs iymphora.
Conclusions: The hugh incidence of PVBi9 infection in AIDS patients assciated to severe
haemotological teraotins suggest a potentary effect of PV-BI9 on the apatho genic effect
of fHIV, prticularly over rhe haemotopoyetc system.
Birriga A. Gustavo. Avenida Maestros #505, 02800 Mexico Cty Moxico Tel and Fix: 525
Mo.B. 1247
EVALUATION OF FREQUENCY OF MYCOBACTERIUM AVIUM COMPLEX (MAC)
COLONIZATION AND CORRELATION WITH THE DEVELOPMENT OF
DISSEMINATED DISEASE IN HIV-POSITIVE ADULT AND PEDIATRIC PATIENTS.
Goon Andrea, Rossi MCVezzoli 5, Massiron E,Tornaghi R' Marchetti G, Franzetti F, Moroni
M, dlArminio Monforte A. Clinic of Infectious Diseases, and ' IVth Pediatric Department.
Unieryity of Milan, L. Sacco Hospita, Milan, Italy.

Objectives: t ctvaluat thc frequency of MAC colonization of the gastro-entenrc and respiratory tracts in HIV pos1tev patients; to correlate the role of the colonization with the
developmenat ' of nfec t;on.
Methods: In a propc'i iv: study we included asymptomatic adult HIV positive patients with
CD4+ < I 0i/ptL and ped: ric HIV positive patients in different stage of HIV disease.
Clinical examination, A-AC smear and cultures from sputum, stool and blood were per
formed at enrollment A second complete examination was performed after six months. A
monthly follow -up was carried out for the patients who resulted to be colonized in sputumr
or in stool.
Results: We enrolled 21 5 adult asymptomatic patients, 73 with and 1 42 without a previous
AIDS diagnosis; the median CD4+ cell count was 75/pL.We collected 215 blood cultures,
167 stool and I 62 sputum specimens at baseline. Four samples resulted positive for MAC, 2
from blood and 2 from stool. All the positive patients had less than 50/pL CD4+ cells. The
2 patients with positive blood cultures were at once treated while the 2 patients positive
from stool were not treated but developed a disseminated disease after a mean of 35 days.
None of the 48 pediatric HIV-infected patients (7 patients with CD4+< 100/pL) had
demonstrated a MAC colonization. At the second examination 50 patients were studied;
64 with and 86 without an AIDS diagnosis. We collected respectively IS50 blood, 77 stool
and 101 sputum samples.Twelve patients resulted positive for MAC, all with CD4+ cell
count <50/pL, 10 were symptomatic and 2 asymptomatic. Blood cultures resulted positive
in 9 patients, stool cultures in 2 and sputum cultures in 5 patients;,in I cases, mycobactena
were isolated from multiple sites. One asymptomatic patient developed a MAC bacteremia
with the disease symptoms after 42 days Second screening was performed on 43 pediatric
patients; MAC colonization/infection did not appear in any case.
Conclusions: MAC colonization in sputum or stool among asymptomatic adult and pediatric
HIV-positive patients did not appear so frequent in Italy as described in USA MAC colonization is likely to manifest in patients with a higher degree of mimmunosuppression. and is quickly
followed by MAC acute infection.A culture positive result from sputum/stool is almost simultaneous with the development of MAC symptoms. Presence of MAC in sputum/stool/blood
was demonstrated to be a highly predictive marker for the disease progression. The low inodence of colonization raises the cost/benefit issue in regard to the screenrng for MAC. At the
same time, because of the low frequency of MAC episodes, a wide MAC prophylax should
be carefully evaluated among adult and pediatric HIV-positive subjects
Andrea Gon,Via GB Grassi 74, 20157 Milano, Italy Tel: ++39 2 35670_1
Fax: ++39 2 3560805
Mo.B. 1248
DETECTION OF HERPESVIRUS-LIKE DNA SEQUENCE (KSHV) IN HIV POSITIVE
PATIENTS WITH AND WITHOUT KAPOSI'S SARCOMA (KS)
Jcure ui Rueda H', Rosetti, S", D'Alessandro L", Lewi D', Monticeli A' *FAIVIH/S Bs.
As., Argentina-;"F.O.A.J.MALBRAN Bs. As., Argentina
Objectives:
I) To detect the presence of KSVHI in serum from HIV+ patients with and without KS.
2) To evaluate risk behaviours in HIV+ patients with KSHV+.
3) To determine in the studied KS population the existence of differences in the CD4 count
and the clinical KS stage in relation with the detection or not of KSHV.
Methods:One hundred HIV+ patients were evaluated, 91 male-9 female, average age: 32.
from May to December 1995. Seventy six homo/ bisexual men, I heterosexual and 1 3
IDUs. Seventeen patients had KS, 83 didn' t. KS clinical stage was determine by New York
classification, CD4 count was determined by flow Cytometry All serum samples were tested twice blindly by polymerase chain reaction (PCR) with specific primers to amplify KS330,
a Herpesvirus-like DNA sequence. As statistic methods the square chi and Fischer's test
were used.
Results: KSHV was detected in 8 patients (8%) from the total population. From 17 KS
patients, 7 (4i1%) were positive. All patients with KSHV were homno/bisexual men.
KS CINICAL STAGE
(-L)4 count '1 9 / 200-) r" s 0011 1! I
iil/ rn/,iiiv tiili'I", /lih r/ofdf
KSHV b-wyh KS. 6(86;'i a
SHiV with KS ( i") I(70 ) }
Conclusions: I) KSHV detection was highly significant among KS patients (P -< 0.00001). 2)
The high incidence of SKHV in homo/bisexual patients suggest the senxuai route as the main
transmission mechanism in our population. 3) In the studied population there was no statistical significant differences between CD4 count and the clinical KS stage (P> 0.005).
Juregui Rueda H, Junin 969, 9~ P"B" o "C". Bs. As. Argentina. Tel.: [phone] -FAX: [phone]
Mo.B.1249
BLEOMYCIN + VINCRISTINE/VPI 6 WITH OR WITHOUT G-CSF IN AIDS PATIENTS
WITH KAPOSI'S SARCOMA
Routy, lean Pierre', MacL eod J'. Urbanek A'. Immunodeficiency Program* and Hemato
Oncology Unit, Montreal Chest Institute/RoyalVictoria Hospital, McGil University
Montreal, Quebec, Canada.
Objective: I) To evaluate the efficacy and toxicity of bleomycin with vincnstine orVP! 6 as a
chemotherapeutic regimen for Kaposis sarcoma (KS) in patients (pts) wth extensive pro
gressive mucocutaneous and/or visceral disease. 2) To evaluate the usefulness of G CSF
(Figrastum) n preventig severe neutropera od infection dun ng chemotherapy
Method: Retrospective chat review of pts treated with bleomyon I Smg/m2 IV cr0wn
cristine 2mg IV everY 2 weeks: pts with peripheral neuropathy were switched ft om cn
cristine toVPI6 (100 mg/mm3 IV). G-CSF Sucg/kg sc 6/7 days was added upon availability.
Results: r9 pts (18 male) with KS were reviewed: mean re 40 n, mean Kanofsky 76%.
mean CD4 59/mm3. Four pts had radiotherapy 2 interferon and 2 themi as prevous
treatment. Six pts had extensie mucocutieous KS. 6 had gastrointestinal KS 7 had pul
oronaty KS.To date, results ire available for I5 pns iclauog coonpiete(CBRin 4(27n), and
partial response(PR) in t I (73%).The time to response was 12 wks (CR) and 8 wks (PR)
Duration of response was I0 wks(CR) and 7 wks(PR). Neutropenia (750-500/mm3) developed 3 times in G CSF,roup(6pts), 9 times in pts not on G CSF(9pts). Severe neutropenia

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