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

Track B: Clinical Science

Mo.B. 1350 - Mo.B. 1354

Conclusions: SyphiI anid N. gonorrhoeae markers have been used a, i, og, i tof high
risk sexual behaviour However in the tropics there could be false pos tiv e le to other
tropical diseases. No such false serologic positive results occur winh \i
HBV markers in combination may provide more reliable results wh' r t,. i, ( used as surrogate marker for high risk sexual behaviour since HIV is predorni.r t pi.i_)raci,,exially in
Ghana.
Prof. J.A.A. MINGLE, Department of Microbiology, U.G.M.S., Box(,. l ANA
Fax: [phone]
Mo.B. 1350
FLOW CYTOMETRIC ANALYSIS OF LYMPHOCYTE SUBSETS IN AIDS PATIENTS,
ASYMPTOMATIC HIV SEROPOSITIVE PERSONS AND HIV SERONEGATIVE
CONTROLS IN VELLORE REGION
Babu, Palla George, Zachariah A*, Mathai D*, John TJ. National AIDS R(e trence Laboratory,
Department of Clinical Virology and *Dept of Medicine, Christian Meci i College Hospital,
Vellore, India
Objective: To determine the distribution of peripheral blood lymphocyte ub(sets in AIDS
patients, HIV seropositives arid healthy controls.
Methods: Peripheral whole blood samples from 27 AIDS patientsl 29 HIV se'opcstive per
sons and I I 0 age and sex matched healthy controls were analyst i by flow ctometry
(FACScan, Becton Dickinson, USA) in order to identify and enumerate lymphocytes bearing
CD3, CD4, CD8, CDI +56+, CD3+HLADR+, CD8+28+, CD8-r 8, CD8t )7+ and
CD8+DR+ surface antigens.
Results: In AIDS patients, all subsets except those with CD3+DR, CD8 -284 and
CD8+57+ were significantly different from healthy controls (P<0.(0 o 0.001) while all sub
sets except those with CDI9+, CD3+DR-+, CD8+38+ CD8+57+ and CI81 D)R4 were
significantly different from asymptomatic persons (P<0.05 or 0.00 1). In asymptoratic persons, only CD4, CD4:CD8 ratio, CDI!+56+, CD3+DR+, CD3+DR7, Cl 194, CD8+28+
and CD8+38+ subsets were significantly different from healthy controis (P<0.01 or 0.001).
The CD4 count of 21 of 110 (19%) healthy controls was less than '450/cicrnm.
Conclusions: The 3 groups showed a very wide distribution of lyimp ocytc plienotypes
whi(ih are relevant in HIV related disease. Significant proportion of h iealty controls had low
CD4 count, high CD8 count and low CD4:CD8 ratio In addition to CD and CD4 counts,
estimation of CD I +56+, CD 19+ and CD8+28+ cells will be valuble for distinguishing
AIDS from asymptomatic state. Low CD4 counts alone should not qualify a person for anti.
retr oviral therapy.
PG. Babu, Dept Virology CMCHospital,Vellore-632004, India Phone [phone] ext 2070,
Fax: [phone] E-mail:abraham@cmc. ernet. in
Mo.B.135 I1
SERUM GP 120 ANTIGEN AND TUMOR NECROSIS FACTOR ALPHA (TNFALPHA)
IN HIV-I INFECTION
ishiT,Tateyama M, Hattori M, Miyasaka S. Fukutake K. Dept. of C I.r 'sitnoL.,Tokyo Medical
College, Japan.
Objective:To evaluate the detection of gp I120 antigen and TNF-a phns in scarum during the
progress of HIV-I infection.
Methods:We retrospectively analysed fifty nine hemophilias with HIV I infreton, ages fromn
16 to 68 years old, followed from Feb./94 to Dec./'95.
The serum levels were measured for gp I 20 antigen of HIV- I (ABI, C mbridge) and TNFalpha (Otsuka, Japan) by using an enzyme-linked immunosorbent assay T-he detectable level
of gp I 20 antigen was more than 100 pg/ml, and that ofTNF-alpha,vas more than 15
pg/ml.
Results:Analysis of the detection of gplI20 antigen and TNF-alpha iaies ir uenoristrated
in the table below:

Results:

Group (n)
lotal (64)
ASN(45)
ARC(I 3)
AIDS(6)
>500(I 6)
500 200(20)
<200(28)

CD4+ cells
(0-12 months)
317 274
346 314
252-160
248-223
674-530
336 --327
101-90

p value
<0,05
0,10
<0,05
0,27
<0,05
0,76
0.32

CD4
(0-12 mos.)
10.0-4,5
I 1,5-4,9
6,6-3,0
6,8-4,0
S16,3-8,2
9,5-5,4
6,8-1,6

<0,05
<0,05
<0,05
0,17
<0,05
<0,05
0,07

In progessors, initial CD4+ cells were 140/mm3, and 358 in non-progressors (p<0,05).
CD4 molecule initial concentration was 3,87 pmol/I in progressors and I 1,5 in rnon
progressors (p-=O,03).
Conclusions: I) Both CD4+ cells and CD4 molecule concentration decreased significatively
in the grop. is 5 whole during a I-year follow-up. However, in ASN patients the CD4+
cells decrease does not reach statistical significance, while CD4 molecule decrease does
reach it. CD44 cells decrease is also nonsignificant in patients with initial levels between 500
and 200.2) Both initial CD4+ cells and CD4 molecule are significantly lower in those
patients who chnically progress in the ensuing year 3) Measurement of CD4 molecule does
not seerrn to offer any significant advantage over CD4+ cells as a marker of progression.
J. Pinilla, C.H. San Millan-San Pedro Med Inter (4oC) CL. Autonoma de La Rioja. 3, 26004
Iogrono. Spain (T: 941-294500)
Mo.B.1353
EVALUATION OF DELAYED-TYPE HYPERSENSITIVITY (ANERGY) SKIN TESTS IN
HIV-INFECTED CHILDREN.
Chantry CJ. Febo IL, Esquihn Ines, Beauchamp B, Rivera C, Diaz C of the Department of
Pediatrics. iUniversity of Puerto Rico School of Medicine, San Juan, Puerto Rico, USA.
Objectives: The objectives of this study were to compare utility of different antigens for
anergy testing in HIV infected children and to seek correlates of anergy by comparing percent of anergic HIV infected children at various clinical disease stages and degrees of
imnrmunosuppression.
Methods: HIV-infected children 9 mos. of age or older had anergy testing placed simultane
ous with tuberculin skin testing. Children 9- I 2 mos. were tested with candida (1:100 dilutioni and tetanus toxoid (i:10 dilution) and children older than 12 mos. with prior mumps
vacinatiori received testing with tetanus toxoid (1:10) and mumps skin test antigen
(MSTA). Results were recorded as longest measured width of induration plus longest measured length of induration divided by 2. Patients (pts.) were considered anergic if both tests
reacted <2 mm

2
3
Io ta!

A
33%( 3)
0%(7)
0%( I)
9%(l I)

Percent Anergy, By Clinical &
Immunological Disease Stage
B C
33%( 3) N/A (0)
14%(7) N/A (0)
27%(Il) 71%(7)
24%(21) 71%(7)

Total
33% (6)
7%(14)
42%(19)
28%(39)

cn (%)
TNF-alpha (+)
TNF-alpha ()
total

gpl20(+)
10 (16.9)
0 (0)
10 (16.9)

gpl 20(-)
10 (16.9)
39 (66.2)
49 (83.1

total.0 (33.8)
39 (66.2)
59 (100)

\O
o
O
Q)
U
c--
O
O
Q1)
C--
0
Q)
cO
cC
(C
116

(+): detectable levels, (-): less than detectable levels. p<0.001 (Fishers ex.,t p obability test)
In the 10 patients with gp 120 detectable level, the positive correiaio tstween serurn levels of gp I 20 antigen and TNF-alpha was observed. Also, negative c rrelation was found
between serum gp 120 antigen level and CD4+ T lymphocyte counti
Conclusion:These findings suggested that serum gpI20 antigen of HIV I iay contribute to
the increased serum levels of TNF-alpha.
Oishi Tsayoshi, 6-7- I, Nishichinjuku, Shinjuku-ku,Tokyo 160 Japan lii: 8 it 13342 6 I II (ext.
5086). Fax: 81I-3-3340-5448
Mo.B. 1352
EVOLUTION AND PROGNOSTIC VALUE OF CD4 MOLECULE CONCENTRATION
IN HIV INFECTED PATIENTS
Pinilla., Anton F., Labarga, Sadaba C., Laborda L., Mugica M., Ginoi,: ( ospita San
Millrin. 26004 Logroho, Spain
Objective:To measure the concentration of CD4 molecule in HIV inlect-d patients, and to
observe its evolution during a I-year time period.To determine the u.l e;iss of Ithis parameter as a prognostic factor, compared to the total number of ClI-I t 1 1L m ocytes.
Methods: Total number of CD4+ TLymphocytes were measured by ltw (rtoetry and
concentration of CD4 molecules by CAPCELIA CD4/CD8 method (Pasteir Institute, Paris)
in 107 patients. Sixty four patients were reevaluated after a 12-month follow p period.,
measuring the same parameters, and classified clinically as being asymptomatic (ASN), having AIDS-related complex (ARC) or AIDS, and according to labor atory values, as having
more than 500, between 500 and 200, or less than 200 CD4+ T-lymphocytes. Patients were
also classified as progressors or non-progressors, according to clinical criteria.

( ) No. oi pt, tested in that disease category.
Results: ifthy -our tests were placed in 50 pts., 39 of which were evaluable (5 never
returned, 6 were placed or read unreliably). Of these 39 pts., I I (28%) were anergic; 72%
responded to one or more antigens. Percent of anergic pts. at various disease stages and
degree of irnmunosuppression (based on the Centers for Disease Control's 1994
Classification for Children) is presented in the table. Candida and tetanus antigens could not
be compared as only one evaluable pt. received this combination and was anergic. Of 28
non-anergic pts 23 responded more to MSTA than to tetanus, 16 of which would have
been anergic if only tetanus had been used.The remaining 5 responded more to tetanus
than MSIA, only one of which was anergic by MSTA.
Conclusions: The majority of our HIV-infected pts., even with severe immunosuppresson,
were not aneri. Only categpry C3 was associated with a majority of anergic pts.letanus
toxoid 1:10 alone significantly overestimates anergy and used together adds little to MSTA.
Ines Esquiin, MD, University of Puerto Rico, Medical Sciences Campus, Pediatric Hospital.
Gamma Project - ACTU, PO Box 365067, San Juan, Puerto Rico, USA 00936-5067
Phone: [phone] Fax: [phone] E-mail: [email protected]
Mo.B. 1354
CHANGES IN CD8 COUNT DURING ANTIRETROVIRAL TREATMENT: CLINICAL
RELEVANCE?
Jchn Bartlett, Joe Eron*, Andrew Hill**, Andrew Phillips***. UNC. Chapel Hill, *Duke
University Medical Centre, Durham, NC, **Glaxo Wellcome Research, Greenford, UK, **
Royal Free Hospitial, London UK.
Background: The clinical relevance of CD8 count is unclear. Correlation between absolute
CD8 count, HIV RNA (PCR) and the incidence of ARC/AIDS were investigated before and
during nucleoside analogue treatment in a sample of 620 patients.
Methods: U.D8 count, HIV I RNA PCR and CDC B/C (ARC/AIDS) disease were measured
at baseline and during treatment in two large North American trials of 3TC: I. AZT/3TC vs
AZl vs 31 C in naive patients (CD4 200 500, n=366) and 2. AZT/3TC vs AZT/ddC in
zidovudine pre treated patients (CD4 100 300, n= 254).
Results. At baseline, there was no significant correlation between CD8 count and either
HIV RNA or CDC disease stage in either trial.There were small (median 10-15%) reductions in CD8 count in all arms during the first 24 weeks of treatment; the size of the reductions did not differ between treatment arms. Baseline CD8 count did not correlate with
reductions in HIV I RNA level during the first two weeks of treatment; the change in CD8
count during the initial 24 weeks of nucleoside analogue treatment did nriot correlate with
greater reductions in HIV- I RNA in any of the treatment arms of the two trials. Baseline