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

Mo.C.1460 - Mo.C.1465

Monday, July 8, 1996

Results: CMV retinitis was found in I 54 (2.4%) of the patients at the time of AIDS diagnosis, and subsequently developed after diagnosis of AIDS in 651I cases, the rate being 9.4 per
100 patient years of follow up. Multivariate analysis showed that the relative risk for the
development of CMV retinitis was much lower for IVDA (RR 0.47, 95% CI 0.35-0.64) or
other mode of transmission (RR 0.58, 95% Cl 0.4 1-0.84) than homo/bisexual transmission.
In an adjusted Cox's model, the probability for developing CMV retinitis was higher than
others for patients who presented with extraocular CMV infection (RR 1.64, 95% CI 1.08 -2.49), PCP (RR I1.82, 95% CI 1.5 1-2.20) or toxoplasmosis (RR 1.76, 95% ClI 1.28-2.43) at
time of AIDS diagnosis. In this model, the likelihood of subsequent CMV retinitis was threefold higher when the initial CD4 Cell Count was <I100 (95% Cl 2.09-4.00) and two-fold
higher when the initial count was 101-200 (95% ClI.47 3.08).The median survival of 8.0
months for patients with CMV retinitis at time of presentation of AIDS was significantly less
than that for other AIDS patients, which was 16. I months.
Conclusions:The presence of CMV retinitis significantly decreases overall survival in AIDS.
The risk of developing CMV retinitis is enhanced in homosexual transmission, certain AIDSassociated diseases and in those with low CD4 cell counts.
Prof Israel Yust,Tel Aviv Sourasky Medical Center, 6 Weizmann Street,Tel Aviv,
Israel.Tel: [phone] Fax [phone]
Mo.C. 1460
AIDS IN PORTUGAL:A PATTERN WITHIN A PATTERN
Paixo, M.T*', Leitao, A.E *, Ferreira, M.O Santos***. * National Institute of Health
**Direccqo Geral da Saude *** AIDS Committee
Objective:To describe the epidemiological patterns of the AIDS epidemic in Portugal
between 1983 and 1995: the differences in prevalence of AIDS cases by HIVI and HIV2,
according to the main epidemiological and demographic features.
Methods: Review of notifications reported through the ongoing surveillance system for the
period 1983-1995, of cases fulfilling the European AIDS surveillance definition.
Results: As of 31 /I 2/95, a total 29 I9 AIDS cases were notified.There were 2674 (91.6%)
cases associated with HIVI and 201 (6.9%) with HIV2; 33 (I.1%) cases in which dual infection could not be excluded and II (0.4%) undetermined and undergoing further typing.
The pattern of spread of the epidemic shows differences for the period 1983-1995.
Differences in transmission categories show that AIDS cases by HIV I are predominantly
associated with sexual and parenteral transmission by illicit drug use; HIV2 is predominantly
reported associated with heterosexual transmission and transfusions and is not reported in
IVDU's, except for a few cases. AIDS defining diseases present at diagnosis vary according to
the type of virus; cases with tuberculosis or pneumonia by P carinii as the first AIDS defining
disease are mostly associated with HIV I, while AIDS cases reported with HIV2 show a large
spectrum of opportunistic infections and other chronic or degenerative diseases.
Comments:There are two simultaneous AIDS epidemics in the country progressing at different rates; the AIDS epidemic associated with HIV I is showing the pattern of other
southern European countries, while AIDS cases reported with HIV 2 show a smaller proportional increase and are linked to heterosexual transmission.
Maria Teresa Paix3o, National Institute of Health, Av. Padre Cruz, I 699 Lisbon, Portugal
Mo.C.146 I1
IDENTIFICATION OF HIV- I CLUSTERS FROM CHILDREN IN ROMANIA
M,Serban*, L.Grtler'*, R.Costa*, M.Cucuruz*, WSchramm**. *University of Medecine
Timisoara (Romania) **University of Medecine M0nich (Germany)
Background: The human immunodeficiency virus (HIV) infection in Romania has some
distinct particularities: recognised only in 1989-1990, it is revealed in more than 90% of
cases in children, more than 80% of them born in 1988-1989; the vertical transmission is
low (<5% of cases), while horizontal transmission through blood and blood products is
incriminated only in < 15% of patients. Therefore the origin of this pediatric epidemic
remains obscure.
Objective: The purpose of the study is to characterise the spectrum of virus strains isolated from Romanian children, who acquired the infection through horizontal transmission, in
order to evaluate the probability of infection through injection with unsterilised needles
and syringes.
Material and Methods: In 30 HIV I seropositive children, selected from various districts of
the country a cluster analysis ofV3 - loop by a peptid - Elisa method was performed.
Results: The results ascertained unimportant heterogenity of the isolated subtypes:
A - 3,33%, 8 - 29,97%, B/E - 9,99%, C - 3,33%, D/E - 13,32%, E/A - 3,43%, E - 33,34%,
F - 3,33%. At those having the same subtype it could be denied the possibility of reciprocal
infection or the transmission in the same medical institution; two HIV positive brothers have
two different clusters of HIV - I.
Conclusions: The idea of an unique source of infection is improbable and questions about
the origin of HIV I infection in Romania remain to be pertinently answered.
Margit Serban, Str. Memorandului Nr. 24, 1900 Timisoara, Romania
Telephone: [phone] Fax [phone]. I19.75
Mo.C. 1462
THE COMPARISON OF HIV/AIDS EPIDEMIC IN MOSCOW AND THE OTHER
ADMINISTRATIVE TERRITORIES OF RUSSIA.
Golikov, Victor A. Gorbacheva E. Pankova G. Moscow AIDS-center Moscow, Russia
Objective: To estimate the differences in HIV/AIDS epidemic between Moscow and the
other administrative territories of Russia (OATR).
Methods; Statistical analysis of epidemiological data from Moscow and OATR since 1991.
Results: In 1995, 48% of all newly registered in Russia HIV-infection cases have been detected in Moscow. In the same time, the population of Moscow is only 6% of the whole population of Russia. During s99 I- 1995 the annual increase of HIV infection incidence was
I5,4%/ in OATR and 34% in Moscow. In I1995 in Moscow it has reached 48%,oThe following
figures characterise the HIV/AIDS epidemic in GATR and in Moscow on 31 I 12. 1995;

Prevalence (number of infected persons per 100000 people)
Infected adults male to female ratio
The percentage of infected children
HIV infections to AIDS ratio
Sexual route of transmission
(including homosexual/heterosexual)
Infections through blood products
Nosocomial infections
Motherto-child transmission

OATR Moscow
0,46 2,63
2:1 6: 1
30.2% 0,4%
13: 1 18: 1
5 1,7' 98,8%
46/54% 64/36%
0,6% 0,8%
44,70

Conclusions: The development of HIV/AIDS epidemic in Russia in the near future will be
determined to the large extent by the situation in Moscow.
VA. Golikov, Russia, 105275, Moscow, 8-Socolinoi gonr, 15 Telephone [phone] I
Fax [phone]
Mo.C. 1463
RISK FACTORS FOR HIV-INFECTION AND HIV-SUBTYPES ISOLATED IN DIFFERENT
REGIONS OF RUSSIA
Ladnaia N. N.*, Savchenko I.*, Bobkov A. F.**, Kazennova E.".', Pokrovsky V V*. * Russia
AIDS Centre, Moscow, Russia; ** D.I. Ivanovsky Institute of Virology Moscow. Russia
Purpose: To study the risk factors for HIV infection in HIV positive persons from different
regions of Russia.
Method: The analysis of the information received in Russia AIDS Centre on risk factors for
HIV-infection in patients registered in different Russia regions and information about HIV
subtypes isolated in 199 I-1995.
Results: From 01.01.1991 618 HIV-infected Russia citizen patients were registered in Russia.
Main risk factors for 444 (71.9%) persons was reported to the Centre. Male-homosexuality
was the main risk factor in 233 (52.5%) cases, hometerosexual contact in 186(4 1.9%) cases.
Mother-to-child transmission took place in I2 (2.7%) cases. I patient was recipent of HIV
infected blood, I-IVDU. In 13 (2.9%) cases the main risk factor was injections in hospitals in
times of nosocomial outbreak in 1989. 28 I (45.5%) of HIV positive lived in Moscow and
Moscow region. Among those, whose main risk factor is known (253)- I 68 (66.4%) were
male homosexuals, 83 (32.8%) - heterosexuals. In Murmansk (25 cases registered) and
Kaliningrad (17 cases) heterosexuals dominates (70.6% and 80.7%), among patients with
known main risk factor of HIV transmission. Among 59 HIV-positive persons with known
main risk factor in Sankt-Petersburg and region 24 (40.7%) were homosexuals and 35
(59.3%)-heterosexuals. In the another Russia regions the number of HIV infected persons
was not great and both main risk factors of transmission took place. Subtype B was predominantly isolated in homosexuals, and A, B, C, D subtypes in heterosexuals.
Conclusion: Sexual HIV-transmission dominated in Russia in 1991 -1995. In the capital
(Moscow)- main risk factor was homosexual contacts. In large seaports (Murmansk,
Kaliningrad and Sankt-Petersburg)-heterosexual contacts. Subtypes of HIV -infection differed
by risk groups of infected patients.
N.N. Ladnaia, Russia AIDS Center, b. 2, 15, 8-ya ulitsa Sokolinoy Gory 105275, Moscow
Russia.Telephone: [phone] Fax: [phone]
Mo.C. 1464
REPORTED AIDS AND HIV INFECTION CASES IN SLOVENIA
Klavs I*, Vidmar Ludvik**,Tomazic J*, Maticic M**, Polak M"**, Kristancic L**, Levicnik
Stezinar S****, Glonar L***, Kastelic*, Piskur Kosmac D***. * Institute of Public Health;
** Infectious Disease Hospital, Clinical Centre,** Microbiology Institute, Medical Faculty;
**** Institute of the RS forTransfusion; *** Ministry of Health, all Ljubljana, Slovenia
Objectives: We obtain information on distribution of AIDS and diagnosed HIV infection
cases according to demographic, behavioural and geographic characteristics and monitor
the AIDS epidemic.
Methods: We regularly collect, analyse and interpret information on reported cases.
Reporting of all diagnosed AIDS and HIV infection cases is obligatory according to
Communicable Diseases Law.The 1993 European AIDS case surveillance definition is used.
Results: A total of 5 I AIDS cases (46 in male and 5 in female) have been reported in
Slovenia between 1986 and end of 1995. During 1986 to 1994 the annual AIDS incidence
rate varied between 0,5 to 3.5 per million population. In 1995 it has raised to 7 per million
population, which is more than I100% increase in comparison to 1994. A total of 49 cases
occurred in adults (45 in male and 4 in female) and 2 in children (I in male and I in female).
The majority of adult male patients were homosexual (29 - 64,4%). Five of 6 heterosexually
acquired cases in male were linked to countries with high prevalence of HIV infection
(Africa). Both 2 male cases with injecting drug use in their history injected abroad. All 4 AIDS
cases in adult female were heterosexually acquired. In addition a total of 58 cases of HIV
infection without developed AIDS (43 in male and 13 in female) were reported.
Conclusions: The AIDS epidemic in Slovenia is still in its very early stage. Men who have
sex with men still represent the majority of reported cases. However, in the future we may
expect most intensive spread among injecting drug users.This is an essential component of
HIV surveillance which is needed for planning, implementing, and monitorinngy prevention and
control efforts.
L.Vidmar, Infectious Disease Hospital, Clinical Centre, Japljeva 2, 61000 Ljubljana, Slovenia,
Telephone: [phone]; Fax:[phone]I; email: irena.klavs(ivz.sigovmail.si
Mo.C.1465
SURVEILLANCE OF HIV INFECTION IN CATALONIA (SPAIN)
Blanch C*,Vall Mayans M*, Matas L**, Sanchez D*, Ausina V**, Casabona I. and the
VIHHOSP collaborative group. CEESCAT Dept of Health, Hosp sUniv Germans T rias
PajoI"(HDGTP), Badalona; *Dept Microbiology, HDGTP (Sparn)
Objective; To monitor HIV prevalence in a sentinel population of hospitalized paitierats i
Catalonia (Spanish autonomous region).
Methods; Patients aged IS to 49 yrs old attending five large hospitals were tseeted for
unlinked anonymous screening of HIV infection in 1995. Patients with known HIV/AIDS
were excluded. Prevalences of HIV were calculated by age group. sex, spe ality group

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