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

Tu.C.220 -Tu.C.224

Tuesday, July 9, 1996

Lessons Learned: HIV/AIDS prevention education for the adolescents of the under-privileged socio-economic group at the community level is needed and it has a good effect on
the community and it is helpful for the prevention of HIV/AIDS.
Dr S D. Khaparde, Director F namily We lfare Training & Research Centre (Govt. Of India), 332,
S.VP.Rod, Bombay-300 c4(India).Tel.: [phone].Fax: [phone]
Tu.C.220
HIV-I SUBTYPES IN FEMALE SEXUAL PARTNERS OF IDU AT THE SAO PAULO
METROPOLITAN AREA
Br gido, Luis Fernando de Macedo15, Rossini, M., Santos, 1. I, Camargo, R.2, Caseiro, M.3,
Nunes, D., Duarte, AJS. Adolfo Lutz Institute, Retrovirus Laboratory; 2AIDS Clinics of
Sapopemba; 3AIDS Clinics of Santos; 4Hospital das Clinicas, FMUSP Sao Paulo, SP; 5National
STD/AIDS P'ogam, Ministry of Health, Brasilia, Brazil
Objective: To study subtype transmissibility by accessing the relative prevalence of HIV subtypos in sexual partners of IDU as compared to other subpopulations of the same geographical are:.
Methods: Sampes from I 2 HIV infected individuals living in the capital of Sao Paulo capital
and rneighboring cites were amplified by nested PCR and resolved in Heteroduplex Mobility
Ass as standardized by the WHO HIV isolation and Characterization protocol. 25 partners of IDU (plDU) were studied, and its relative prevalence was compared to 14 women
and 73 men with other risk / vulnerability factors.
Results: HIV- I subtypes in the study population HIV I B=88.4%; F= 10.7 %; C=0.9 %) was
cons stent to previous observations. Partners of IDU showed a virtually identical subtype
distribution as in men that have sex with men (MSM) (B =24, F - I) and women with
unknown risk factors (B= 12; F = I). Men with unknown risk factors and IDU showed a
higher frequency of non B"subtypes. A significant difference in the relative prevalence of
subtypes "B" and "F in IDU (B= 16, F=6) as compared to female partners of IDU (B=24,
F= I) (p<0.04, fisher exact test) was detected.
Conclusion: These preliminary results suggest that women that have one or more IDU
sexual partners have lower proportion of HIV subtypes "F" as compared to the IDU population. Men with undetermined risk factors also have a higher prevalence of non "B" subtypes, but MSM have subtype prevalences similar to female groups. Although it needs further conirmtion, this significant discordance may indicate a lower sexual transmission of
the F" subtype as compared to "B" subtype. Alternatively the higher prevalence of"F" subtype in male IDU may suggest a more recent introduction of this subtype in the population of the S.o Paulo metropolitan area, with differential expansion associated to the higher trinsrnissibility of HIV by an intravenous route.The presence of HIV "C" subtype (n= I)
confirms previous observations. It is important follow its trend to access if the potential
sexual transmissibility of the Brasilian "C" subtype is comparable to that detected in other
area, of the world.
Luis Fernando M. Brigi do Ministerio da Saude, Bloco G, sobreloja, sala 115. Brasilia, Brazil
70.058 900 Tel: [phone] Fax: [phone]
Tu.C.22 I
MOLECULAR EPIDEMIOLOGY OF HIV-I SPREAD IN SOUTHEAST ASIA
TakeeYutaka*, Kusagawa t, SSato, H,Watanabe, S*, Nohtomi, K*,Thwe, M**, Ow, K-Y**,
1win, S*, Sar, K**, Kywe, B*, Hien, NG" *,Thang, BD***, Long, HT**,Yamazaki, S*.
*National Institute of Health,Tokyo, Japan; **Ministry of Health,Yangon, Myanmar;
**"Fliational Institute of Health and Hygiene, Hanoi,Vietnam
Objectives: To determine the molecular epidemiology of the HIV spread in southeast Asian
courtries, including Myanmar and Vietnam.
Methods: Blood specimens were collected in 1994-1995 from seropositive persons of various r isk groups in Myanmar and southern Vietnam. HIV - I env gene C2/V3 regions from
PBMCs were amplified with PCR and sequenced.V3 peptide EIA (C.-P Pau et al.) were perforned for scrolo gical detection of Thailand HIV I subtypes.
Results: Two HIVI subtypes E and B (Thai-B) were found in Myanmar.The subtype B was
predominantly distributed in IDUs (I 2/12). Among CSWs and STDs, the subtype E was
exclusively detected in the eastern and southern states of Myanmar, although both subtypes
were mixedly present in Yangon area.The average intra-subtype sequence divergences were
5.5% for subtype B and 5.3% for subtype E, close to the values observed inThailand in
1994. On the other hand, the subtype E was distributed in both IDUs (14/14) and CSWs
(4/4 in southern Vietnam.
Conclusions: Two distinct HIV I subtypes E and B (Thai-B), originally identified in Thailand,
were broadly distributed in surrounding southeast Asian countries.The pattern of HIV
spread in Myanm,: except in Yangon area, showed similar epidemiological characteristics to
that oft hailand; i.e.The subtype E were distributed primarily in persons infected sexually
and the subtype B are predominantly detected among IDUs. In contrast, in southern
Vietnam, the subtype E was prevailing in both risk populations. Since HIV infection was
detected in ST[D population prior to IDUs in southern Vietnam, HIV I subtype E seems to
have been first ntroduced to heterosexual population and then spread to needle-sharing
IDU.These irdings will provide the insight for understanding the epidemiologic patterns of
HIV transmison and for future vaccine strategies in this particular region of Asia.
Yut ia: Takebe, AIDS Research Cente, National Institute of Health, I-23- I Toyama,
Shinjuku ku,Tokyo 162, J(ipan.Tel: (8 I)-3 5285 IIII ext. 2532; Fax: [phone]
Tu.C.222
EPIDEMIOLOGY AND SUBTYPES OF HIV-I CIRCULATING IN NORTH-WESTERN
REGION OF RUSSIA
Smolskayal-., Leinikki P. Albert ]. **, Korovina G.,VIasov N., Novicova Vt.
iSl.rosrburg Paitur Institute, Steetersbug Russia, ceNational Pubic Death Institute,
F rinad.:'" Swed: h Icnstitute for In fectrous Diseaise Control, Stockholm, Sweden
Objective La doscribe a:rrent epiden ologial stitus of DIV/AIDS epidemic in NorthWe ter: Reg:o r I Russra To rnvestigate DIV- subtypes circulating in Russia for additional
epdemralcg:cl orroatior iboct spreid and origrin o IV- infectrons.
Methods: We analyzed the re ut o the epidem clog al surveillance which was based on
mas screening o different population groups for ant HIV antibodies with subsequent
sis of each case of HIV seropositivity HIV I strains from 31 infected individuals including different risk groups were characterized.Two genomic regions coding for gag p7/p9

(7 strains) and V3 domain of HIV I envelope protein gp 120 (24 strains) were amplified
from uncultured patient's lymphocytes and directly sequenced using a solid phase
sequencing technique.
Results: Since 1987 more than 16 million HIV tests (ELISA) have been conducted in the
region and 179 cases of HIV/AIDS were registered among residernts of the region. Over a
half of patients live in St.Petersburg. Most part of other patients live in big seaports
(Murmansk, Kaliringrad, Arkhangelsk). Of 31 samples most of the viruses (2 I) found
belonged to subtype B with the most infectious chains acquired through male to male contacts.The other 10 sequences belonged to African subtypes (A-I; F-6; G-2; unknown-I) and
were connected most with heterosexual route of transmission. Analysis of the genetic relatedness was consistent with epidemiological information.The main sources of HIV infection
in the region are: a) for heterosexual males -women in epidemic countries or HIV-positive
Russian women; b) for homosexual males - their Russian sexual partners: c) for women -
multiple sexual partners including persons from epidemic countries.
Conclusions: The results indicate genomic heterogeneity and suggest that import of HIV- I
from Europe, USA and Africa had occurred to Russia. But at the present stage of epidemic
the importation of HIV will not be so important as during the first years of pandemic.
TTSmolskaya, 14 Mira Street, St.Petersburg Pasteur Institute, St.Petersburg, Russia, I197 I0 I
Telephone [phone], Fax [phone]
Tu.C.223
PREVALENCE OF HIV-I SUBTYPE B IN BLOOD DONORS IN CHINA
Zhong, Ping*, Fransen K**, Zhu W*, Duan JL*, Liu GZ*, Heyndrickx L, Nkengason JN**,
Leonaers A**, Lu QG*, Ji WM*, van der Green G**, Gou SQ*. *Shanghai Institute of
Biological Products, Shanghai, PR. China; **Institute of Tropical Medicine, Antwerp, Belgium.
Objective: To identify serologically and genetically the human immunodeficiency virus type I
(HIV- I) prevailing in blood donors from a blood donor station in China.
Methods: 356 pooled plasma, initially screened in 2 136 individual blood donors with a
ocally made HIV- 1/2 ELISA in a blood donor station in Henan province, were re-tested. 6
HIV - positive pooled plasma were further investigated.An in-house HIV 1/2 peptides
ELISA, a Labsystems- made HIV- 1/2 peptide ELISA, an in house HIV- I Western Blot and
PCR with the primers encoding pol and env genome of HIV I were used to assess and
confirm the presence of the HIV I infection for the 6 pooled plasma. Heteroduplex mobility assay (HMA) for analysis of env genes was applied to determine the genotype of HIV I.
Results:

S60
S62
S72
S78
S139
S302

in-house Labsystems in-house RT - PCR
ELISA ELISA Western blot pol env
+ + + + +
+ + + + +
+ + + + +
+ + + + +
+ + + + +
+ + + + +

HMA
Genotype
B
B
B
B
B
B

Conclusions: I.The study indicates the presence of HIV-I infected blood donors in a local
blood donor station in China. 2.The genetic subtype study shows that the HIV-I currently
spreading in blood donors in China belongs to HIV-I subtype B.The HMA method could
be used as a convenient way to determine HIV-I genotype in developing countries.
P Zhong, I1262 Yan An Road (W), Shanghai 200052, PR. China.Tel: [phone];
Fax: 86 21 - 62801807.
Tu.C.224
THE MOLECULAR EPIDEMIOLOGY OF HIV-I IN UGANDA
Rayfield Mark A--, Biryahwaho B2, Hu D I, Bags J, Luo C-C I, Downing R2, Carr LI, Dela
Torre N, Candal D I, Otten RA, George JR', Schochetman G, Dondero TJ I. I HIV LIB,
DASTLR, CDC, Atlanta, GA, USA 2Uganda Viral Research Institute, Entebbe, Uganda
Objectives/Methods: To determine the prevalence and distribution of HIV-I subtypes in
Uganda, we obtained leftover blood from hospitals and clinics from five districts in Uganda.
Unlinked samples without personal identifiers were tested for HIV I/2. Positive samples
were further characterized using subtype specific peptides, subtype A and D specific DNA
probes to the env C2V3 region, and genetic sequencing.
Results: To date, over I 200 HIV I sero-positive specimens have been collected. Of II 88
persons, 71 I1 (59.8%) were from Kampala and 368 (31 %) from Mpigi district both in SouthCentral Uganda. 63 (5.3%) persons were from Hoima in the West, 23 (I.9%) were from
Kisoro in the southwest, and 23 (I.9%) were from Arua in northwestern Uganda. Of I 174
persons with demographic information, 800 (68. %) were women and 374 (31.9%) were
men. Using a combination of subtype specific peptides, subtype A and D specific probes to
the env C2V3 region, and phylogenetic analysis of the sequences, the subtypes of 276 persons were determined or predicted to be 154 subtype A (55.8%), 100 subtype D (36.2%),
with 22 (8.0%) indeterminants requiring further analysis.The distribution of subtypes A and
D varied geographically:

District
Kampala (C)
Mpg: (C)
Hoima (W)
Kisoro (SW)
Arua (NW)

A D
115 77
23 14
8 3
2 I
6 5
154 100? Totals
20 212
2 39

0
0
22

276

Conclusion: This study represents one of the largest surveillance efforts to determine the
prevalent HIV-I strains in any country of the world and confirms that subtypes A and D
truly represent the predominant HIV-I strains throughout Uganda.These studies should
prove useful in studying any changes in the fequencies of strain distribution over time and
possible strain specific differences in relation to viral specific transmissibility and pathogenesis
Mark A. Rayfield, Ph.D., MailStop G-1 5, CDC, I 600 Clifton Rd., Atlanta, GA 30333
Telephone: [phone]; Fax: [phone]; email: marl @ciddas I.em.cdc.gov

243