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

Track B: Clinical Science
Conclusions: Invasive cervical ca is still occurring at low rate in pts vtlh HIV-irection in
Italy usually with a relatively good immune function. On the other hand there is a higher
prevalence of Cis (65%) emphasizing the importance of integrating g/ynecolo)gical care into
medical service for HIV-infected women. Supported by ISS grants.
Emanuela Vaccher, Division of Medical Oncology and AIDS, Centro PR'fer;rnto
Oncologico,V Pedemontana 12, 3308I Aviano (PN) -ItalyTel: 434/6' )'I. 1 'ax
434/659531.
Tu.B.2258
POST EXPOSURE ZIDOVUDINE (ZDV) PROPHYLAXIS AMONG HEALTH CARE
WORKERS IN THAILAND, 1992-1995
Pimjai Satasit, Ratree Sirisreetreerux, Chaiyos Kunanusont. AIDS Di,,on. i)e,,.irtment of
Communicable Disease Control, Ministry of Public health (MOPH), IonrthabLuri 1000,
Thailand
Objective:To describe characteristics of health care workers who a:. sdectally expose to
patients blood or body fluids and request post exposure Zidovudire.I',) fioni the AIDS
Division, and to identify determinants of completing the course of 6 weeks administration
of Zidovudine among these HCWs.
Methods:The AIDS Division has set up a special system to supply /[tv sip'ce 1992. HCWs
who accidentally exposed to patients blood or body fluids were recomrended to take an
immediate 200 mg. of ZDV and request complete packages of medicat on from the AIDS
Division. HCWs were tested on the day of accident and 3 and 6 rnraths after:Test results
were compiled confidentially
Results: From Nov I1992 to Dec I1995, 175 health care workers (HCVIs), 37 males, 138
females, age (mean~s.d.) 28.8~ 12.0 years, in 106 hospitals requested ZDV fiom the AIDS
Division. Most were nurses (1I09, 62.3%), and physicians (23, 12. 1%). A total of i 19 HCWs
(68%) reported punctured wound, 26 HCWs (I 5%) reported mucosal exposure, and 30
HCWs (I 7%) reported cut wounds. Among 175 patients related to accidents, I 7 (66.9%)
were HIV positive, 36 (20.6%) were HIV-negative, and 22 (I 2.5%) were not tested. Among
175 HCWs, on accident date, 2 (I. 1%) were HIV-positive, 154 (88%) were HIV negative,
and 19 (10.9%) refused blood test. Patients' HIV serostatus was not associated (OR I.15,
95%CI 0.50, 2.62) while adverse reactions (nausea/vomitting) were associ.ated with completeness (6 wks) of ZDV administration (OR=6.10, 95%CI 2.99, 12.58). Subsequent blood
test among HCWs at 3 and 6 months after exposures revealed no further seroconversion.
Conclusion: A good surveillance system is needed to quantify the rate of non-reporting.
Universal precautions practice and system must be strengthened to inimize accidents
among HCWs.
Pimjai Satasit, AIDS Division, Dept of Communicable Disease Control, Mlinistry of Public
Health, Nonthaburi I I000,Thailand. Facsimile [66]-(2)-5903210
Tu.B.2259
THE NEW SOUTH WALES 24 HOUR NEEDLESTICK INJURY HOTLINE
FURNER.Virginia L., Gold, J., Melling, P, Murphy C., Resnik, S.,Tomkins, M., Schroeder, K.
Albion Street Centre, Sydney, NSW, Australia.
Hospital personnel are exposed to a variety of occupational hazards Needlestick injury
continues to be a common occupational injury A New South Wales (NW) Department
of Health Report published in June 1994 stressed the urgent need a: develop a coordinated approach to the provision of information, support and referral for health care workers
who sustain occupationally related needlestick injuries in NSW health cre facilities.The
diverse nature of healthcare settings in NSW and their geographic isolition often impacts
upon the management of occupational exposures to blood and body fluids Assessment of
exposures and initial management varies between institutions and often reflects the level of
staff education and previous experience in the areas of infection corrol and transmission
of blood borne disease. In an effort to ensure access to confidentii, appropriate and immediate services for purposes of assessment and initial management followinc exposure a 24 -hour needlestick injury hotline was launched in September 1995 for helth workers, paramedics and police throughout NSWThis government funded initiative is designed to act as
an adjunct to and not an alternative for existing local policy and services. Calls to the hotline are answered by a member of a team of three doctors and three clinical nurse consultants who offer expert advice for the exposed person and/or their supervisor or medical
officer: Counselling and referral to a local service for further risk assessmenrt and treatment
is offered where relevant.
Dr.Virginia Furner, Deputy Director: Albion Street Centre 150-154 Alnion Street, Surry Hills,
NSW 2010, Australia.Tel.: [phone] Fax: [phone]. rEmnul: [email protected]
Tu.B.2260
AUDITORY BRAINSTEM EVOKED POTENTIALS IN ASYMPT OMATIC HIV POSITIVE
PATIENTS
Lima, M.A.M.T*, Fukuda, Y**, Verdeal, Juan Carlos*. *Hospital da Lago0, Ric de Janeiro,
Brazil; **Escola Paulista de Medici na, Sac Paulc, Rrazil
Objective: To detect early abnormalities in the central nervous system of HIV asymptomatic (Group II - Centers for Disease Control 1986) patients by Aud'ory Br instem
Evoked Potentials (ABR).
Methods:Thirty (I5 men rnd 15 women) asymptomatic HIV posit persons were submitted to ABR, in low stimulus rate (I I clicks per second) and high stimulus rate (6 I clicks
per second) and compared to 30 non HIV healthy controls with otherise comparable
demographic data.The analysis of the latencies of the waves IIII and V,,a of the inter
peaks I III, IllV and I V were compared by Student'st test between the two groups.
Results: There were no significant differences in the ABR between the two,roups neither
in the low stimulus rate nor after stress of the br-ain stem auditory pt, iys with a high
stimulus rate.
Conclusions: ABR in the stimulus rate of I I and 6 I clicks per second is not an eficient
method to detect early abnormalities in asymptomatic HIV positive pi'irs.
J.C.Verdeal, Rua Humberto de Campos 4 10 Apto 1502 Leblon Rio de jneiro - Brazil -

CEP 22430 190 FAX [phone]

Tu.B.2258 - Tu.B.2264
Tu.B.226 I
AUTONOMIC DYSFUNCTION IN HIV INFECTION
Rogstad Karen E 1, Shah R2,Testfaledet G3, Abdullah M S3, Ahmed-Jushuf I H4. I Royal
Hallamshire Hospital, Sheffield, England; 2University of Southampton, England; 3Aga Khan
Hospital, Nairobi; 4Nottingham City Hospital, England.
Aim: To evaluate the presence and extent of autonomic dysfunction in native Africans
infected with HIV compared with controls.
Methods: Tests of autonomic function were performed on 25 patients (7 asymptomatic, 8
ARC, 10 AIDS) and 25 age-sex matched controls, at the Aga Khan Hospital. Nairobi.Tests
included heart rate response to deep breathing,Valsalva manoeuvre, isometric exercise, cold
presser test and mental stress; blood pressure response to Valsalva manoeuvre.
Results: There was a significant difference in tests of autonomic function between AIDS
patients and controls for supine heart rate (p<0.01),Valsalva manoeuvre (p=0.05) and the
cold presser test (p=0.05).There was a trend for worsening autonomic function from
asymptomatic disease to AIDS but this did not reach statistical significance.There was evidence of autonomic hypersensitivity to exercise in patients with asymptomatic HIV infection
and ARC.
Conclusion: This is the first age-sex matched study on autonomic dysfunction in HIV infected patients, which has controlled for ethnicity, and the only one to have been undertaken in
African patients.We have shown that there is a significant amount of autonomic dysfunction
in AIDS patients with a trend in earlier stages of the disease.There is also evidence of
hypersensitivity in earlier disease,
Dr Karen E Rogstad, Consultant Physician, Dept of G U Medicine, Royal Hallamshire
Hospital, Glossop Road, Sheffield S I10 2JF, England Telephone: [phone] Fax: 0114 27 I
3408
Tu.B.2262
AUTONOMOUS NEUROPATHY (ANP) IN HIV- I-SERO POSITIVE INDIVIDUALS
Bohlke, Anja, Roick Holger, Walter M, Giesen HJv, Hefter H, Arendt G. Department of
Neurology, Heinrich-Heine-University Duesseldorf, FRG.
Issue: Encephalopathy and polyneuropathy [PNP] are well known as HIV- I associated neurological symptoms, but little is known about the involvement of the autonomous nervous
system in HIV -I-infection.
Project: We performed standardized electrophysiological tests of the autonomous nervous
system (sympathetic skin response [SSR], respiratory heart beat variation [HBV] and
infrared pupillomretry) in 32 neurologically asymptomatic HIV- I-seropositive volunteers.
Additionally we screened for signs of polyneuropathy (electroneurography [ENG]),
myelopathy (somatosensensory evoked potentials [SSEP]) or encephalopathy (contraction
time [CT]).
Results: Electrophysiological abnormalities of the autonomous nervous system [ANP] were
present in 9/32 (28. I %) and could be divided into two major groups: ANP associated with
subclinical PNP [ANP/PNP] and ANP associated with subclinical myelopathy proven by
pathological SSEP [ANP/SSEP].The ANP/PNP-group showed abnormalities in SSR which
was interpreted in respect to PNP whereas the ANP/SSEP-group showed preferentially
abnormal HBV assumed to be an affection of the spinal ganglion. Motor abnormalities were
detected preferentially in the ANP/SSEP-group (50% vs. 20%).
Lessons learned: Autonomic dysfunction in HIV- I-infection obviously presents in two different forms: dysfunction of the central or the peripheral autonomous system. Whether or not
a different clinical course will be associated has to be examined in future studies.
H. Roick Dept. of Neurology, Postfach 101007, D-4000 I Dosseldorf, ER.G.Telephone
49.211.8 1. 1898 I,Telefax 49.211.81.18469 E-Mail: [email protected]
Tu.B.2263
EXTRAPYRAMIDAL MOTOR PERFORMANCE AND BRAIN ATROPHY IN HIV-IINFECTION.
Giesen, Hans-Jorgen von, Hefter H, Roick H, Aulich A+, Arendt G. Department of
Neurology and Radiology (+), University of Dosseldorf, FRG.
Issue: HIV- I as a neurotropic virus is known to affect predominantly the basal ganglia thus
causing both motor abnormalities and cognitive deficits possibly due to disturbances of
frontal-basal ganglia networks.
Project: We therefore correlated standard morphometric parameters (CC - distance
between the heads of the caudate nuclei, IT = distance between the inner tables of the
skull; FH = distance of the frontal horns) quantifying frontal ((FH/IT) and caudate (CC/IT)
atrophy in computed tomography and electrophysiological parameters (tremor peak frequency most rapid alternating movements, reaction (RT) and contraction time (MRC)) evaluating extrapyramidal motor function both in 4 I HIV- I seropositive patients.
Results: MRC was the most affected electrophysiological parameter MRC alterations highly
significantly correlated with caudate atrophy in HIV- I infection (r = 0.39 I; p < 0.05). In HIVI seropositive patients correlation with frontal atrophy was even more significant (r =
0.484; p < 0.01).
Lessons learned: These results suggest that disturbances of frontal - basal ganglia circuits
contribute to HIV- I encephalopathy.
H.J.v.Giesen Dept of Neurology Postfach 101007, D-40001 Dosseldorf, F.R.G.Telephone:
49.211.81.1898 ITelefax 49.2 II.81.18469 E-Mail: [email protected]
Tu.B.2264
FDG AND METHIONINE POSITRON EMISSION TOMOGRAPHY (PET) SCANNING
IN PATIENTS WITH HIV DISEASE AND CEREBRAL PATHOLOGY.
M Campbe.*, MJ O'Doherty SF Barrington, J Lowe, CSB Bradbeer*. Clinical PET Centre,
Genitourinary Medicine*, and Haemophilia Centre, St Thomas' Hospital, London, UK
Aims:To assess the role of PET scanning in patients with HIV disease and cerebral pathology using I 8 F Fluorodeoxyglucose and II C-Methionine.
Objectives: The proportion of patients with cerebral pathology is increasing. MRI and CT
identify space occupying lesions but are not always able to differentiate tumours from

opportunistic infection. FDG PET has been suggested as a possible method to subdivide
these patients.

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