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

Track C: Epidemiology and Public Health

Tu.C.2515 -Tu.C.2519

Office, and the Register of Deaths of the Public Health Department of each local health
district were consulted to determine the causes of death. Statistical analysis was performed
using the t-test and the X2 test.
Results: A total number of 1022 deaths (the largest published report) reveals the following:
Cause of death # Patients M F HIV + HIV - Unknown Age

overdose
AIDS
Road accident
Suicide
Epathopaties
Other
Unknown
Total

389 (38.1%)
328 (32.1%)
109 (10.7%)
47 (4.6%)
26 (2.5%)
75 (7.3%)
48 (4.7%)
1022

341
275
83
40
23
62
42
866

48
53
26
7
3
13
6
156

100
328
22
10
13
15
12
500

130
34
14
9
26
6
219

159
53
23
4
34
30
303

28.6 SD 5.7
31.3 SD 4
26.9 SD 5
29.2 SD 5.1
30.2 SD 6.8
28.4 SD 4.5
29.2 SD 4.7
29.4 SD 5.3

Conclusions: A further complete evaluation of data shows further that: I) AIDS is the principal cause of death since I199 I and is rising 2) The high mean age of death in AIDS patients
may be due to its long period of incubation 3) Our data do not reveal higher percentages
of HIV seropositivity among IDUs who died of overdose and suicide.
Prof Paolo Mezzelani Clinica Medica - Policlinico Borgo Roma 37134 VERONA - ITALY Tel.
0039-45-8074604 FAX [phone]/(Home)0039-45-8004826
Tu.C.25 15
THE SERO-PREVALENCE AND INCIDENCE RATES OF HIV INFECTION AMONG
IDU BY COHORT STUDY FROM 1992 TO 1995 IN RUILI ANDS OTHER COUNTIES
OF CHINA
Zheng, Xiwen*, Zhang J**, Qu X*, Cheng H**,Tian C*, Li D*et al. *Center for AIDS
Surveillance, Institute of Epidemiology and Microbiology Chinese Academy of Preventive
Medicine, Beijing; ** provencial Anti-epidemic Station of Yunnan
Objective: To determine sero-prevalence and incidence rates of HIV among drug users and
to understand the different reasons of sero-prevalence among three counties.
Methods: Two thousand one hundred and ninety drug users (smoke and IV) have been
enrolled from 03/92 to 10/95. Four hundred and ninety IDU (222 HIV+ and 268 HIV-)
whoentered cohort have been followed. Field surveys were conducted in March every year.
Sera were tested with ELISA for screening test, and the Western blot was for confirming
test.
Results: The sero-prevalence of HIV infection showed high lever (8 1.8%, 85.7%, 61.8%,
70.5%) for Ruili county(R), middle (44.6%, 40.0%, 38.5%, 43.5%) for Longchuan(L), and
low(5. 1%, 0%, 0%, 3. 1%) for Luxi(X) during 1992- 1995.Two hundreds and twenty
nine(85.4%) of 268 IDU with HIV- were followed.The sero-conversion(incidence rate,/hundred person-year) was 43.2%, 28.6%, 13.3%, I 6.2% for R, I 2.2%, I19.4%,22.6%,23.9% for L,
0%,0%, 1.7%,0% for X countyThree counties have similar rates of IDU among drug users,
about one third in 1992 and increased to half.The sero-prevalence of HIV among spouses
increased from 3.1% to 10.3%.The results of KAP survey explained the difference of seroprevalence.The drug users in R or X county have different rate of Thai race(95.9%, 39.9%),
illiterate(46.6%,6.6%),never heard of AIDS(66.4%, I 9.7%), ever visited Myanmar(4 1.0%, 0%).
Conclusion: The existence of high, middle and low sero-prevalence of HIV infection for
three neighourhood counties during 1992-1995 showed the possibility of prevention of HIV
epidemic. But the risk factors of the epidemic are still existing for L and X counties and
can't relax prevention.
Zheng Xiwen, 27 Nanwei Road, Beijing, China 100050 Tel: [phone] Fax: [phone] I 6 email: [email protected]
Tu.C.2516
PREVALENCE OF HBV AND HCV MARKERS IN HIV POSITIVE PATIENTS AND IN
HIGH-RISK GROUP OF HIV INFECTION.
Leszczyszyn-Pynka, Magdalena, Wnuk, A., Boron-Kaczmarska, A., Bander, D., Urbanowicz, W.,
Wawrzynowicz-Syczewska, M. Dept. of Infectious Diseases, Medical Academy Szczecin,
Poland
Objective: To assess prevalence of HBV and HCV infection and establish rationale for vaccination against HBV in injecting drug users (IDUs) and in HIV+ non-IDU patients.
Methods: Serological markers of HBV and HCV infection were obtained in 74 (54 men, 20
women) subjects: 58 IDUs (mean age=24, 9+5, 7ys; range: I 8-40ys) and I16 HIV + nonIDUs (mean age=36, 6+9, 6ys; range: I9-59ys).The cost of diagnostic procedures and vaccination against HBV was estimated.
Results: HIV infection was confirmed in 50% (29/58) IDUs and 55.2% (32/58) of them have
had an evidence of HBV and 84.5% (49/58) - of HCV infection. Mean age of starting drug
addiction (DA) was I 8, 3+3, 7ys (range: I 3-27ys). Duration of DA ranged from 3 months to
17 ys (mean time=5, 8+4, l ys).The HBV markers prevalence depended on duration of DA
and exhibited 6.3% before 2-ys lasting period, 43.5% - before 5-ys and 100% after 5-ys lasting period of DA. In HIV+ non-IDUs 25% (4/16) have had markers of HBV and 12.5%
(2/16) were infected with HCV.The cost of HBV infection diagnostics was equal to 55%
cost of full vaccination procedure.
Conclusions: The main risk factor for HIV infection in Poland is DA. Because of high prevalence of HBV in the IDUs cohort the implementation of vaccination program in this group
is undoubtedly needed.We think that the target group for anti-HBV vaccine should be 13 -15ys old adolescents from districts threatened with DA and IDUs with duration of the
habit shorter than 2 ys. In HIV+ subjects cost of assessment of anti-HBs levels after vaccination must be included in total cost of the procedure.
M. Leszczyszyn-Pynka, Arkonska 4, 7 I -455 Szczecin, Poland.Telephone: 0-48-9 I -54 I 459; Fax:
0-48-9 I -54 1459
Tu.C.2517
HIV AMONG INTRAVENOUS DRUG USERS AND OTHERS VIRAL MARKERS
Oueiros Lucinda,Tender A, Mateus M,Teixeira A, Quelhas D. Transmissible Disease
Laboratory Regional Blood Center of Porto, Porto-Portugal.
Objective: To determine HIV infection among IVDUs and its relation with other infectious
diseases.

Methods: A hundred and forty (140) serum samples were analyzed, belonging to HIV EIA
positive IVDUs. All serum samples were confirmed by WB. In addition their sera was tested
to detect the presence of Anti-HCV, AgHBs, AcHBc, Anti-CMV, Anti-HAVAnti-HEVAntiHTLV antibodies.
Results: In serious viral infection (HIV and HCV) as well as in other more common viral
diseases (HAV and CMV) the presence of antibodies is higher than eighty per cent (80%).
As far as Hepatitis B is concerned we found 15.7% infected patients and 73.6% with
resolved infection.The HTLV infection does not present any confirmed serum.This proves
the low importance of this virus in our country Concerning HEV it can be said that its
importance is low, although several cases have been found.
Test No %
WB.I Positive 117 83.6
WB.2 Positive 4 2.9
WB. I +WB.2 Pos. 2 1.4
WB. Indeterminate 17 12. I
Test Pos (n) % Neg (n') %
Anti- HCV 123 87.9 17 12. I
AgHBs 22 15.7 118 84.3
AcHBc 103 73.6 37 26.4
Anti-HAV 72 82.8 15 17.2
Anti -CMV 116 82.9 24 17.1
Anti-HEV 14 10 126 90
#Anti-HTLV 4 2.9 I 36 97. I
#HTLV WB.- Pos-0; Ind -3 Neg.- I
Conclusion: Due to the very high existence of serious infectious diseases diagnosed in
IVDUs, it becomes necessary and urgent to define preventive strategies in order to reduce
the risk of infection.
Maria Lucinda de Magalhaes Queiros, Centro Reginal de Sangue do Porto, U 100 PortoPortugal.Tel: [phone]; Fax: [phone].
Tu.C.2518
EVIDENCE OF STATIC,VULNERABLE BIRTH COHORTS OF MALE INJECTING DRUG
USERS IN SWITZERLAND
Zellweger, Ulrich, Wang J, Somaini B. Institut fur- Sozial- und Praventivmedizin der
Universit.t Zurich, Switzerland.
Objective:To describe age trends in birth cohorts among male IDUs in Switzerland and
selected European countries.
Methods: Using European AIDS surveillance data through 1994, we selected data for male
IDUs in Switzerland and other selected countries---Spain, Italy Portugal and France as countries with high incidence among IDUs in 1994., and the Netherlands and Germany as countries with low incidence. Cases diagnosed in 1986 and earlier were aggregated into one categoryYear at birth was plotted against year of AIDS diagnosis for each country separately
Results: When looking at mean year at birth, the individual country profiles can be divided
neatly into 3 distinct patterns. At best, a slight increase in mean year at birth can be
observed over time in Switzerland (0.8 years between 1987 and 1994) and in the
Netherlands (I.4 years). A moderate increase can be seen in Italy (2. I years) and France
(2.8 years) whereas a more dramatic increase can be witnessed in Germany (3.9 years),
Spain (4.2 years), Portugal (6.3 years between I 988 and I 994). As for distribution of
birthyears at each year of diagnosis, Switzerland is unique in that there is a neat series of
parallel bell curves of near normal distribution centered around 1960 (see graph).The
Mediterranean countries analyzed exhibit bell curves bent somewhat and shifting steadily
towards the right over time. In contrast, the distribution in Germany and the Netherlands is
flat without any clear single peak over a 20-year timespan.
Conclusions: Most of the countries examined show increasing shift of AIDS cases to
younger birth cohorts. In Switzerland and the Netherlands, however, it appears that a
steady cohort bears the brunt of the epidemic. Since they are two countries where AIDS
incidence appears to be stabilizing overall, age may prove to be a useful indicator of trends
in the overall epidemic curve. In Switzerland, however, over 80% of all AIDS cases ever diagnosed were among male IDUs born between 1954-1964, a development which remains
strikingly stable over time.
U.Zellweget Institut fur Sozial- und Praventivmedizin, Sumatrastr. 30, CH-8006 Zurich,
Switzerland.Tel: (4 1- I) 257 66 49; Fax: (41-1I) 257 69 62; Email: [email protected]
Tu.C.2519
UNSAFE SEXUAL BEHAVIOR AMONG INJECTING DRUG USERS IN BANGKOK
Raktham. Suwanee*, Des Jarlais DC**, Choopanya K*,Vanichseni S* Friedmann P**
*Bangkok Metropolitan Administration, Bangkok, Thailand; **Beth Israel Medical Center
NewYork, NY USA
Objective: Bangkok, Thailand has high rates of both injecting drug use and heterosexual
transmission of HIV. Injecting drug users in Bangkok are at risk for both acquiring HIV
through sexual behavior and for transmitting HIV to their sexual partners.
Methods: 600 injecting drug users recruited through Bangkok Metropolitan Administration
drug treatment clinics were surveyed in the fall of 1993. Informed consents were obtained,
a face-to-face questionnaire was administered, and serum was collected fur HIV testing.
Results: 94.3% of the subjects were male; the mean age was 31.4 (SD=8.3) years HIV
seroprevalence was 38.3%. Almost half (47.6%) of subjects reported no sexual activity in
the 6 months prior to the interview. 229 (38.2%) of subjects reported sexual activity with
primary partners; 14% of these reported always using condoms with primary partners.
Always using condoms with primary partners was associated with having been incarcerated
(OR = 3.4, 95% CII. I to I I. I), having been previously tested for HIV (OR = 2.7, 95% CI
I.04 to 7.2); and injecting for < --5 years (OR = 0.3, 95% CI 0. I to 0.8). Only 58 (10%) of
subjects reported sexual activity with casual partners; 27 (47%) of these reported always
using condoms with casual partners.

8)
0,O
u
c
0
<v
c
0
8)
u
c)
a)
c
0
U
I)
0
c
8)
c
3
354