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

Mo.B.1151 - Mo.B.I 157

Monday, July 8, 1996

2. Honoring appointment system for post-donating counseling. 3. Simple awrd, gsven sto
regular donors e.g. caps,Tshirts 4. Restructuring of the blood donorr club progir imme in
institutions and communities that was first started in 1993. 5. Publicity everi w+trh the,-use
of media.
Results: I. The re-organization of mobile teams to specific areas has had an e medi te
effrect, the number of donations having increased. 2.The effect of honoring appoinments fco
post-donation counseling has yet to be evaluated. It is conjectured that ther- will rbe an
ncrease in subsequent donations.

New Donors
1994 July- Sept 857 Oct-Dec 597
1995 July-Sept 1036 Oct-Dec 1699

Subsequent Donations
1994 July-Sept 546 Oct-Dec 597
1995 July-Sept 39 1 Oct-Dec 435

Conclusion: Strategies have been devised to increase voluntary blood donations by 53%.
This is vital in the quest to provide safe blood.
Millicent Forbes Stein, Ubts, PRO.Box 1772 Kampala, Uganda. Fax: 256 - 41 - 257484
Mo.B. 1151
CONFIRMATION TESTING OF HIV P24+ SEROCONVERSION PANEL SAMPLES:
APPLICATION TO BLOOD SUPPLY TESTING
Toedter; Gary P. Brewer K, Hofheinz D. Coulter Corporation, Miami, Florida USA
Objective: To determine the specificity of confirmation testing of HIV- I p24 positive sampies in the pre-seroconversion window period.
Methods: Twelve HIV- I seroconversion panels. Panels A, C, E., G, I, J, L, P RV, Z. AD (Boston
Biomedica. Boston, MA) were tested using the Coulter HIV- I p24 Antigen Assay Samples
found to be initially reactive were repeat tested, then confirmed using the Coulter HIV- I
p24 Antigen Neutralization Kit.
Results: Ninety-nine panel samples were screened. Of these, 5 1 antigen positive samples
were identified, with an optical density range of 0.074 (S/C.1 I0) to >3.9 (S/C 50.8).When
tested in the neutralization procedure, 50/51 I of the samples met the criteria for neutralization (OD>cutoff, >50% reduction of signal). One sample, with an estimated p24 concentra
tion of> 1,250 pg/ml, needed to be diluted 1:10 prior to testing in order to met the 50%
reduction criteria. Consequently 51/5I initial reactive seroconversion panel samples could
be confirmed with the neutralization procedure.
Conclusion: It was confirmed that the neutralization procedure has the sensitivity to accurately confirm that a sample is HIV p24 antigen positive in samples obtained from individuals in the pre-seroconversion window period. Furthermore, the study has demonstrated
that all window period samples found to be repeat reactive met the neutralization criteria.
This study reflects data which will be found in a blood donor screening setting, as the seroconversion panel samples are collected from blood donor populations.Therefore, it can
concluded that the data seen here is an accurate model for p24 antigen confirmation in
blood donor screening.
Gary PToedter, PO. Box I169015, Miami, FL 33116, USA Telephone: [phone],
Fax: [phone]
Mo.B.1 152
DETECTION OF HIV GENOME USING NESTED RT-PCR IN BLOOD PRODUCTS
IN JAPAN
Namiko Yoshihara, H.Suzuki, K.Fukushima, M.Matsuo, N.Hashimroto. AIDS Research Center,
NIH,Tokyo, Japan
Objective: To determine HIV genome in blood products in Japan. Because, thirty percent of
Japanese hemophiliacs have been infected with HIV which contaminated the coagulation
factor concentrates (blood products) they used in their treatment largely We compared
with unheated blood products since produced in 1985 and current products.
Methods: We used nested R[ PCR which has been improved for detection of HIV genome.
Because blood products are containing excessive protein and a small number of RNA
copies. We used glycogen from Slipper Limpet as the carrier in RNA extraction Concerning
nested RT PCR, we performed the combination of I st PCR and 2nd PCR changing cycle
number We used Hot Start method.
Results: We detected HIV genome in several unheated blood products which have been
produced between the years 1978 and 1985. However, current blood products using Japanese blood donor were negative.
Conclusion: It seems that current blood products in Japan are safe concerning HIV infection. Consequently our PCR method may be more sensitive and useful for detection of HIV
genome in blood products.
Namiko Yoshihara, -23 IiToyama, Shinyukkuku,Tokyo, 162, Japan.Tel.: (81 )-3-5285-1 182,
Fax:[phone] I I50
Mo.B. I 153
PROPOSAL OF A NEW MODEL OF HOSPITAL CARE IN HIV/AIDS
Bevacqua Adriana. N', Maglio F"'", Barreda V*. San Martin Hospital, Parana, Fntre Rios,
Argentina; *Muhiz Hospital, C.Federal, Argentina
Issue: Incorporatiori of patents pertaining to self- help groups in the assistance strategy of
an Infections- Diseases Service.
Project: The functions of self-help groups are: administrative, companion of patients, participation in medical functions, social support, education and prevention. Professionals and
technicians are involved in promotion, counselling and supervision.
Results: Decrease in rate of. in-patients, mortality rate, treatment withdrawal. Evaluating the
quality of life from the patients view by means of qualitative techniques we demonstrate
the importance of new life projects.These were based upon solidary net works that contnributed to the social well being of patients.
Lesson learned: The active participation of HIV/AIDS patients as an strategy of medical
care in a Hospital Service contributes to the best bio medical and quality of life results.
AN Bevacqua, Bias Parer 1863, 31 00 Parana, Entre Rios, Argentina Telephone: [phone] Fax: [phone]

Mo.B. I154
HOME CARE FOR HIV + PATIENTS IN BRAZIL
Zardenver, Gor, r. Lt iL., Raimundo PA.K. Affiliated Physicians of Golden Cross
Objective: lTo dole, r,.e i c th of stay prevalence of opportunistic infections and cause
mortis in Hl iiV i, a; vate home care service (Golden Cross) in Brazil.
Methods: Retrospe ve 'stidy of 61 charts from September 5,1994 to Feb 2,1995.
Results: 327 pts had been followed and 61 (18.6%) were HIV+.The average duration of
the home care treatment was 20 days (range: 1-73 days).The diagnosis were: bacterial
infections (sinusitis, pneumonia, otitis and sepsis ) in 22%. CMV (retinitis, mielitis and colitis) in
I 8%. diarrhea -14%, PCP- I I%, Anemia-9.8%, others-25.2%.
51.5% were discharged due to clinical response, 33% were hospitalized to lack of health
insurance coverage.
Conclusions: The majority of HIV associated diseases in these HIV+ pts succeeded in the
home care. Beside the advantages of home care described in the international literature, it
may also bring a economic impact in minimizing costs related with care of HIV+ pts, partic
ularly in developing countries.
R. Zajdenverg, Rua Si Ferrerra 232/504, Rio de Janeiro-RJ-2207 I - I100, Brazil,
Tel/Fax:[phone]. email:[email protected]
Mo.B. I 155
THE DEVELOPMENT AND IMPLEMENTATION OF A SEAMLESS PHARMACEUTICAL
CARE PROGRAM FOR HIV PATIENTS.
Foisy M*,Tseng A**, Blaikie N***. * The Wellesley Hospital. University of Toronto; ''The
Wellesley Health Centre, The University of Toronto; **'The Wellesley Drug StoreToronto.
Ontario, Canada.
Issue: Due to the complex and progressive course of HIV disease, patients will require
varying types and intensities of medical care.Throughout a patient s illness, ambulatory community and hospital pharmacists can all play key roles in ass sting patients with their medica
tion-related concerns.There is a need for increased communication and case coordination
in order to avoid duplication of services and to minimize discrepancies in drug therapies
and care plans.
Project:Three unique HIV pharmacy practice sites (inpatient, clinic, and community) at a
university-affiliated institution were integrated in -ecognition of the growing HIV population
in the community A seamless pharmaceutical care model was developed, and an HIV pharmacy program was implemented in June 1995, with management support.To facilitate the
provision of seamless pharmaceutical care, the following tools and supports were created:
common patient profiles, weekly pharmacy HIV rounds, a physician-pharmacist communication letter and an HIV drug acquisition manual.
Results: After 3 months, I I patients were receiving pharmaceutical care from at least two
pharmacy practice sites. Positive outcomes from the integrated program include: enhanced
ability to make informed and appropriate therapeutic recommendations and care plans, more
comprehensive patient follow-up, and faclitated cross-coverage of patents.We have received
nrumerous positive comments from patients and their families regarding this service, and the
physician acceptance rate of pharmacist recommendations is very high. In addition, establishment of our working group has also allowed for increased sharing of new drug information,
joint collaboration on projlects, and provision of professional and emotional support.
Lessons Learned: Comprehensive pharmaceutical care requires involvement and coordination
of pharmacists from a spectrum of practice sites. Our group has successfully developed a
model and implemented a program to provide seamless pharaceutical care to HIV patients.
This model is being adapted by pharmacists in other specialty practces at our nstitution, and
may also serve as a framework for integration of pharmacy practice sites elsewhere.
Michelle FoisyThe Wellesley Hospital. C/O Pharmacy Department, 160 Wellesley St. East,
Toronto, Ontario, Canada, M4Y IJ3;Telephone 416 I -926-5053 ext. 6951; Fax [phone].

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Mo.B. I 156
IMPROVING, ENRICHING AND ENABLING APPROPRIATE HOME-BASED CARE FOR
PEOPLE WITH HIV AND AIDS
Walker Dawn, R.N., Co-Executive Director: The Canadian Association for Community Care
(formerly HomeSupport Canada and the Canadian LongTerm Care Association), Ottawa ON
Issue: Face-to-face networking and collaboration at the local level improves and enriches
the training of the homecare/home support secto:
Project: There have been various models of training targeting the home care sector providing care to people living with AIDS.These sessions have-been held in a number of regions:
British Columbia, Ontario, Atlantic Canada, and most recently Alberta. Plans are underway
for similar yet different processes in the Northwest Territories and Quebec. Each
session/symposium has been different due to a number of needs and environmental issues:
demographics, provincial policies, types of services, profile of the clients, existing level of
knowledge, geography and other environmental factors.
Results: This session will discuss the comparisons that will be based on both the presessron
expectation questionnaires, session evaluations and 6-month post evaluations that demonstrate the need to break the barriers between the home care sector and the community of
people living with HIV/AIDS.
Lessons Learned: Training for the home care sector is enriched by active partropation in all
aspects of the development and delivery by the HIV/AIDS comnmunty at the local level.
Dawn Walker, 70 45 Rideau Street, Ottawa, Ontario K I N S V8 Canada
Telephone: [phone] Fax: [phone]
Mo.B.I 157
DEVELOPMENT OF AN OCCUPATIONAL THERAPY ROLE TO PROVIDE A
CONTINUUM OF CARE ACROSS INSTITUTION AND COMMUNITY
Thomas, Sheila*.*Wellesley Hospital and Wellesley Health Centre,Torornto, Ontario Canada
Issue: Occupational therapy (OT) services are traditionally provided in the hospital or in
the community setting depending on the current health status or location of the person living with HIV/AIDS. People with HIV/AIDS lack continuity of care as their disease progresses
because they do not see the same therapist when they are in the hospital, home, or prima
ry care setting.
Project: A nontraditional role for the occupational therapist was developed to provide a
seamless continuum of care for people living with HIV/AIDS across the hospital, ambulatory 8 I