Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

12th World AIDS Conference

Abstracts 60115-60119 1021

has been available in last years. In this abstract we present the accuracy of one
saliva test using one or 2 ml of saliva specimen.
Objectives: To determine the sensitivity and specificity of a screening test for
HIV antibodies using saliva samples.
Methods: Paired saliva and serum samples were collected from 98 blood
donors and 30 patients from an HIV/AIDS treatment clinic in Sao Paulo, Brazil,
and tested for HIV antibodies after written consent. Virostika" HIV Uni-Form II plus
O and ICE" HIV-1.0.2 were used for serological diagnosis of HIV infection and
Salivax' -HIV, a visual screening immunoassay, for detection of HIV antibodies in
saliva using 1 ml or 2 ml of whole saliva.
Results: The sensitivity and specificity of Salivax"-HIV using 1 ml of whole
saliva was 36% and 100%, respectively using 2 ml of whole saliva was 89% and
100% using 2 ml saliva specimen.
Table 1. Accuracy of Salivax' -HIV for determination of HIV antibody status

Salivax -HIV Response

EIA
Positive Negative
1 ml 2 ml 1 ml 2 ml
4 17 0 0
7 2 47 51

Positive
Negative

Positive results in both commercial EIA's
Conclusion: There was a significant increase in sensitivity after collecting 2 ml
of whole-saliva even with this small sample size. Salivax" -HIV may prove useful
for surveillance purposes in areas with serodiagnostic restrictions and must be
evaluated with large sample sizes, before any public health recommendation as
diagnostic tools for HIV infection.
60115 Prevalence of STDs in HIV/AIDS patients in the
Dominican Republic
Adolfo Arthur Nouel', N. Morera2. 1Wenceslao Alvarez 253, Santo Domingo;
2Dermatology and Skin Surgery Institute, Santo Domingo, Dominican Republic
Objective: To determine the prevalence of Sexually Transmitted Disease in
patients infected with human HIV, at the Department of Sexually Transmitted
Disease of Dermatology and Skin Surgery Institute of Santo Domingo, Dominican
Republic.
Design: Retrospective study.
Methods: The medical histories and laboratory results of 360 HIV/AIDS patients
attending the Department of Sexually Transmitted Diseases were examined, to
determine their past and present history of STDs at the time of consultation.
Results: A total of 198 patients informed having suffered one or more STDs,
with a ratio of 3 to 1, males above females. STD's most commonly reported
were: gonorrhea 50%, syphilis 30%, genital ulcerations 28%, genital warts 14%.
Gonorrhea-syphilis association was the most significant, reaching a 12%. The 85
patients who denied STD history had one or more STD's at the time of examination. During the initial visit, 176 patients had one or more STDs, with the female
group exceeding the males by 6%. The most frecuent STDs were: vaginitis 44%,
genital herpes 27%, genital warts 24%, Syphilis 18%. The average age of patients
was 33 years of age, 58% male and 42% female.
Conclusion: The study shows a 78% prevalence of Sexually Transmitted
Diseases in patients infected with human HIV.
60116 Female sex workers (FSWs) AIDS orphans multi
prolonged problem in Kenya: a case study
M. Njoroge, E. Ngugi, A. Waweru. Kenya Voluntary Women Rehabilitation
Centre (K-VOWRC), Kenya
Introduction: One of the most devastating impact of AIDS is death of parent(s)
most of who are young between 18 and 45 years. They leave orphans for example, Kenya will have an estimated two hundred thousand (200,000) orphans by
the year 2000 some of who will be from FSWs who are single parents.
Objective: To reduce total orphanage impact due to AIDS death.
Method: Prospective data was corrected from 11 FSWs between 1996-1997
in Nairobi using indepth interview, participatory observation and focus group
discussion. The women who were at different stages of AIDS disease were education and counselled inorder to empower them to live positively including the
preparation of the most appropriate member of kingship system to take care of
her children when she is no longer there.
Result: Each of the women practiced self exposure as a therapeutic outcome
of counselling. Their age ranged from 22-46 years with a mean of 31.7. Children's
age ranged from 2-22 years with the majority being under 17 i.e 36 (90%) out of
40.
Preparation of children's support included shelter (parenting), food and education through liaison and networking with social and educational, formal and
informal settings.
K-VOWRC took a leadership role in all this but exited as appropriate without
living a gap. The breakdown of what the children were doing at the time of their
mothers demise include, school 25, street 8, prostitution 3, causal labourers 2
and one married as a girl child. Members of kinship system prepared to take
care of the orphans with support from K-VOWRC included grandparents, aunties,
uncles, sisters, brothers and older children (18-22). The majority of the relatives
were positive about taking over the extra responsibility of bring up the orphans.
And one uncle said, "Bahati likes being around and held with a cuddle like any
other child. I feel I have a duty to take on the role of a parent". Grandparents

(couple) said, "we are determined to bring up Wangari's 3 children as she would
have wished. We loved our daughter but God also chooses the best for reasons
known to Him".
Notwithstanding some relatives were negative and declined to take over the
responsibility as one auntie said "people should carry their own load, my sister is
the one who stubbed herself with the knife". Thus blaming her sister for getting
AIDS.
Conclusion: Although the extended family kinship system is being stretched
to the brim the majority of relatives are willing to give the orphans a home, love
and care but financial and material resources remain a hindrance, thus poverty is
a key factor.
The preparation of families should start when the women becomes sick with
AIDS and appropriate support e.g counselling extended after she passes away.
Otherwise some children will end up in the street/prostitution and become vulnerable to contracting STD/HIV.
S60117 Clinical and immunological prognostic criteria in HIV
infected children
Emma N. Symovanyan, V.B. Denisenco, L.P. Syzyakina, V.N. Cernyshov,
N.M. Colodyagnaya. 29 Nahichevansky Street, Medical University,
Rostov-on-Don, Russia
Objectives: To give characteristics of clinical aspects and immune status disorders with consideration of HIV infection progression in children.
Design: Prospective, controlled study.
Methods: Seventy-five HIV infected children ranging in age from 3 to 5 year
with rapid /44/ and slow /31/ disease progression during three-year period were
studied. Clinical and paraclinical assessment was done. CD3, CD4, CD8, CD21
lymphocyte count were quantatiated by using the FACScan flow cytometer. IgA,
IgM, IgG and CIC level were studied.
Results: Clinical prognostic criteria were HIV infection in infancy, short incubation period, prolonged and severe primary HIV infection, the absence of asymptomatic phase, the association of marked hepatosplenomegaly with frequent acute
respiratory infections, HIV-encephalopaty, chronic diarrhea, prolonged fever, and
generalized opportunistic infections and malignant tumors. Immunological criteria
were further decrease of CD3, CD4, CD21 lymphocytes count, CD4/CD8 ratio,
high level of IgA, IgM, IgG and CIC.
Conclusion: Clinical and immunological data have to be used in the prognosis
of the HIV infection course in children.
S60118 Serum lipids changes in HIV-infected patients under
combination therapy containing a protease inhibitor
Antony I. Papadopoulos, E.P. Evangelopoulou, N.A. Nicolaidi, Z.N. Zolotas,
G.T. Groutsis, M.T. Montsenigos, S.G.D. Stergiou. 1st Social Security (I.K.A.)
Hospital, 22 Pellis St, Halandri, Athens, Greece
Objectives: To study the alterations in serum lipids levels after the first administration of protease inhibitors in HIV-infected patients
Methods: We retrospectively studied 84 patients (67 male, 17 female mean
age 40.5 yrs) for a period up to 1 year. Serum lipids (cholesterol and triglycerides)
were measured at baseline, 3, 6, 9 and 12 months (mo). Patients with secondary
causes of hyperlipidaemia were excluded. Serum lipid changes were evaluated
in relation to the individual protease inhibitor, the previous administration of antiretroviral therapy, age and the CD4 count. Two tailed t-test for paired samples
was used.
Results: Mean serum cholesterol (mg/dl) increased from 167 at baseline to
192 at 3 mo (n = 67, p < 0.01), 207 at 6 mo (n = 36), 204 at 9 mo (n = 17)
and 195 at 12 mo (n = 6). The increases were greater (p - 0.05) in antiretroviral
naive patients and also in those who took ritonavir. Mean serum triglycerides
(mg/dl) increased from 162 at baseline to 225 at 3 mo (n = 67, p < 0.01), 307
at 6 mo (n = 36, p - 0.1), 334 at 9 mo (n = 17, p 0.05) and 349 (n = 6) at
12 mo. Triglycerides levels tended to increase with indinavir but major increases
were noted with ritonavir (p < 0.01) with values up to 2,493 mg/dl. No case of
pancreatitis was noted.
Conclusions: Saquinavir had no effect on serum lipids levels, while indinavir
showed a tendency to increase triglyceride levels. Marked increases of cholesterol and especially in triglycerides were noted with ritonavir but they were not
followed with clinical sequelae.
160119 A comparative study of sexual risk behaviour
Kulasiri Buddha Korala. Central STD Clinic Desaram Place PO Box 567
Colombo 10, Sri Lanka
Objective: To study the sexual risk reduction behaviour in a high risk group in
comparison with a control group
Methodology: The study has been designed as a comparative cross sectional
study of a high risk population who may have engaged in high risk sexual be
haviour and a control group (CG). The study group (SG) consisted of men in
the 15-49 year age group who associate with tourists in the tourist resort in
Hikkaduwa. Since there was no sample frame available to identify the respondents the technique of "snowball sampling" was used. The CG was selected
from males who came for pre-employment medical examination to the Central
STD Clinic, Colombo. A stuctured interviewer administered questioannaire was
applied to both groups.