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

1044 Abstracts 60247-60251

12th World AIDS Conference

60247 1 Correlation between the birth of HIV-infected child and
relation a mother to high risk group at Ukrainian women
Nelly Tchentsova1, Olena Kislykh', E.V. Maximenok1, M. Vatamanyuk1,
D.P. Luzan', A.M. Scherbinskaya2. 1Centre for AIDS Prevention 4 Protasiv Yar.
uz, Kyiv 252038; 2 Institute of Epidemiology & Infectiv Dis, Ukraine
Objectives: The problem of children, born to HIV-infected mothers has become
urgent in connection with sharp increase of number HIV-infected persons in
Ukraine for last 2 years. The purpose of the represented work was an establishment of dependence between the relation of a mother to high risk group and time
of revealing at a child of p 24 antigen or disappearance of maternal antibodies in
absence of an HIV-infection.
Design: Prospective study
Methods: For 1996-1997 years we surveyed serum samples received from 26
children, born to HIV-infected mothers. Children were observed every 3 month
from the moment of birth up to an establishment of the laboratory diagnosis
"HIV-infection" or before disappearance of maternal antibodies at absence of an
p 24 antigen, others clinical and immunological symptoms. Each sample of sera
was surveyed on presence of antibodies to HIV by EIA and WB was compared in
tandem with p 24 antigen and titers AB p 24 detection.
Results: At 14 from 26 children the p 24 antigen was detected, from them in
the age of about the 3 months at 8 children, in the age of about 10 months - at
6. Titres to p 24 < 5 were determined at 12 children, titres from 1: 10 up to 1:400
- at 2-rd children. Mothers of 7 children from this group were IDUs. Mothers of
other HIV-infected children were not known, but it is possible to assume, that
they too concerned to high risk group as children were left. At other 12 children
the maternal antibodies have disappeared on the average in 10-12 months after
birth, thus the p 24 antigen did not come to light. The mothers of these children
were not relate to IDUs and were infected by their husbands.
Conclusion: Probability of birth HIV-infected child considerably rises at a
mother-IDUs. At the same time, the birth of children by the women concerning group of high risk, testify to insufficient knowledge of the population about
HIV/AIDS and small efficiency of testing pregnant on antibodies to HIV as preventive measure.
60248 1Evaluation of selected questions from the medical and
dental history questionnaire of HIV+/AIDS patients
Mario Alves', M.C.F. Alves2, P.M. Alves3, M. Vale3, V. Dourado3. 1801 S.
Paulina Street Room 458, Chicago, Illinois 60612; 2 VIC-College of Dentistry,
Chicago, USA; 3Universidade Federal Da Bahia, Salvador, Brazil
HIV+/AIDS patients from the UIC-Ryan White dental clinic complete an extensive
medical and dental history questionnaire from which 10 questions were chosen to
evaluate their self-assessment of health. 5 questions have yes or no answers and
5 require short written answers. 326 randomly selected charts from patients who
finished their treatment before November 1997 were evaluated. From 236 men
(72.4%) and 90 women (27.6%) with ages varying from 19 to 68, 78 were white
(24%), 189 black (58%), 48 hispanic (15%) and 11 others (3%). The question
"Are you in good health?" presented 176 yes (54%), 129 no (40%) and 21 blank
answers (6%). On changes in their health within the past year the answers were
156 yes (48%), 147 no (45%) and 23 blank (7%). The date of last medical exam
was answered as follows: current year 176 (54%), previous year - 34 (10%),
2 or more years before - 27 (8%) and 89 blank (27%). The question "Are you
under physician care?" registered 277 yes (85%), 33 no (10%) and 16 blank
(5%). What condition being treated received the following answers 70 HIV/AIDS
(22%), 5 others (2%) and 251 blank (77%). 187 patients (57%) knew the name of
their physician while 139 (43%) did not know it. On serious illness/hospitalization
165 answered yes (51%), 133 no (41%) and 28 blank (9%). 42 patients (13%)
had HIV/AIDS, 29 (12%) pneumonia, 68 (21%) others, and 177 (54%) blank.
259 patients (77%) acknowledged their HIV+ status and 76 (23%) had AIDS.
On hepatitis the information was 77 yes (24%) and 249 no (76%). 74% of the
questions were answered and 26% were not.
Lesson Learned: Patients feel more comfortable answering the medical and
dental history questionnaire by themselves, but unassisted answering can be inaccurate. Patients have problems understanding the questions, and are reserved
to answer some "personal" questions. When the questionnaire is reviewed with
them most of the blank questions (96%) are answered.
60249 HLA antigens associated with long-term non progression
of HIV infection
Roberto Paganelli1, M.P. Perrone2, L. Laurenti2, S. Coluzzi2, R. Ferrara',
G. Girelli2. 1Dept. of Clinical Med. Chair of Clin. Immunol. Allergy V. Universita
37-00185, Rome; 2Dept. of Haem. Cell. Biotech-Un. La Sapeinza, Rome, Italy
Objective: To investigate the HLA type in a selected cohort (NO.P.H.RO.CO.) of
long-term HIV+ non progressors (LTnP), to assess the association with putative
protective loci.
Design: Open, controlled study of cohort.

Methods: Twenty LTnP (asymptomatic HIV+ without treatment, CD4+ > 500,
duration of seropositivity 8-10 years) were typed for HLA class I and II antigens.
The antigenic frequency was compared with 13 HIV+ progressors (group A) and
853 healthy subjects typed for class I HLA, 153 of them typed also for class II
(group B). HLA typing was performed using serological test according to NIH
guidelines.

Results: In LTnP the presence of the A32 antigen was increased (p < 0.05
vs groups A and B), the B35 was decreased (p < 0.0001 vs A and p < 0.0025
vs B), the DR11 was decreased (p < 0.0001 vs A and B). These data agree
with the literature; however also the DR1 antigen, associated with development
of Kaposi's sarcoma, was increased in LTnP (p < 0.025 vs A and p < 0.00025 vs
B).
Conclusions: In a cohort of LTnP, we found a decrease of HLA antigens associated with rapid progression, and an increase of an antigen related to slow/no
progression. An exception was the increase of DR1 in LTnP. Our data confirm
that certain MHC antigens might protect from progression to AIDS.
60250 Prevalence of CCR5 heterozygous deletion in long-term
non progressors, and its viro-immunological correlates
Roberto Paganelli', M.L. Romiti2, A. De Luca3, G. Antonelli4, E. Riva5, F. Aiuti',
C. Alario. 1 Chair Clinical Immunology Allergy, V Universita 37 - 00185, Rome;
2Dept. Publ. Health, Univ. Tor Vergata, Rome; 3lnst. Infect. Dis., Univ. S. Cuore,
Rome; 4Dept. Biomedicine, Univ. of Pisa, Pisa; 5lnst. of Virology, Univ. La
Sapienza, Rome, Italy
Objectives: To study the presence of mutated CCR5 HIV coreceptor in both infected and non infected subjects, as well as a cohort of long-term non progressors
(LTnP), and correlate this finding with viro-immunological analysis to assess the
relevance of CCR5 mutations.
Design: Prospective cohort study.
Methods: The population studied (total n. = 211) consisted of 77 seronegative
subjects, 91 HIV-1 infected symptomatic progressors, 16 HIV-1 infected asymptomatic subjects with short (<4 years) history of infection, and 27 LTnP. Three
different protocols were used for CCR-5 mutation analysis: single PCR amplification of regions flanking the A32 bp deletion, nested PCR, and sequencing of
the CCR-5 gene. CXCR-4 was analysed by cytofluorimetry. Virus isolation and
phenotyping, CD4+ cell count, and in vitro beta chemokines production were
performed by standard methods.
Results: CCR-5 homozygous mutation was not observed. Heterozygous A32
deletions were found in 7.79% controls, 7.69% progressors with HIV-1 infection,
18.75% asymptomatic early HIV-1+ controls, and 25.93% LTnP. CXCR-4 expression was similar in LTnP and asymptomatic HIV-1+ controls. Most subjects in the
LTnP cohort had NSI virus and HIV-RNA < 104 copies/ml, and after a longitudinal follow-up of 18 months, asymptomatic subjects (both LTnP and controls)
with heterozygous deletions presented stable plasma HIV-1 viremia, whereas it
almost doubled in cases with wt CCR-5 phenotype. No relationship was found
with the in vitro production of beta chemokines.
Conclusions: Present data indicate that heterozygous A32 CCR-5 genotype
represents an advantage for HIV-1 infected subjects in terms of delayed progression of disease and lower plasma viremia. The cohort of LTnP is however
heterogeneous, and other factors might explain their preserved immune status
and lack of progression.
60251 Volunteer characteristics and responses to working with
PWA in Japan
Akiko Takail, T. Hardy2. 1 The Univ. of Tokyo Sch. of Int'l Health, Tokyo;
2-3-4-602 Kotobashi Sumidaku Tokyo 130; 2Tamagawa Univ, Tokyo, Japan
Objectives: To establish the social characteristics of volunteers working with
PWA in Japan; to begin an understanding of the motives of the volunteers; and to
discover the volunteers' experiences and stresses and rewards associated with
their work.
Design: Preliminary research, including participant observation, interviews,
and questionnaires.
Methods: We distributed 30 questionnaires at 3 major AIDS-related social service centers in Tokyo, Kyoto, and Fukuoka. We also conducted 10 interviews. One
of us worked at 1 volunteer organization in the capacity of participant-observer.
The other conducted in-depth longitudinal interviews with a full-time volunteer,
who served as a chief informant.
Results: Volunteers come disproportionately from groups without power in
Japanese society: specifically, Christians, women, gay men and women, the
relatively young, and those without a major or permanent career track, including
housewives/mothers with children are at school. Their motives fc volunteering
follow one of two major trends: for Christians the volunteer activity is based
on moral an ethical imperatives to serve others. For gay men and women and
younger volunteers, social and political issues of equality and justice are more
important. Provisionally, 40% reported stresses associated with the clients, including emotional overload. 50% reported significant rewards associated with
clients, that volunteers made a personal contribution to the larger community by
assisting individuals. 48% reported stresses associated with the volunteer organizations themselves, including unresponsive administrators' and lack of support
for volunteers' initiatives.
Conclusion: Knowledge of volunteer social characteristics and motives can
help NGO's develop programs that more effectively take these characteristics into

account, both in recruiting volunteers an in assigning volunteers to tasks. Knowledge of stresses associated with the volunteer experience can aid organizations
in shaping their responses to volunteer contributions to administrative tasks and
activities.