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

12th World AIDS Conference

Abstracts 60450-60455 1083

(- 6620 copies/ml) showed significantly higher scores of problem- and emotionoriented coping, constructive activity, self-accusation and practice more relaxation
than individuals with higher viremia (- 6620 copies/ml). LTS with lower viremia
attribute a higher number of cofactors to their infection and to the future course
of the infection.
Conclusion: Asymptomatic long term survivors with a stable state of immunity show few psychological symptoms, and well-being scores comparable with
healthy controls. This finding is important as an immunological stabilisation is to
be expected with many HIV-positive persons treated with antiviral triple therapy.
The positive correlation of high self-efficacy, active coping strategies, high scores
of cofactors attribution with well-being and low psychological symptoms show the
potential of psychological interventions.
60450 Acquisition of explicit and implicit long-term-memory
and performance in language tests by HIV-1 seropositive
patients
Andrea M.N. Capuano1, M.A.M. Parente2, G.F. Xavier3. 1R Lacerda de Almeida
81, 05015-050 Sao Paulo; 2Maria Alice de Mattos Pimewta, Porto Alegre RS;
3Gilberto F Sao Paulo, SP Brasil
Objectives: To evaluate acquisition of explicit and implicit long-term-memory and
performance in language tests by HIV-1 seropositive patients.
Methods: 28 HIV-1 seropositive 22-60 years old patients with no signs of
clinic neurological alterations, divided either according to the symptomatology
(non-AIDS, n = 18; AIDS, n = 10) or to the CD4 lymphocyte counts (less than 200
cells/mm3, n = 12; between 200-500 cells/mm3, n = 12 more than 500 cells/mm3,
n = 4) and 7 seronegative healthy controls matched for age, were administered
(1) a mirror reading acquisition test and a verbal recognition task, both for assessment of implicit and explicit long-term memory; (2) specific language evaluation
tests (naming, lexical access, oral comprehension, repetition and reading), and
(3) a neuropsychological evaluation by the MiniExam of Mental Status and Digit
Span.
Results: There were no significant differences between HIV-1 seropositive
groups (divided either according to the symptomatology or to the CD4 lymphocyte counts) and seronegative controls in any of the tasks.
Conclusion: Performance of HIV-1 seropositive patients is not disrupted either
for acquisition of explicit and implicit (mirror reading) long-term-memory or for
language as evaluated by naming, lexical access, oral comprehension, repetition
and reading tests.
[60452 Asymptomatic cryptococcal meningitis in 2 HIV+ patients
Oladayo Oladeji, Giampiero Carosi, S. Casari, G.P. Gregis, D. Ripamonti. Clinica
Mallatie Infettive Spedalicivil, Piazzale 1 25125 Brecia, Italy
Background: Present data indicate that 75% -90% of HIV+ patients with CNS
cryptococcal infection present with features of subacute meningitis or meningoencephalitis with fever, malaise and headache 2-4 weeks prior to presentation.
Overt meningeal symptoms are unusual and occur in one-quarter to one-third
of patients, nausea and vomiting in 40%, while a minority may present with
symptoms compatible with encephalopathy such as lethargy, altered mentation,
personality changes and memory loss. Thus although insidious in onset, in no
case is the total absence of symptoms reported.
Method/Results: We report 2 cases of asymptomatic cryptococcal meningeal
infection in 2 male AIDS patients with 3 and 5 CD4+ cells//pL respectively. The
first presented with fever and neutropenia following chemotherapy for gastric and
cutaneous Kaposi's sarcoma - which resolved after G-CSF and antibiotic therapy.
All routine laboratory and instrumental exams were negative except for soluble
cryptococcal antigens, at a titre of 1:20. CSF following lumbar puncture was
unremarkable but culture studies were positive for Cryptococcus. The second
had been admitted for dyspnea and pancytopenia. Chest x-rays and sputum tests
were negative as were routine laboratory exams excluding soluble cryptococcal
antigens which were positive with a titre of 1:10. CSF was altered showing 145
mg/L of protein, 3 mmol/L of glucose and 36 cells//iL and cultures were positive
for Cryptococcus. Needless to say both patients were subsequently treated but
the prognosis attached to this disease is somewhat grave, reportedly 10-25%.
Conclusions: Cryptococcal infection goes unsuspected in seriously immunocompromised patients. Earlier diagnosis means less aggressive treatment compatible with a discrete quality of life. The serum test for soluble cryptococcal
antigens, a highly sensitive and specific test should be used as a screening exam
in all seriously compromised patients even in the absence of specific symptoms.
| 60453 Efficacy of a standardized acupuncture regimen for
neuropathic pain in HIV patients
Paola Nasta', G.P. Carosi1, R. Favalli2, S. Perini2, G. Lazzaroni2. 'Clinica Di
Malattie Infettive, Universita Di Brescia, Spedali Civili; 2'Associazione Medici
Agopuntori Di Brescia (UMAB), Brescia. Italy

Objective: We report preliminary data on evaluation of the efficacy of standardized acupuncture regimen on the relief of pain due to peripheral neuropathy in
HIV patients (pts) compared to an observational group.
Methods: HIV pts with symptomatic neuropathy, demonstrated by electromiography, are enrolled. Pts are randomized to recive standardized acupuncture twice
weekly for 3 paeriods of 5 weeks, or to stay in observational group. Booth groups,

at the end of every periods are evaluated by Visual Analogue Scale (VAS) of 10
cm to asses patients perception of the effectivness on asthenia and pain.
Results: Eleven pts are enrolled in acupuncture group (Gr A), and 8 pts in
observational group (Gr B). Pretreatment the mean pain intensty VAS score was
8.2 cm for Gr A; at the end of acupuncture treatment, mean VAS pain intensity
was 1.6 cm (decrease of 6.6 cm) with a pain relief of 81%.
In observational group, pain VAS was 7.5 cm at first visit, and 7.2 cm at last
observation (decrease of 0.3 cm) with a pain relief of 4%.
About asthenia in Gr A, the mean VAS intensity was 7.1 cm and post treatment
0.8 cm (decrease of 6.9 cm) with an asthenia relief of 88%.
In Gr B, asthenia VAS was 7 cm firstly and 6.8 cm at last visit (decrease of 0.2
cm) with an asthenia relief of 3%.
Conclusion: In spite of little studied population, these preliminary data suggest
that acupuncture, without collateral effect, can help in treatment of neuropathic
pain of HIV pts.
160454 Mother-to-child HIV transmission in the Czech Republic
Jana Vandasova1, M. Bruckova1, M. Stankova2, H. Rozsypal2, M. Reinis',
K. Vojtechovsky'. 'National Institute of Public Health Srobarova 48 10042
Prague 10; 2AIDS Center Prague, Czech Republic
Objective: To study and to establish the importance of selected virological parameters in vertically transmitted HIV infection.
Design: Virological investigation of HIV infected women and their newborns.
Methods: Quantitative HIV RNA assay (Roche) was used to follow up virus
load in plasma of HIV infected mothers during pregnancy and delivery. In addition
HIV DNA assay and conventional serological tests were performed repeatedly in
their newborns.
Results: Since 1990 when HIV antibody testing of pregnant women started
in the Czech Republic, in 20 of them HIV infection was diagnosed. Moreover 5
women became pregnant after knowing their HIV positive status. A total of 20
women gave birth to 21 children (twins were born once). One child only was
diagnosed as HIV infected so far. The mother was infected 3 years before pregnancy and AZT was started at week 19 of gestation. At the time of delivery she
yielded more than 190.000 HIV RNA copies/ml blood. Her newborn girl, delivered
by CS, had HIV DNA positive test in the second months and virus load at almost
the same level as that of her mother. After appropriate AZT treatment the baby's
plasma virus decreased to 3.000 RNA copies/mi. at 7th mont. The child is doing
well, no markers of HIV disease progression are noted 7 month after birth. All
other investigated HIV infected pregnant women did not reach the limit of 5.000
HIV RNA copies/ml plasma at the time of delivery. They did not show any clinical
symptoms of HIV disease at that time. They did not transmit the virus to their
newborns.
Conclusion: Infectious virus load in plasma and clinical stage of HIV infected
mothers are the most important factors in mother-to-child HIV transmission. AZT
prophylaxis in both mother and child may prevent the transmission of the virus or
decrease the virus load in infected newborns.
60455 Existing facts, need for negotiation skills & health
seeking behaviours among the women in prostitution
(WIP)
Usha Raghavan', Priya Srinivasan2, Raqha Varalakshmi3. '50/5
Mararapartments I Mainroad, Shenoynagareast Chennai; 'Social Worker,
Chennai; 3 Counsellor, Chennai, India
Aim: Aim of the study is to know the existing situation and induce the social and
cultural context of health and health seeking behaviour, the women in prostitution
to reduce the risk of getting STD/HIV/AIDS.
Design: Open study. Attendees of STD Clinics of Government Hospitals, NGOs
identified WIPs Brothel Owners/Pimps, Contractors.
Methodology: Indepth Audio-Visual Shows conducted in groups with the help
of the field workers and Peer Educators; (2) Arranged Health Camps according to
the convenience of the WIPs (Counselling is also part of the Camp); (3) Repeated
Message of getting exposed to the virus which has no cure or vaccine which
indirectly insist the need for condom usage.
Results: There were lot of objections from this samples thinking that their
profession will be affected. TLC (Tender, Loving & Care) change them to accept the field workers as one among them, given a chance to educate about
STD/HIV/AIDS and need for condom usage. Even WIPs insist the client to use
condom, the client refuse for various reasons. The women become powerless
and accept the sexual act without the condom, otherwise she will be loosing the
client in result will be loosing the bread for the family. Health Service evidence
shows that men are more likely than women to seek treatment for STDs from
Specialised Clinics.
Conclusion: There is a need to strengthen the partnership links between the
sex trade and STD/HIV/AIDS Prevention Workers. WIPS requires specialised
training in negotiating skills. Development of effective prevention and treatment
strategies of STD/HIV/AIDS. The society attitude towards the WIPs need a

change.