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

12th World AIDS Conference

Abstracts 60548-60552 1101

patients developed an ADI, and 29 (7.4%) patients died. Laboratory data are
shown in the Table.

Initial Last Visit
Median CD4 (range) 150 (0-1080) 230 (0-1000)
Median log10 VL (range) 4.399(1.67-6.03) 3.694 (2-5.875)

Change P value
60 (-280-510) <0.001
-0.5 ( 5.27-3.5) <0.001

104 (32%) had a plasma HIV-RNA level (VL) below 400 copies/mL (BLD) at
their most recent visit. Patients who had a VL BLD at their last visit had a median
CD4 cell count increase of 120 cells compared to an increase of only 42 cells for
those patients who had a VL greater than 400 at their last visit (p < 0.001).
Conclusions: suppression of plasma HIV-RNA after PI administration is associated with a greater magnitude of CD4 cell increase than incomplete suppression.
Most patients did not achieve "complete" suppression after PI administration.
Factors predictive of complete suppression will be presented.
160548 Prevention of abandonment children affected or infected
by HIV and preparing their future
Vicharn Vithayasai. 181/208 MOO3 Chotananivade2 SOI 6 Changpeuk District
Muang Chiangmai, Thailand
Issue: Supporting children affected by HIV/AIDS in villages/communities surrounding Chiang Mai province in northern region of Thailand
Project: As the HIV epidemic in Chiang Mai continues to expand rapidly, a
thousand children are suffering from its impact. The social and economic support
are provided to children of families with HIV/AIDS. Planning and preparing future
of children are introduced to their parents/guardians. They are supported basic
need, future's planning on education and vocation. Home based care and meeting of them are the important strategies for approaching and rehabilitation. Our
project establishes vocational workshops where any villages could join the work
with them that is the natural ways to learn and receive better understanding about
AIDS. More over, the project has trained volunteers to assist other HIV affected
families.
Results: Support the Children Foundation has run this program since 1994 with
94 families and increased to 350 families in 1997. Within 4 years, its activities are
beneficial to target groups and people surround, as well. Many thousand people
are educated on AIDS and are convinced on caring and assisting orphans
There is no fixed method for managing on AIDS problem. Everyone should
learn its situation and always consider carefully in any acts.
S60549 High prevalence of HIV among young childbearing
women in Catalonia, Spain: Results from the unlinked
anonymous neonatal surveys through 1996
Marti Vail Mayans', A. Maya2, L. Matas3, J. Casabona', T. Pampols2,
V. Ausina3. 1Ceescat Hosp Univ Germans Trias Pujol, Ctra. Canyet SN, 08916
Badalona; 2lnstitut Bioquimica Clinica Barcelona; 3Hosp Univ Germans Trias,
Pujol Badalona, Spain
Background: Since 1994 Spain is the country with the highest AIDS incidence
rate in Europe. With a yearly incidence rate of around 20 per 100,000, Catalonia
contributes with one fourth of the cases diagnosed in Spain. During 1996-97,
1906 cases (unadjusted for reporting delays) were reported in Catalonia: 58%
IDUs, 20% heterosexuals and 15% homosexuals were the main categories.
Objective: To monitor HIV seroprevalence among a representative sample of
women delivering children as a reflection of the spread of the HIV infection in a
fairly stable heterosexual population.
Methods: The Catalan unlinked anonymous neonatal HIV testing programme
was started in 1995. Yearly surveys of half of the newborns in Catalonia (26,000
approximately) have been undertaken since then. Samples have been provided
by the central laboratory in charge of the routine universal Newborn Screening
programme (coverage,99%). A 3 mm dried blood spot was punched out of
each filter paper selected. HIV testing in blood eluates was done following WHO
strategy II with Gacpat + Gacelisa.
Results: Overall seroprevalence for 1994 and 1995 (1996 in course) showed
respectively, a prevalence of 0.32% and 0.31% (95% Cl: 0.24-0.38). The mean
age of HIV infected women was younger (27.5) than that of uninfected women
(29) (p = 0.004). The prevalence was the highest in the 20-24 years age group
(0.62%) decreasing then significantly in the older groups up to 0.14% in the >35
years old (p for trend <0.001).
Conclusion: HIV prevalence in this population is among the highest in Europe.
With a clear commitment to reduce the HIV spread among youth in Catalonia,
preventive health and educational efforts should be targetted to children and
adolescents.
60550 Community screening program to determine the
prevalence of cytomegalovirus retinitis in the age of
HAART
Susan Ray1, Michael Giordano2, M.H. Heinemann3, S. Sledz3, R. Janis3,
S. Merrick3. 1 Cornell Clinical Trials Unit 525 E 68th Street Box 566; 2Cornell
University Medical College, New York, NY; 3 The New York University Medical
College, New York, NY, USA
Objective: Anecdotal reports indicate a decrease in the prevalence of CMV-R
(Cytomegalovirus Retinitis). A CMV Screening Program was developed to iden
tify patients with CMV-R to recruit for a clinical trial and to provide a community
service.
Method: CMV-R screenings were held at 7 AIDS service organizations and at a
hospital clinic. Screenings included a visual acuity test and a dilated fundascopic
exam by an HIV-experienced retinologist. This program targeted individuals with
CD4 counts less than 100, although individuals with CD4 count greater than 100
were also screened. Patients with other identified eye abnormalities would be
referred for appropriate follow-up care.
Results: 168 patients were screened for CMV-R. 49% had recent or current
CD4 counts less than 100. 80% were identified as being treated with HAART. No
active CMV-R was identified, although 2 patients had inactive CMV-R. However,
16 patients were referred for cataracts or glaucoma.
Conclusion: The CMV Screening Program confirms anecdotal reports of decreased CMV-R. It also represents a feasible and effective method for identifying
potential study participants and provide a needed community service. Although
no patients were identified with CMV-R, the program will continue due to potential
drug resistance and the resurgence of opportunistic infections.
S60551 Vif: Non-specific incorporation into Gag particles, and no
influence on particle formation, processing nor
maturation
Asato Kijomi', Hoshikawa Nariyoshi2, K. Yoshihara', A. Yasuda3, T. Kurata1,
A. Kojimi'. 'Dept. Pathol., Natl. Inst. Infect. Dis., Toyama 1-23-1, Shinjuku-Ku,
Tokyo; 2Dept. Internal Medicine Kosei Hospital, Tokyo; 3Nippon Zeon Co. Lt.,
Kawasaki, Japan
Objectives: Recent reports have described the presence of the Vif protein in
HIV-1 virions, but the specificity of Vif incorporation remains an open question.
Vif function is also controversial. Some papers suggest that Vif affects virus
assembly, processing or maturation which are Gag and Gag-Pol functions, and
increases virus infectivity in non-permissive cells. Others claim the absence of
Vif effects on these steps. To gain insight of Vif effects, Vif was co-expressed in
trans with Gag or Gag-Pol by recombinant vaccinia viruses, and the stage of the
HIV-like Gag particle formation was analyzed.
Methods: Recombinant vaccinia virus (RVV) expressing HIV-1 Vif was constructed and used for co-infection experiments with RVVs expressing Gag, Gag
mutants or Gag-Pol. Expression of Vif and Gag proteins were analyzed by immunofluorescence and Western blotting using anti-Vif and anti-Gag antibodies. Vif
packaging, Gag particle formation and processing of mature Gag proteins were
examined with virion fractions collected by ultracentrifugation from culture medium
of co-infected cells. Morphology of Gag particles produced in the presence or
absence of Vif was analyzed by electron microscopy of RVV-infected cells.
Results: Amounts of Vif protein incorporated into Gag particles does not increase when cells expressed increasing amounts of Gag protein by increasing
m.o.i. of RVV. Cells co-infected with increasing m.o.i. of RVV-Vif and constant
m.o.i of RVV-Gag released Gag particles with increasing amounts of Vif. All of
10 mt-Gag particles containing a mutation within either p17, p24 or p15 domain
processed Vif proteins in them. Vif incorporation, Gag particle formation and
Gag-Pol processing in non-permissive H9 cells showed no detectable differences
from those in permissive M8166 cells, when RVV-Gag-Pol infected with or without
RVV-Vif.
Conclusion: Vif incorporation into Gag particles was dependent on amounts
of Vif expressed in cells but independent on amounts of Gag. Formation of Gag
particles and processing of Gag proteins was similar between permissive and
non-permissive cells. Therefore, target step of Vif function appears not to be the
final stage of the HIV-1 life cycle; virus assembly, processing of viral protein and
virus maturation.
60552 Recombination events in env of SIVcpz over 8 years in a
naturally infected chimpanzee
Leo Heyndrickx', Pascale Ondoa', B. Willems', J. Vingerhoets', D. Davis1,
L. Kestens1, J.L. Heeney2, G. Van Der Groen1. 1Department of Microbiology,
Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium;
2Biomedical Primate Research Center, Rijswijck, The Netherlands
Background: To monitor genetic diversity in the env gene of SIVcpz during a
natural infection and to correlate changes with viraemia, viral phenotype and
immune control.
Methods: Chimpanzee CD4 and CD8 cells were purified using magnetic
beads. Virus was isolated by stimulating lymphocytes with PHA and quantified
by co-culturing cells or plasma with human PBMC, monitoring by antigen-capture
ELISA. The env glycoproteins of co-cultured isolates were cloned and sequenced.
Variable region length polymorphisms were determined with polyacrylamide gel
electrophoresis. Neutralization was determined by mixing human PBMC-grown
virus with antibodies and detecting residual virus in human PBMC.
Results: Cell-associated virus shows three periods of raised titre: months 7-22,
44 & 63-73. Virus could always be isolated from purified CD4 cells but reduction
from peak titres co-incided with a failure to isolate virus from chimpanzee PBMC.

At these time points (months 48 & 80) CD8 cells were able to control virus replication in purified CD4 cells. Three patterns of genetic variabilty were observed:
V2 regions cycled both in their length and number; the V4 region showed an early
elongated variant, undergoing a deletion for months 7 and 15 and subsequently
using an alternative deletion; mutations accumulated progressively within putative
neutralizing epitopes of V2 and the region flanking the C-terminus of the GPG
loop. Similarly, there have been four peaks (months 15, 25, 38-41 & 73) in the