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

12th World AIDS Conference

Abstracts 60727-60732 1135

I 60727 Identification of HIV-1 subtypes B and F, B/F
recombinants and dual infections in Argentina
R. Daniela Fernandez-Medina12, R.D. Rabinovich2, O. Libonatti2, H. Wigzell1,
M. Jansson1. MTC- Karolinska Institute Box 280 S171 77 Stockholm, Sweden;
2Centro Nacional de Referencia para SIDA, Buenos Aires, Argentina
Objectives: To investigate the genetic variation of HIV-1 sequences derived from
HIV-1 infected individuals residing in different regions from Argentina.
Methods: 23 HIV-1 seropositive individuals were included in this study. Proviral
DNA sequences were obtained from uncultured PBMC. Molecular cloning and
sequencing were performed on viral DNA representing the envC2V3 and gag p17
regions from two samples. Obtained sequences were phylogenetically analyzed
by using the PHYLIP program and RIP Program was used to detect the presence
of recombinant sequences.
Results: Phylogenetic analysis demonstrated that subtypes B and F viruses
are circulating among HIV-1 infected individuals in Argentina. Subtype F viruses
were, however, found mainly among intravenous drug users (IDU) and heterosexual partners of IDU, as previously reported in Brazil. RIP analysis revealed
the presence of a B/F recombinant virus in the C2V3 region that interestingly
resembled previous reported B/F recombinants from Brazil and Argentina. Finally,
we identify two individuals harboring highly heterogeneous sequences. Molecular
cloning and sequencing of the C2V3 region from one of this patients showed the
presence of two viral populations diverging in average in 20% at the nucleotide
level. A second patient was found to be infected with two viruses belonging to
subtypes B and F as demonstrated by molecularly cloned sequences of both
C2V3 and p17 regions.
Conclusions: Two different subtypes of HIV-1 were found in Argentina. The
existence of different subtypes circulating in the same geographic region creates
conditions for dual infections to arise, which in turn rises possibilities for recombination, as demonstrated by the results of the present study. The study of this
phenomena is important for understanding the HIV-1 evolution in regions where
more than one subtype is spreading.
60728 1 Solidarity in the time of AIDS: Minority status at
international law
Andrew Doupe. c/o Yann Siegenthaler, Rue de Savoie 1207 Geneva,
Switzerland, Switzerland
Issue: Whether the term 'minority' is capable of encompassing other groups
i.e. HIV infected, which require similar protection of their rights as is presently
accorded to the recognized minorities under ICCPR, Art. 27.
Project: Deconstruction of the legal working definitions of 'minority' with emphasis on the social utility of the term.
Results: By following such an approach the 'nationality' requirement is seen in
its true light ie as a threat to peace and security, which explains the reticience in
recognizing new minorities However, the reduction of the nationality requirement
to its essential characteristics creates the opportunity for individuals to form a
sense of solidarity based on other life views. Identification is the crucial element
in conjunction with the rationale for minority rights if any given group is to be
granted the protection accorded to minorities. Finally the question of loyalty to the
State is addressed. It is suggested that minority status for the HIV infected can
be justly claimed because of the failure of States to 'include' these people. As
such minority status is a means whereby this failure is acknowledged and rights
can be protected.
The theoretical framework exists to accord the HIV infected minority status. It
would require States to actively choose to accord this status to the infected. However, the theortical frame work as described provides the bounds of an alternative
view if the current policies continue to prove to fail, but still within the international
framework.
60729 Sentinel studies in intravenous drug users in Mexico
Carlos Magis Rodriguez1, A. Ruiz Badillo2, R.E. Loo Mendez2, M. Santarriaga
Sandoval2, P.E. Uribe Zuniga2.?Tlalpan 4585 2 DO. Piso Col. Torrielo Guerra
C.P. 14050 Mexico D.F; 2AIDS National Council, Mexico, D.F, Mexico
Objective: To analyze HIV seroprevalence, sociodemographic profile, sexual
practices and other risk factors in intravenous drug users (IVDU) in Mexico.
Methods: Surveillance Sentinel surveys where performed between 1990-1997
in 16 large and medium cities of the country. During this period we studied 17,105
men and 31,783 women, they were recruited in HIV detection centers, streets,
STD's clinics, public baths and bars. All were done on a voluntary and confidential
basis with pre and post counseling and confirmed by Western Blot.
Results: Only 1070(6.2%) of the men were IVDU and 260(0.8%) of the women.
The seroprevalence in men was 5.9% and 1.9% in women. The mean age for
men was 29 years and 26 for women. The OR for use of drugs in men was 1.32
(95% Cl 1.01-1.72) and in women 3.15 (95% CI 1.29-7.72). We only analyzed
the Odds Ratio for risks in men because of the very few infected women. Men that
have sex with men OR 3.29 (95% Cl 1.84-5.88); Men that have sex with male

sex workers OR 2.33 (95% CI 1.15-5.04). 70% of the group shared syringes but
the OR was not significant (0.73). Only 35% cleaned the syringes.
Conclusions: Only sentinel studies provide information of the HIV infection for
epidemiological surveillance in Mexico. The population studied is autoselected.
The prevalence in men is only lower that MSM (15%) and is growing since 1988,
1.2% to 1997 with 5.9%. The prevalence is also high in women compared to the
0.4% found in female sex workers.

60730 Female condoms as effective as male condoms in
preventing sexually transmitted diseases
Pamela French', Mary Latka2, E.L. Gollub3, C. Rogers3, J. ODonnell4,
Z. Stein5. New York 1250 South Collegeville Road UP 4215, Collegeville, PA
19426; 2New York Academy of Medicine, New York NY; 3Philadelphia Dept of
Public Health, Philadelphia PA; 4Allegheny University, Philadelphia PA;
5Columbia Univ School of Public Health, NY, USA
Objective: To compare the efficacy of female condoms vs male condoms in
preventing sexually transmitted diseases (STDs).
Design: Prospective cohort derived from a randomized intervention trial.
Methods: All female patients seen at Philadelphia's largest STD clinic between
May 1, 1995 and April 12, 1996 (n-2100) were randomized to receive counseling
about male or female condoms, and given a large supply of that method to take
home and use. A third arm that received counseling in a safer sex hierarchy is
not included in this analysis. We report here on eligible women with a clinical
diagnosis of at least one of four STDs: gonorrhea, chlamydia, trichomoniasis or
early syphilis who consented to return bi-monthly for six months (n = 174). At
follow-up women were examined for new STDs, administered a questionnaire,
and given a new supply of condoms. The primary efficacy endpoint was laboratory
confirmed infection (excluding oral infection) with one of four STDs: gonorrhea,
chlamydia, early syphilis or trichomoniasis. Laboratory personnel were blind to
condom group status.
Results: Reinfection rates were 11/62 (18%) in the male condom group and
21/112 (19%) in the female condom group over a six month period. Cumulative
relative risk and 95% confidence interval: 1.0 (0.6-1.8).
Conclusion: In this STD clinic, serving high risk women, female condoms are
as effective as male condoms in preventing gonorrhea, chlamydia, syphilis and
trichomoniasis.
S60731 Stability of plasma HIV viral load in Vacutainer plasma
preparation tubes (PPT ") during overnight shipment
Lynne Rainen1, B. Yen-Lieberman2, S. Herman3, M. Holodniy4. Becton
Dickinson Vacutainer Systems 1 Becton Drive Franklin Lakes NJ 07417;
2Cleveland Clinic Cleveland OH; 3Roche Molecular Systems Branchburg NJ:
4AIDS Research Center Palo Alto CA, USA
Background: We determined the performance of VACUTAINER' Plasma Preparation Tubes" (PPT) for the collection of whole blood and the stability of plasma
HIV viral load obtained from PPT tubes that are processed and then shipped
overnight under various conditions
Methods: After informed consent, whole blood (WB) was obtained from 20
HIV seropositive and collected in one EDTA and four PPT tubes. The EDTA and
3 PPT tubes were centrifuged at 1100 x g for 10 min within 1 h of collection.
Separated EDTA plasma, 1 full PPT tube (containing plasma) and separated PPT
plasma were frozen at 70 C within 1 h. Two PPT tubes had plasma held at
room temperature (RT) and 4 C for 6 h. One PPT was held on the bench as WB
at RT for 6 h and centrifuged. Samples were then shipped overnight at ambient
temperature, and on wet or dry ice. Temperature monitors recorded internal shipping box temperatures overnight. Samples were then further processed the next
day, when all samples were frozen at -70 C until assayed. Plasma viral load
was determined using the Roche Amplicor HIV-1 Monitor Assay. Viral load values
were compared within and across subjects using nonparametric analyses.
Results: Compared to frozen EDTA plasma, viral load values obtained from
immediately frozen PPT tube plasma (separated or whole tube) were not significantly different. Values from PPT plasma after 6 h storage at either RT or 4 C,
followed by shipment at the three conditions, were not significantly different when
compared to baseline EDTA or PPT plasma.
Conclusions: HIV viral load obtained from PPT tube plasma is equivalent to
standard EDTA plasma. Plasma viral load is not affected by storage or shipment
temperature when collected in PPT tubes. Plasma can be shipped in spun PPT
tubes and are safer and more convenient than regular EDTA tubes.
|60732 Ten years of AIDS in Pretoria - A clinical profile
Gerasimos Lecatsas. Department of Virology, PO. Box 173, Medunsa. 0204,
South Africa
Objectives: To monitor the diverse clinical presentation and increase in number
of patients on initial diagnosis of HIV positivity at a large teaching hospital serving
a semi-rural population.
Methods: Adults and children (up to age 5) with initial confirmed HIV infection
have been monitored over a period of 10 years for signs and symptoms on
presentation.
Results: A dramatic increase in numbers occurred after five years and in
1997 the patients admitted numbered almost 2000 from an initial figure of 11 in
1988. In the final 2 months of the study, approximately 400 patients presented
with a total of 67 different syndromes, while children presented with a total of
38 different syndromes. At the start of the study most patients fell within a few

well defined syndromes. As numbers increased, the variety of syndromes has
increased dramatically, with a few patients in each specific syndrome. Amongst
children, males outnumbered females as indicated in our earlier studies.
Conclusion: With increasing numbers of AIDS patients admitted to this hospital, the variety of presenting syndromes has increased dramatically. What factors
may play a role in this diversity serves as a basis for future investigations.