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

1142 Abstracts 60769-60774

12th World AIDS Conference

was found to be relatively low. Thus, there is a necessary to provide more opportunities of education on maternal-child HIV infection for the women, planning to
get pregnant.
60769 Motivations for HIV detection in French centers of
anonymous and free detection
Laurent Misery1, B. Pages1, P. Vergnon2. 1Department of Dermatology Herriot
Hosp. 69437 Lyon; 2Department of Medical Information, Lyon, France
Background: In France, HIV detection is possible in the centers of anonymous
and free detection (CDAG). These centers depend on french counties. They
provide about 25% of HIV detections. The aim of the study was to determine why
people ask for a HIV detection and why in a CDAG.
Methods: In the CDAG of Lyon, an anonymous questionnaire had been proposed to all patients during six randomized weeks. Twenty-seven questions were
concerning identity, motivations, CDAG and sexuality.
Results: The response rate was 757/891 (85%). Sex ratio was 1.1. Seroprevalence was 0.67% (6). The HIV detection was performed for the first time in 51.8%.
The mean age was 26.2 years. 80% of the patients were interested by anonymity
and gratuity. The main motivation was the intention to start a relationship with
reciprocal fidelity and without use of condoms.16.7% were anxious because of
their partners and 43.3% because of a not safe sexual relation. Only 29 patients
(3.8%) suffered from symptoms compatible with HIV infection.
Conclusion: This study underlines the limits of prevention campains because
most of the patients know the actions for HIV prevention. We have to find new
processes for HIV prevention and why people are not always safe in their sexuality. Nonetheless, the main motivation for HIV detection is the beginning of stable
relationship with one partner.
S60770 Neutralizing effect of secretory IgA to HIV in parotid
saliva of HIV-infected patients
Philippe Moja1, C. Desgranges2, B. Pozzettol, F. Lucht1, C. Genin. 1 Gimap
University of St.-Etienene 15 Rue A. Pare 42023 St.-Etienne Cedex2; 21NSERM
U271, Lyon, France
Background: The aim of this study was to test S-lgA purified from secretions of
HIV seropositive patients in a neutralization assay to determine whether specific
S-I&A can protect from HIV infection.
Methods: Parotid saliva samples were collected from 72 HIV-1 seropositive
individuals with known CD4 cell counts and from 30 seronegative volunteers.
Subjects with elevated albumin concentration in their saliva suggesting contamination with blood, were excluded. Screening of parotid saliva samples containing
S-lgA to HIV was performed using an ELISA after IgG removal. Specificity to IRV
was studied by Western Blot analysis.
For the neutralization assay, S-lgA were purified from parotid saliva by immunoaffinity chromatography. Duplicate samples of 1/pg of S-IgA were incubated with
100 TCID50 of HIVMN, then MT4 cells were added to the culture and incubated
for another 2 hrs at 37 C in 5%CO2. The supernatants were removed and fresh
culture medium was added to the cells. On day 7, supernatants were collected
for a reverse transcriptase assay.
Results: 39% of tested patients (28/72) were positive for S-IgA to HIV in parotid
saliva. IgA specificity to the all structural proteins of HIV was found except to
gp41. 15/28 patients who had anti gp120 S-lgA, were selected. Viral infection of
MT4 cells with HIVMN was inhibited by purified serum IgA from 11 out of these
15 infected patients. In addition in 7 out of 15 parotid saliva, S-IgA showed very
effective neutralization activity. No correlation between neutralizing activity and
CD4+ cell counts was found in these patients.
Conclusion: These data demonstrate that secretory IgA, which is the predominant isotype in secretions, can inhibit HIVMN infection of MT4 cells. HIV
neutralization has been carried out with CD4+ T cell line adapted virus strain as a
standardized model system, but the use of mucosal autologous primary isolates
in neutralization test would be useful to estimate the actual protective effect of
these antibodies in each patient.
S60771 Infusion of cryropreserved autologous lymphocytes can
improve immunocompetence and decrease viral load in
HIV-infected patients
John M. Dwyer12, A.E. Trickett2, M. Kelly3, B.A. Cameron2, A. Lloyd3,
R.A. Ffrench4. Division of Medicine, Prince of Wales Hosp., High Street,
Randwick, NSW; 2Faculty Medicine; 3 nflammation Research Unit, University of
New South Wales, Randwick Sydney, NSW; 4Depts.
Immunology/Immunopathology, WestMead Hospital, NSW, Australia
Objective: Therapeutic measures aimed at boosting the immunity of patients
infected with the human immunodeficiency virus (HIV) are a critical component of
strategies for effective therapy of HIV and acquired immune deficiency syndrome
(AIDS).

Design: Prospective, uncontrolled study.
Methods: To improve immunocompetence in patients with progressive disease, autologous lymphocytes which were collected and cryopreserved earlier in
the course of HIV-infection were reinfused.
Results: None of the 12 patients receiving cell infusions experienced any
adverse effects. Improvement in immunological parameters (CD4+ and/or CDS+
lymphocyte counts, HIV-specific cytotoxic T lymphocyte activity, or viral load)

were seen in 7 patients. Restoration of the CD4+ count to the level recorded at
the time of cell harvest was achieved in 2 patients with less advanced disease.
Plasma HIV RNA was reduced by more than 0.5 logs in 2 of the 4 patients tested.
Conclusion: These results suggest that cellular immunotherapy using cryopreserved autologous lymphocytes has the potential to improve some measures
of immunity in patients with HIV/AIDS and warrants further investigation.
i 60772 STD/AIDS in workplace - The study about knowledge,
attitude and practice
Otto Santana. SBN BLCQ. 01 Ed. Roberto Simonsen 9~ and Brasilia, DF CEP
70-040.903, Brazil
Issue: To identify knowledge, attitude and practice (KAP) of industries workers
with ages which are more vulnerable to contract AIDS.
Project: A research involving 16 groups from 14 states of Brazil of industrial
activities which comprises companies where the Social Service of Industry - SESI
developed some actions of health education and prevention of STD/AIDS. The
transversal inquiry was adopted as a model. The aim of this research KAP has to
determine the level of the workers about the theme, aiming the identification of
the weak areas on Knowledge and behaviour in prevention of STD/AIDS as well
as on discrimination of people living with HIV/AIDS.
Results: The most of researches Know the correct forms to transmite HIV but
the false belief persist for example: to giving blood, mosquitoes, public pool and
common utensil. However the condon was recognised like a better way to prevent
STD/AIDS it wasn't used at sexual relationship. It's help to keep the risk behavior
and discrimination.
Lesson Learned: It was proved that the methodology that has been used was
inefficient. It's necessary to create a new way that envolve to think, to do and the
emotion to take a behaviour changes.
60773 HIV-1 viral load in Ghana (West Africa): No HIV-2
interference
William Ampofo1, N. Yamamoto1, Y. Koyaniga1, K. Ishikiwa2, T. Sata2
J. Brandful3, J. Barnor3. 1Microbiol Dept, Tokyo Med & Dental Univ, 1-5-45
Yushima Bunkyo-Ku, Tokyo 113; 2AIDS Pathol Lab Nat Inst Infect Dis, Tokyo
162, Japan; 3Noguchi Mem Inst, Univ of Ghana Legon, Accra, Ghana
Objectives: To quantitate HIV-1 RNA in plasma from Ghanaian HIV seropositive
patients and to assess any HIV-2 interference.
Methods: Plasma was obtained from patients in southern Ghana during 1996
and 1997. After screening for HIV-1 and HIV-2 antibodies with confirmation by
PCR, 130 (including 18 known HIV-1 subtype A) samples were assayed by the
Roche Amplicor HIV-1 Monitor test. The non-subtype B specific Amplicor HIV-1
Monitor Primer Mix (HMPM) was also incorporated. T cell counts of CD4 and
CD8 (whole blood) and virus isolations (patient PBMC) were also performed.
Results: There was a mean 100 fold increase in HIV-1 RNA copies/mL when
the new HMPM was applied in the assays. About 96% validity resulted with RNA
amounts averaging 400,000 copies/mL and 94% of the HIV-1 subtype A samples
were in the 1000 to over 750,000 copies/mL range. 17 HIV-1 isolates were obtained from samples with more than 20,000 copies/mL. Eight PCR confirmed dual
HIV-1 & HIV-2 infected AIDS patients, had on average, 300,000 RNA copies/mL.
Four HIV-2 only infected samples showed mean RNA of 540 copies/mL, close to
the detection limit of 400 copies/mL. CD4 levels did not differ significantly between
the single and dual HIV infected groups. In HIV-1 infected samples, CD4 counts
less than 200 cells/uL were usually associated with RNA amounts greater than
20,000 copies/mL.
Conclusion: The improved Roche AMPLICOR HIV-1 MONITOR test is a useful HIV-1 quantitation assay for Ghana. The high HIV-1 RNA levels in the dual
infections reflect insignificant HIV-2 cross-protection against HIV-1 in Ghana.
Follow-up studies will investigate more closely, correlations in viral load, T cell
counts and clinical outcome.
S60774 Rural migration and AIDS in Mexico: Assessment of the
educational material
Raul Ortiz Mondragon1, Martha Loya-Sepulveda2, S. Silva Bustillos2, P.E. Uribe
Zuriga2. 1Calz. De Tlalpan 4585 2do Piso Col. Tone, LLO Guerra C.P 14050
Mexico, D.F; 2AIDS National Council, Mexico, D.F, Mexico
Objective: To evaluate the impact of an educational video and comic for AIDS
prevention in a Mexican rural area with migration to the United States (US).
Method: Data was collated of a sample of three migrant town's migrants: all
subjects selected were participants in an educational intervention and responded
one questionnaire that asked them about video and comic content The Study was
done five months after the video and comic were used.
Results: The educational video was more spontaneously reported 25%. Of
those, 36% judged it realistic; 26% impacting; 21% informative; 5% interesting
and 5% intelligible. 58% of the sample identified the video aim with HIV preven
tion and 26% only with migration. 33% said that video's subject addressed how
Mexican migrants are infected with HIV in the United States and how they infect
their sexual partners in Mexico. The comic was not remembered spontaneously,
although 80% did when asked. 20% didn't read the story, of them 11% kept it, 6%
give it to some familiar and only 3.6% throw it away. Between those who read the
comic (63.8%) the same percent keep it or give it to some familiar or friend. In
general's people opinion the video and the comic had the same subject.