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

12th World AIDS Conference

Abstracts 60831-60835 1153

nucleotide sequences led to the proposal that IL-16 is synthesized in the form of
a large precursor protein (pro-IL-16). The complete pro-IL-16 cDNA was subsequently molecularly cloned, sequenced, and expressed in COS-7 cells. Pro-IL-16
is most likely synthesized as a 67 kDa protein and is encoded from a major 2.6 kb
transcript. Recombinant pro-IL-16 polypeptides are specifically cleaved in lysates
of CD8(+) cells. N-terminal sequencing of cleavage products suggests that the
naturally secreted bioactive form of IL-16 is a fragment of 121 amino acids.
Moreover, we characterised the gene structure of IL-16 in detail and identified the
promoter region involved in the regulation of IL-16 expression.
60831] Circulating immune complexes in AIDS patients and the
rationale for an ex vivo immunoadsorption therapy
Joachim Denner. Paul-Ehrlich-lnstitut; Paul-Ehrlich-STR.51-59; 63225 Langen,
Germany
Background: In the serum of HIV-1 infected individuals increased amounts of
circulating immune complexes (CIC) had been found which are known to be immunosuppressive. In order to study the role of CIC in HIV induced pathogenesis,
we investigated their incidence and kinetics of appearance in untreated patients,
and in patients treated with AZT monotherapy or with a triple drug combination
therapy. In addition, we studied whether CIC contain viral proteins.
Methods: CIC were measured in the sera of HIV-1 infected individuals using
different Clq-ELISAs, a C1q-RID assay and the PEG method. The presence
of viral proteins in CIC was studied by immunoprecipitation and Western blot
analysis using specific antibodies against the main HIV proteins. For this, CIC
were purified using protein G or C1q affinity chromatography. The Ig subtypes
contained in CIC were measured by Western blot analysis.
Results: CIC were found in a large portion of HIV-1 infected individuals, and
their amount increased with progression to AIDS and decreased in the final
stage. During AZT monotherapy the p24 concentration in the peripheral blood decreased, but the amount of CIC remained unchanged. After combination therapy
the amount of CIC either decreased significantly or remained unchanged over a
long period. The CIC not only contained IgG but also other subtypes, mainly IgA.
Viral proteins including p24, gp41 and gp120 were found in CIC removed from
sera by affinity chromatography (supported by BIOMED 2; BHM4-CT96-1011).
Conclusion: Affinity chromatography enabeled us to remove CIC containing viral proteins from the serum of HIV infected individuals. Since CIC are
immunosuppressive and contain immunosuppressive viral proteins, an ex vivo
immunoadsorption removing CIC as well as viral particles and viral proteins may
have a profound therapeutic effect.
[60832 Methodological issues when researching hard to reach
groups-working with a diverse gay and lesbian
community in Cape Town, South Africa
Giles Griffin1, H. De Pinho2, N. Stein3. 1PO Box 43282, Woodstock; 2Womens
Health Research Unit, Dept. Community, University of Cape Town, Cape Town;
3Director: TRIANGLE Project, Cape Town, South Africa
Issue: Conducting community based research with hard-to-reach populations
poses various challenges for the research team and the community which is
being studied.
Project: Issues raised in an initial baseline survey were explored further in a
qualitative study. Focus groups were used as the method of study. Members of
the gay, lesbian and bisexual community were used as part of the research team
in order to build capacity.
Results: The following issues were highlighted: 1. The difficulty of recruiting a
sample in a largely hidden community; 2. Suspicion and mistrust of the research
process; 3. Problems associated with conducting groups in three different languages; 4. Issues of involving community members in the entire process in order
to build capacity.
Lessons learned: Hidden communities of many kinds exist within society.
When conducting research with these hard to reach groups, a multitude of issues
surface. The difficulties of sample selection are central as these communities are
marginalised. It is often the needs of the most invisible communities which are
ignored and remain difficult to uncover. Thus it is crucial to involve members of
these communities in all stages of the process.
60833 Risk reduction training for street youth as a follow-up
process of the outreach program for AIDS/STD
prevention
Ika Harmawati1, Hadi Nasrun2. 'JL TRM Gang Kapas JIT/705 Badran
Yogyakarta 55231; 2Lentera PKBI-DIY Yogyakarta, Indonesia
Issues: Evaluation of risk reduction training for street youth.
Project: Lentera works with youth at risk, of ages 11-24, both male and female. The majority of the street youth with whom Lentera works are male. Risk
reduction training is offered as a follow-up to the outreach program. The partic
ipants are usually a group of 20-25 youth, both male and female. The material
is a combination of AIDS, STD, sexual development and reproductive health,
discussions of sexuality, information on HIV testing, and a card game on the level
of risk of various behaviours. The material was given in the form of presentations,
discussions, and games.
Result: Outreach indeed has the effect of increasing requests for condoms,
changing attitudes of the street youth to be more open in talking about STDs

and AIDS, and being more willing to use the clinic facilities for sexual health
checkups. Risk reduction training was seen to be beneficial to street youth, and
they had also met with outreach workers. Their knowledge about sexual health
issues including AIDS was increased. They were able to concentrate better and
liked better the information which was presented in games. It was found that for
female street youth, the level of sexual abuse which they are exposed to is high.
The dependence of female street youth on their partners was also high.
Lesson Learned: The outreach program and risk reduction training are an
effective method for AIDS prevention among street youth. Because of the weak
bargaining position of female street youth, special material is needed for female
street youth. For example, training them to be bolder in negotiating with their
partner, or giving material on sexual abuse. Because of this, it needs to be
reconsidered whether to keep holding risk reduction training for male and female
street youth at the same time.
S60834 HIV-1 coreceptor usage and CCR5 defective allele in
mother-to-child transmission
Francesca Salvatori'2, C.C. Colognesi2, E.T. Tresoldi2, A.P. Plebani3,
A.B. Bucceri4, A.S. Siccardi2, G.S. Scarlatti2. 1Unit of Immunobiology of HIV
Dibit HSR via Olgettina 58, 20132, Milan; 2Unit of Immunobiology of HIV Dibit
HSR, Milan; 3First Clinic of Pediatrics Univ. of Milan, Milan; Department of
Gynecology and Obstetrics, Milan, Italy
Objectives: The chemokine receptors have been identified as essential coreceptors for HIV-1: CXCR4, for T-cell-line-tropic HIV-1 strains, and CCR5, for
non-T-cell-line-tropic HIV-1 isolates. Furthermore, a defective CCR5 allele has
been linked to resistance to HIV-1 infection in homozygotes infected by the
sexual route, suggesting a critical role of CCR5 in HIV-1 transmission. To investigate the role of HIV-1 coreceptor usage and the defective CCR5 allele
during mother-to-child HIV-1 transmission, we studied 15 transmitting and 18
non-transmitting seropositive mothers and the respective children.
Methods: The cells of the children were analyzed for their CCR5 genotype by
DNA-PCR. All viral isolates were characterized for tropism and syncytium-inducing capacity in the MT-2, PM1, Jurkat, Jurkat-tat cell lines. The viral isolates
were tested for chemokine receptor specificity by infecting the human glioma
cells U87.CD4 stably expressing one of the chemokine receptors CCR2b, CCR3,
CCR5 and CXCR4.
Results: A defective CCR5 allele was found in 1 out of 15 infected children
(6.6%), and in 4 out of 19 uninfected children (21%). All children with a defective CCR5 gene were heterozygotes except an uninfected one, Furthermore, we
found a correlation between the biological phenotype of the maternal viral isolate
and the risk of transmission: 6 transmitting mothers but only 2 non-transmitting
harboured a rapid/high virus. All slow/low viral isolates used CCR5 as a coreceptor, as assessed in the transfected U87 cells. By contrast, rapid/high and MT-2
tropic isolates showed the ability to use CXCR4 and, in most instances, CCR5
and/or CCR3. The 5 mothers harbouring viral isolates capable of using multiple
coreceptors transmitted in 2 cases such viruses and in the other 3 cases viruses
which used only CCR5. Interestingly, the only infected child with a defective CCR5
allele was infected with a rapid/high virus capable of using CXCR4, CCR5 and
CCR3 as coreceptors.
Conclusions: A defective CCR5 gene is more frequent in HIV-1 uninfected
children than in infected ones. Mothers who harbour a virus with a rapid/high
phenotype have a higher risk to transmit the infection to their children. Moreover,
rapid/high and MT-2 tropic viruses can still be transmitted to individuals carrying
a CCR5 defective allele.
60835 The simultanity of HIV, and HBV, HCV and syphilis among
the addicted prisoners
Azita Nowroozi', M.R. Zali2, M.M. Gooya3, P. Kowsarian4, M. Raoufi3. 6,
Baghaii St. Banihashem S9, Tehran 16639; 2Shaheed Beheshti University,
Tehran; 3lran Medical University Tehran; 4 Tehran University Tehran, Iran
Objective: To identify simultanity of infection with HIV on one hand, and HBV,
HCV (as two predominant blood-born infectious agents) and syphilis (as one of
the most common STD) on the other hand.
Methods: In early of 1996, 400 injection drug users were randomly selected
from the population of 12000 addicted prisoners and underwent second generation
of ELISA (for HIV and HBV), ELISA III for HCV and VDRL and FTAabs for syphilis;
tests for HIV and syphilis were performed in Pasteur Institute (Tehran-lran) and
tests for HBV and HCV were done in Research Center for Gastroenterology and
Liver Diseases (Tehran-lran). A questionnaire was filled out according to given
history of each patient.
Results: The average age of samples was 34.2 years. The educational level
were mostly in the level of Primary and secondary school (68.4%). Most of addicts
were injection opiom (52.7%)(self made) and heroin users (34.8%). The history of
tatooing and hajamat (phlebotomy) were noted in 32.5% and 1.25%, respectively.
None of the samples were infected by HIV but VDRL, FTAabs (being coincident
with VDRL in 75% cases), HBSAg and anti-HCV were positive in 8%, 6%, 16.4%

and 45%, respectively.
Conclusion: This study had two intresting findings: 1) Although it is highly
possible that HIV co-transfer with HCV and HBV or through the involvement with
syphilis, all addicts who underwent this study were HIV negative; 2) Among the
injection drug users, the results of VDRL and FTAabs may falsly become positive.
However, in our study 6 percent of addicts were coincidentaly positive for VDRL
and FTAabs, a result being highly suggestive of true syphilis.