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

12th World AIDS Conference

Abstracts 60854-60859 1157

is possible and critical to understanding HIV epidemic dynamics and shaping
behavioral interventions.
60854 1 Analysis of the HIV RT resistance profile of patients
receiving AZT and either 3TC, ddl or ddC using LiPA
HIV-1 RT assay
Fran Sheridan1, S. Rusconi2, S. La Set-Catamancio2. 1Murex Biotech Limited,
Central Road, Dartford, France; 2Universita Di Milano, Osepedale Luigi Sacco,
Milan, Italy
Background: The Murex-lnnogenetics LiPA HIV-1 RT assay can be used to identify the presence of mutations of the reverse transcriptase gene at codons 41, 69,
70, 74, 184 and 215 of HIV-1, which have been shown to confer resistance to nucleoside analogs. The M184V mutation of the reverse transcriptase gene of HIV-1
has been associated with resistance to 3TC, ddC and ddl. We used the LiPA assay
to assess the AZT resistance profile of patients receiving AZT with either 3TC,
ddC or ddl as dual therapy and also to identify the presence of either consensus
methionine 184 or the mutant valine 184 with these three groups of patients.
Methods: The study group consisted of thirty-one patients, eighteen of whom
received AZT + 3TC dual therapy, seven received AZT + ddl and six received
AZT + ddC therapy. These patients were considered to be failing current therapy
on the basis of their clinical symptoms, viral load and CD4 count.
Results: The M184V mutation was observed in 38.9% (7/18) of patients receiving AZT/3TC combination therapy. Two patient samples failed to produce a
signal at the codon 184 probe. The M184V mutation was not observed in either
patient group receiving ddl or ddC as co-therapy with AZT although these patient
groups are relatively small. The AZT reverse transcriptase profile was similar
among the three therapy regimens. There was a high incidence of the T215Y and
M41L mutation in the three therapy groups. However the prevalence of the K70R
mutation was significantly higher when patients were treated with either ddl or
ddC as co-therapy with AZT when compared with patients on AZT/3TC.
Conclusions: We did not detect the presence of the M184V mutation in patients treated with AZT/ddl or AZT/ddC dual therapy. This may be due to the
limited number of patients profiled. We found the incidence of the K70R mutation
to be higher with patients treated with AZT/ddl or AZT/ddC when compared with
patients treated with AZT/3TC. This may suggest a difference in the selective
pressure on virus treated with ddl or ddC as co-therapy compared with 3TC as
co-therapy.
S60855 STD: Medicines logistic - Santos experience
Aurelio Amparo, R.T.M. Noguera, M.G.A. Alvarez. Programa Municipal de
DST/AIDS, Santos, SP Brazil
Issues: To raise/evaluate medicine distribution situation STD standardized by
Santos health utities.
Project: 22 health unities drugstores have been visited at the municipal net
and central store houses and the employees who provide medicine release were
interviewed, to evaluate the procedures and acknowledge distribution control
methods. The process has been analysed as: a) medicine release register; b)
storage control method; c) consume prediction, requisition, maximun storage,
STD medicine limit balance.
Results: 41% professionals who execute drugstore fix activities are nursing
assistants who are function deviated, 52% perform multiple activities inside the
unity. In the majority the unities register medicine release through prescription
(2ns copy), 16% register on notebooks or formats, 25% are registered according
unity convenience. In 55% of the unities the nursing assistents orient about correct
usaage of medicine, 21% is realized by the nurse and 24% by the doctor.
Lesson Learned: Observing this situation, we can conclude the suitabletraining is required to professionals who act in the drugstores and perform exclusive
orientation function of pharmacist to orient and eliminate remaining doubts.
S60856 Destined to do much more
Josefina dela Cruz1, I.F.F. Fonacier-Fellizar2, O.T.M. Monzon3. 1533 United
Nations Avenue Manila 1000; 2Children's Laboratory Foundation Inc Quezon
City; 3AIDS Society of the Philippines Manila, Philippines
Issue: Secretariats of international and national conferences and gatherings can
be a strategic point for Advocacy. Community Organization, Social Mobilization
and Role-model of Public Relations in the field of HIV/AIDS.
Project: Secretariats have long been stereotyped as doing the clerical and
"dirty jobs" for organizers and participants. Indeed, many has remained locked
up in that cell. However, for the 4th International Congress on AIDS in Asia and
the Pacific, the secretariat personnel, who were experienced HIV/AIDS workers,
turned the whole affair into a full0blast Advocacy for HIV AIDS Prevention, Treatment, Care and Support. From planning till the next conference, a conscious
effort to pursue the mission of the work was implemented.
Results: A quick response mechanism for HIV/AIDS Workers, Communities

and Volunteers was defined; Social mobilization of hundreds of organizations
and individuals representing different sectors of the Society was achieved. Most
significant, provided the venue for exchange and participation of certain sectors
which have been antagonistic or agonized by HIV/AIDS such as the Church and
the Conservatives.
Lessons: Advocacy for HIV/AIDS Prevention, Treatment, Care and Support is
a way of life that workers in the field should continuously pursue wherever they

may be and whatever role they perform at that point in time. The Secretariat or
similar set-ups can be turned into a power pack intervention venue.
60857 Counselling in reproductive health among young people
in the shitta community, Lagos State
Magdalene Mfon Ita. 14, Adebola Street, Off Adeniran Ogunsanya Street,
Surnere, Lagos, Nigeria
Objective: To eradicate ignorance among the youth and empower them with
adequate information about their reproductive health.
Design: Counselling and visitation.
Method: Counselling booths/centres were erected at strategic locations of the
community Peer Health Educators (PHEs) and Reproductive Health Counsellors were available 9 hours, 6 days of the week and disseminated information
on issues concerning their reproductive health (RH). This entails education on
HIV/AIDS, sexually transmitted diseases or infections (STDs or STIs) female
genital mutilation, early marriage, teenage pregnancy, use of contraceptives with
emphasis on proper use of condom. To promote information dissemination to
all nooks and crannies of the community, PHEs carry out house to house visits
and work place visits. Distribution of information, education and communication
(IECs) materials to youths to further armed them with more knowledge on their
RH and sales of condoms was effective in attracting youth for counselling.
Results: Within the period of 12 months 971 youths were counselled and
visited. 963 condoms were sold and over a thousand freely distributed.
Conclusion: Counselling on RH has brought about an amazing increase in the
number of youth willing to live risk behaviour free lives, the sales of contraceptives mostly condoms and a decrease in the number of cases of HIV/AIDS/STDs,
teenage pregnancy and abortion among the Shitta youths. However, as a result
of the population a lot of youth remained unreached in the untouched grounds of
Shitta and its environs.
S60858 Multinational study for the preventive therapy of latent
tuberculosis in HIV positive individuals: Isoniazid vs.
rifabutin
Alberto Matteelli, G. Carosi, L. Signorini, A. Tebaldi, S. Caligaris, M. Gulletta.
Clinic Infectious Diseases Piazza Spedali Civili & 25125 Brescia, Italy
Background: Potential problems with INH for preventive therapy of latent tuberculosis infection in HIV positive patients include decreased compliance, adverse
events, and failure to prevent disease due to INH-resistant organisms. A controlled, double-blind, randomised, multinational study comparing isoniazide (INH)
300 mg daily for 12 months Vs rifabutin (RBT) 300 mg daily for 3 months for the
preventive therapy of latent tuberculosis in HIV-positive individuals was launched
in 1995.
Objectives: to demonstrate the equivalent efficacy and to measure tolerability
of the two treatment regimens.
Patients and Methods: This is a Phase III, multicentre, randomised, double blind, two arm comparative trial. Recruiting centres were located in North
America, Latin America, Africa, Far East, and Europe. A positive tuberculin skin
test and documented HIV infection were the major eligibility criteria. Enrolled
subjects received INH or INH placebo for 12 months and RBT or RBT placebo
during the first three months. A follow-up period of 24 months was planned. The
primary endpoint was the time to development of active tuberculosis. Clinical and
laboratory examinations performed during drugs administration were used for the
safety analysis.
Results: From October 1995 to April 1995 628 patients were enrolled. Since
this represented only 33% of the 1880 subjects expected by that date and required
to demonstrate the equivalent efficacy of the two drugs, the study enrolment was
terminated in August 1997. Follow-up of recruited patients was also cut at the
end of treatment as it was calculated that a period of 5 years would still be
insufficient to provide enough events for statistical analysis of efficacy. At August
1997 107 (17%) of enrolled patients discontinued treatment, of whom 5 developed
active TB. Analysis of reasons for discontinuation and adverse events is being
completed.
Conclusions: Difficulties in identification of dual infected subjects, interaction
with protease inhibitor antiretroviral drugs, and declining interest on TB prevention in northern countries contributed to the early termination of this multinational
study. The equivalence between RBT and INH for preventive therapy of latent TB
in HIV positive patients will not be demonstrated. However, the study will provide
valuable comparative data on compliance to treatment and occurrence of adverse
events.
60859 Incidence of mycobacterial infections among HIV positive
subjects: 1988-1997
Enrico Bombana, S. Tedoldi, D. Ripamonti, G. Chatel, A. Beltrame, I. El-Hamad,
C. Scolari. Clinica Malattie Infettive Tropicali Piazza Spedali Civili N 1 25125
Brescia, Italy

Objective: To describe annual trend of incidence of tuberculosis (TB) and disseminated Mycobacterium avium infection (DMAC) among HIV positive subjects.
Methods: The clinical charts of all HIV infected subjects regularly followed up
at the Clinic of Infectious and Tropical Diseases of the University of Brescia, Italy,
during the period 1988-1997 were reviewed. For incidence calculation subjects
were included in the denominator if they attended the outpatients departments at