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

12th World AIDS Conference

Abstracts 12119-12123 35

such as CD4 cell count and anti-viral therapy, zinc deficiency and plasma copper/zinc ratio >1 were associated with higher HIV-1 related mortality (RR, 95%
Cl: 4.98, 1.30-19.0 and 8.28, 1.03-66.58, respectively). The risk of dying from
HIV-1 disease was reduced by 6% for every unit of increased plasma zinc (RR,
95% Cl: 0.94, 0.91-0.98). Neither copper deficiency nor plasma copper appeared
to be associated with HIV-1 related mortality.
Conclusion: Both plasma zinc deficiency and the plasma copper/zinc ratio may
be used as markers of survival in HIV-1 infection. Copper/zinc ratio, however,
was shown to be a stronger predictor.
S12119 1 CD4+ response within 6 months after HIV
seroconversion, 1987 to 1995
Philippe Vanhems. Centre Hospitalier Lyon-Sud, Unitd d'Hygiene, Epidemiologie,
et Information Medicale, Pavilion 1M, 69495 Pierre Bdnite Cedex, France
Objectives: There is some evidence that after HIV infection, progression to
immunodeficiency has accelerated (Weiss, 1992; Gorham, 1993). In order to
test this hypothesis, we compared CD4 Count (/mm3) at 6 months after HIV-1
seroconversion (n = 266) in relation to the year of seroconversion (SC).
Design: Patients free of antiretroviral drugs enrolled in the Swiss HIV Cohort
Study.
Methods: The proportion of individuals with a CD4 count <500/mm3,
<350/mm3 and <200/mm3 by year of SC were compared using the X2 for
trend. Adjusted linear regression analysis was used with the first CD4 count as
dependent variable and the year of SC as independent variable.
Results:
Comparison of proportion by year of SC
Year of SC N Days from SC Mean %CD4 < 500 %CD4 < 350 %CD4 < 200
to CD4 count of CD4

12121 Analysis of vitamin A and E plasma levels in HIV+
ex-homeless subjects living in a support house in Rio de
Janeiro, Brazil
Lucia Renata Meireles-de-Souza1, S. Silveira-Campos2, C.R. Soares3,
L.A. Diaz-Carneiro2, M.I. Linhares-Carvalho4, L. Trugo3, L.R. Castello-Branco5.
1Av Brazil Mangainhos, Rio de Jainero; 2Fio-Cruz-Banco Da Providencia, Rio
De Jainero, RJ; 3Dept. Biochemistry-IQ-UFRJ, Rio De Jainero, RJ; 4 Bancoda
Providencia, Rio De Jainero; 5Dept. Immulogy-Fiocruz-Bancoda Providencia,
Rio de Jainero, Brazil
Objectives: To evaluate the plasma levels of vitamins A and E in ex-homeless
HIV-1 infected and AIDS patients living in a support house and correlate to clinical,
immunological and nutritional data.
Methods: Fasting blood samples were obtained from 14 HIV+ male subjects
and 5 HIV-control men (all of them related no vitamin supplemental use) and
analysed by HPLC for vitamins A and E. These results were correlated to CD4
counts, disease stage, anthropometric measures and dietary intake.
Results: The vitamin A status of both groups was adequate. Vitamin E plasma
levels of HIV-infected and non-infected subjects were in the normal range, except
for one AIDS patient that presented vitamin E deficiency and was in the beginning
of tuberculosis treatment and on double therapy. All other patients were well
clinically and had been living in the house for at least 2 months where it was
offered them 6 meals a day. Seven patients on combined therapy presented
normal levels of vitamins and were well clinically with CD4 counts increasing and
viral load bellow 700 copies per ml.
Conclusion: We found that almost all the ex-homeless HIV+ subjects living in
the Support House presented adequate vitamin status, even though they denied
the use of vitamin supplements. More data is needed in order to understand
if the use of triple therapy may have some interference on the vitamin absorption/metabolism. We are now evaluating, prospectively, HIV+ outpatient groups
under triple therapy or not to test this hypothesis.

-1987-1988 40
1989-1990 90
1991-1992 75
1993-1994 40
1995 21

210
167
173
187
147

570
567
621
698
435

32
40
35
30
65

15
28
16
10
38

p = 0.31, p=0.87, p = 0.69.
The year of SC was not associated with the level of CD4+ count by linear
regression analysis (/ coefficient: -66 cell/y, 95% Cl -66 to +100, p = 0.28) after
adjustment on age, risk factor, days from SC to CD4 count, and city.
Conclusion: The proportion of patients who were immunosuppressed 6 months
after SC did not vary between 1987 and 1995. These data do not provide any
evidence that the natural history of early stage of HIV infection has changed
112120 Effects of oxandrolone on malnutrition in HIV-infected
children
Sarah Wheeler, M. Haight, L.S. Heller, M.L. Loro, F. Kaufman, C. Salata,
J.A. Church. Childrens Hospital, Los Angeles, 4650 Sunset Blvd., MS #75, Los
Angeles, CA 90027, USA
Objective: To evaluate the short-term safety and efficacy of oxandrolone (Ox) for
HIV-associated malnutrition in children.
Methods: Eight HIV+ malnourished children (4 F, 4 M) 4-14 yrs of age were
treated (Rx) for 3 mos with 0.1 mg/kg/day Ox orally: HIV RNA, CD4+ T-cell levels,
endocrinologic, studies; resting energy expenditure (REE), respiratory quotient
(RQ), nutritional measures, quantitative CT and skinfold body composition measurements were done monthly during Rx and for 3 months after Rx.
Results:

12122 Epidemiological and clinical characteristics of a cohort
of patients with advanced HIV infection, in Lima-Peru
Manuel Montoya1, Rosa Mostorino', C.S.R. Seas2, S.E. Echevarria2,
C.M. Magui2a2, E.G.H. Gutuzzo2. Universidad Peruana Cayetano Heredia,
Lima; 2 nstituto Alexander Von Humbolt, Lima, Peru
Objectives: To describe the demographic characteristic and diseases in patients
(pts) with HIV/AIDS and CD4 counts lower than 200 cell/dl who attended the Infectious Diseases Department of National Hospital Cayetano Heredia Lima-Peru.
Methods: Were included in the study patients 15 years old or older, with a
recently confirmed HIV infection who had a CD4 cell count lower than 200 at time
of diagnosis, who acquirer the diseases by sexual route, Who had no received
antiviral therapy.
Results: Between 1991 to 1997, 174 pts were included in the study: 137 were
males (79%), homosexuals 56 (41%), bisexuals 30 (22%) and heterosexuals 51
(37%). Mean age of the whole group was 37.4 years, alcohol and drug abuse was
observed in 76 (44%) and 53 (31%) pts. Pulmonary TB in 24 (14%) pts. HZ in 19
(11%) pts. STDS 26 (15%) pts. And wasting syndrome in 40 (23%) pts. Where in
the most common past infectious observed
Clinical stage at the time of diagnosis were: 86 (50%) pts. in the IVC (C3) and
35 (20%) were asymptomatic (A3). Mean CD4 cells counts was 113 cell/dl. By the
time of diagnosis of HIV infection 417 events were observed: Wasting syndrome
97, diarrhoea 94, PCP 37 pulmonary TB 27, disseminated TB 16.
Ninety-nine (57%) did not received antiviral therapy 57 (30%) pts. received only
drug, 12 (8%) pts. received 2 drugs and 9 (5%) pts. Triple therapy.
Mean of time for devolving AIDS were 16 months and death 40 month in pts
without antiviral therapy:
Conclusion: Advanced HIV infection in Peru affected principally homosexuals
young males. Tuberculosis is the most common diseases acquired in the past,
wasting syndrome and diarrhoea are the most common indicatives of diseases
stage and devolving AIDS or death in patients without antiviral therapy had a
short evolution.
S12123 Prevalence of HCV-infection compares to HBV-infection
among Ukrainian HIV-infected patients
Nelly Tchentsoval, Elena Maximenok1, L.O. Roschenko', K.F. Zelenetskya1,
A.D. Vovk2, S.N. Antonyak2, O.N. Kislykh1. 'Centre for AIDS Prevention 4
Protasiv Yar Uzviz Kyiv 252038; 2Research Institute Epidemiology and Inf Dis,
Kyiv 252038, Ukraine
Objectives: The existence of cofactors in development and dissemination of
HIV-infection, including HBV, is well known. The influence HCV as cofactor of
HIV-infection, from our point of view, is investigated insufficiently. The purpose
of the present research was comparative study of prevalence HCV and HBV
infection among HIV-infected IDUs and heterosexual, which were treated in clinic
of our AIDS Centre.
Design: Prospective study
Methods: The researches were carried out with use of the following tests-systems: ABBOTT AUSZUME Monoclonal, ABBOTT HCV 3.0, Monolisa Anti-HCV
(S.D.P.), UBI HCV EIA 4.0 (Organon Teknika). The HCV positive results were
confirmed by ABBOTT HCV EIA Supplemental Assay (ABBOTT), Deciscan HCV
(S.D.P.), LiaTek HCV III (Organon Teknika). 177 patient were investigated during

Weight (wt)
Height (ht)
Body Mass Index
Triceps skinfold (fat)
Fat area femur (CT)
Arm muscle area
Muscle area femur (CT)

After 3 Months on Rx (n = 8)
(mean ~ s.d)
+1.54 kg (~1.07)
+ 1.23 cm (~0.67)
+ 0.78 (~0.74)
-0.94 mm (~1.08)
-0.85 cm2 (~4.0)
+2.34 cm2 (~1.82)
+6.39 cm2 (-6.04)

After 3 Months off Rx (n = 6)
(mean ~ s.d)
+0.51 kg (~1.08)
+1.92 cm (~1.22)
-0.13 (~0.71)
+0.75 mm (~0.76)
+0.68 cm2 (~4.21)
-0.25 cm2 (~1.82)
-1.60 cm 2(~5.42)

HIV RNA and T-cells-did not change significantly. IgF and IgF1-BP3 increased
suggesting an anabolic effect of Rx. On Rx 5 of 8 pts had an accelerated wt
growth velocity and 6 of 8 pts had accelerated ht growth velocity. Off Rx 3 of 6
pts had decelerated wt growth velocity and 3 of the 6 pts continued accelerated
ht growth velocity. No adverse clinical events were noted. REE studies resulted
in an upward trend on Rx, with a decrease off Rx, which paralled the change in
muscle accretion. RQ remained within normal limits while on Rx and off Rx.
Conclusions: 3 mo Rx with Ox was well tolerated, safe, and was associated
with increased wt, ht, body mass index, muscle mass, REE, IgF, IgF1-BP3 and
decreased fat. Wt gains were maintained and accelerated linear growth continued
during the 3 months off Rx, although muscle mass was lost, REE declined and fat
was increased. The stable RQ suggests an improved utilization of calories during
Rx.