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

12th World AIDS Conference

Abstracts 31218-31222 539

Results: In group 1, the median initial plasma HIV RNA was 62.0 loglo copies/ml
and the median initial peripheral CD4+ cell count was 42.7 ~ 45.4/mm3 (range
12-522) (P = ns vs. groups 2, 3). After one year of HAAT the median plasma HIV
RNA was 2.5 logio copies/ml (P < 0.01 in respect to baseline determination) and
the median CD4+ cell count was 112.2 ~ 71.6/mm3 (p < 0.0001 in respect to
baseline determination; P = ns vs. group 4). We observed 39 pts (42%) with OC
out of 93 pts selected for the study (2 pts with one and 37 with more than one OC
episode). Only 2 pts from group I developed OC at 26 and 35 days, respectively.
At the end of the follow up, 12 pts in group 2 and 11 in group 3 suffered from OC.
Based on these data, the cumulative rate of developing OC after 12 months from
the beginning of the study was 7% in group 1, 57%, and 78% in groups 2 and 3,
respectively (P - 0.001, Mantel Cox). Also if we only consider patients of groups
1 and 4, a significantly higher frequency (32%) of OC was observed in non-IP
treated patients (P < 0.001, Mantel Cox).
Conclusion: HAAT has resulted in a marked decrease in the incidence of OC
in HIV+ pts. This result appears not completely dependent on the number of
CD4+ cells, since the patients have been matched for CD4+ cell number at the
beginning and 6 months after HAAT. Also in the light of recent in vitro and in
experimental candidosis results obtained by our group, an antifungal effect of IP
should be postulated.
31218 Clinical and biological study of superficial mycoses in
AIDS patients in Yaounde
Julienne Petmy Lohoue1, Kaptue Lazare 2, Folefack Temfack Medard3,
Leopold Zekeng3. 1Laboratoire de Mycologie PO/Box 668 Yaounde;
2Sidalerte/Cameroon Yaounde; 3CHU Service Hematologie Yaounde, Cameroon
Objectives: To determine the mycotic nature of superficial lesions in HIV infected
patients.
Design: Cross-sectional, descriptive study.
Methods: This involved consecutive sampling of all HIV positive patients (confirmed by Western Blot) with superficial lesions and who agreed to enter the study.
Specimens taken included swabs of wet lesions scrapping from the skin and nails.
These were analysed in the laboratory by the following procedures: direct microscopic examination in 30% potassium hydroxide or cotton blue; culture on
sabouraud's agar containing chloramphenicol and/or actidion;identification of isolates basing on their macroscopic, microscopic and/or physiologic characteristics
(in human scrum, PCB-medium and Api20c medium).
Results: 74 patients were recruted, including 42 males and 32 females. Their
ages ranged from 18 to 63 years. A total of 91 lesions were observed and the
accompagning symptoms included Prurutis (49.45%) burning sensation (20.88%)
and dysphagia (15.38%). Laboratory analysis confirmed 46 of these lesions as
fungal in origin. Dark onyxis was the lesion most encountered amongst onychomycosis. A global infestation rate of 52.7% was recorded and the stage of HIV
infection did not influence the infestation. The isolates comprised of 41 strains
including 29 (70.73%) yeast, 9 (21.95%) dermatophytes, 2 (4.88%) strains of
Hendersonula toruloidea and 1 (2.44%) strain of Cladosporium sp. The most
common yeast was C. albicans (72.41%) followed by C. guilliermondii, and G.
candidum (6.9%), C. parakrusei (3.45%) Trichophyton rubrum was the most
commun dermatophytc (77.78%) followed by T soudanense (22.22%).
Conclusion: The fungal flora found in skin lesions includes yeasts, dermatophytes and rare fungal strains like Hendersonula toruloidea and cladosporium
sp.
31219 Use of eubiotics and carbohydrate-containing bacterial
biopolymers for anti-candidiasis vaccines construction
Svitlana L. Rybalko1, A.W. Shapiro Anatoly1, N. Antonjak Svitlana1, T. Dyadun
Svitlana', B. Sorokulowa Irina2, F. Grytsak Tanja1, P. Selnikova Olga1. 'Institute
of Epidemiology and Infective Diseases, Kruglouniversitetskaja Str. 14, flat 19,
252024 Kiev, 2Institute of Microbiology and Virology of Academy of Sciences,
Kiev, Ukraine
Objectives: To study the anticandidiasis vaccines (ACVs) effect in experimental
systems and in HIV-infected patients.
Design: Clinical study of ACVs.
Methods: Polyvalent corpuscular ACVs were used obtained by subcutaneous
rabbit immunization (the suspension containing 109 cells/ml was injected with
daily intervals during three weeks, the doses increasing from 0.3 ml up to 1 ml per
animal). Two eubiotics, biosporin and subalin, as well as carbohydrate-containing
biopolymers (CCBBs) (200 p/g/dose) from eubiotic culture media were used as immune response activators. The AIDS patients with different candidiasis conditions
(heavy Candida albicans infection of oral cavity, enteric and broncho-pneumonic
diseases) were treated.
Results: Our data suggest the high stimulating effect of eubiotics (biosporin
and subalin) on anti-candidiasis IgM and IgG synthesis (1:1,280-1:320) and their
prolonged circulation. The highest effect was found with an eubiotical CCBB, the
IgM and IgG levels, respectively, having been 1:40,960 and 10,240 on the 5th
day p.i., 1:20,480 and 1,5120 in two weeks, 1:5,120 and 1,2560 in a month; in

3 months the IgG concentration was also high. The effectiveness of Candidainfected AIDS patients treatment was rather high, being, however, dependent on
immune system suppression level.
Conclusion: The CCBB of eubiotic origin possess the marked adjuvant properties. The use of these substances together with the ACV favors the development
of anti-Candida antibodies production in AIDS patients.

31220 Extrapulmonary dissemination of Pneumocystis carinii in
immunosuppressed rats during acute PCP
Chiara Atzori, Elena Angeli, F. Agostoni, A. Mainini, L. Drago, M.R. Gismondo,
A. Cargnel. 2 Dept of Infect. Diseases, Sacco Hospital Via G.B. Grassi 74,
20157 Milano, Italy
Objective: The occurrence of P carinii blood dissemination and extrapulmonary
localisation in lymphoreticular tissue during acute PCP was studied in immunosuppressed rats by using ITSs nested PCR.
Methods: 51 dexamethasone immunosuppressed, originally certified P carinii
free, Sprague-Dawley female rats were transtracheally infected with 5 x 105/ml
rat-derived P carinii trophozoites. Weekly, rats were sacrificed by intracardiac
exanguination. Blood (for serum, plasma and PBMC), lungs, liver and spleen
were carefully collected for PCR analysis. Lungs were also morphologically examined after Giemsa staining. 6 rats, after 6 weeks of immunosuppression, were
treated with subcutaneous cotrimoxazole (120 mg/Kg/die). They were sacrificed
at different times during specific chemotherapy and samples were collected and
processed as previously described.
Results: PCR analysis with ITSs primers revealed the presence of P carinii
DNA in 74.5% of immunosuppressed rats on lungs, in 22.2% on liver and in 11.1%
on spleen. P carinii DNA was also detected in 14.3% of rats on PBMC samples.
All sera and plasma samples collected resulted negative after ITSs nested PCR.
In 6 treated rats, we analysed P carinii DNA clearance during therapy from lungs
and blood compartment: after 1 week of therapy, we detected the presence of
P carinii DNA only on lungs, while after 3 weeks PBMC samples were P. carinii
DNA positive and lungs became negative. After 4 weeks of therapy, we did not
detect the presence of P carinii DNA either on lungs or on PBMC samples.
Conclusions: Our observations suggest that extrapulmonary P carinii dissemination in lymphoreticular tissue can spontaneously occur in immunosuppressed
rats during acute PCP and it does not seem to be exclusively related to subsequent specific chemotherapy. Differently from our data on specimens from AIDS
patients with PCP, plasma and sera samples were repeatedly negative in the
experimental rat model.
Supported by grant ISS-AIDS IX Project 1996 9404-05
31221 Molecular phylogeny of microsporidia including species
infecting HIV-infected patients
Caspar Franzen, A. MOller, P. Hartmann, G. Fatkenheuer, V. Diehl,
B. Salzberger. Department of internal medicine I, University of Cologne
Joseph-Stelzmann Str. 9, 50924 Kdln, Germany
Objectives: Taxonomy of microsporidia is still controversial and the four major published classifications differ significantely. We performed a phylogenetic
analysis of the small subunit ribosomal DNA (SSU-rDNA) of a broad range of
microsporidia including five species infecting HIV-infected patients.
Methods: DNA sequences were obtained from Genbank or the EBML database.
The sequences were aligned on a personal computer using ClustalW and edited
by hand. Phylogenetic analysis were based on comparison of -1200 sites that
were judged to be in alignment. Alignment files were analyzed and phylogenetic
trees were constructed by different algorithms: maximum parsimony, compatibility, maximum likelihood, and distance methods (PHYLIP version 3.57c). All trees
were calculated with a random order of addition of sequences using the jumble
option in order to increase the probability of finding the shortest or most likely
tree. Bootstramp values for the dendrogramms generated were obtained from
100 resamplings.
Results: The figure shows the consensus tree found using DNAPARS from
100 resamplings, using ten differnet orders of addition of species during each
run. Thermoplasma acidophilum was used as outgroup.
Conclusion: The tree presented here shows the relationship calculated for
the SSU-rDNA of a larger number of microsporidia than have previously been
included in a molecular based tree. The species infecting HIV-infected patients
are located in the Encephalitozoon group (E. hellem, E cuniculi, E. intestinalis) or
in the Endoreticulatus group (E. bieneusi, V corneae).
31222 Stool pathogens in diarrhoea associated with HIV illness
and importance of cryptosporidium - A 7-year study in
Calcutta, India
Parthajit Banerjee', T. Chakrabarti2, K.L. Banerjee3. 1Div. of Parasitology School
of Tropical Medicine Chittaranjan Avenue, Calcutta; 2School of Tropical
Medicine, Calcutta; 3Calcutta Medical College, Calcutta, India
Objective: To assess the prevalence of Cryptosporidium in relation other intestinal
pathogens in HIV patients.
Design: Controlled study.
Methods: The study spans over a period of 7 years (August '90 to Dec. '97) and
was undertaken in School of Tropical Medicine, Calcutta, India. Stool samples
from 141 seropositive, 83 AIDS cases and 25 each from healthy individuals and
immunocompromised subjects were examined. Samples were collected in sterile

containers and transported to the laboratory. Conventional methods were used
to detect Intestinal protozoa, Cryptosporidium, Isospora, Helminths, Bacteria and
Fungii.
Results: Out of 141 HIV seropositive cases, 9 were diarrhoic of which Cryptosporidium was isolated in 7, Giardia in 1 and E.coli in 1 case. Out of 83 AIDS
cases, 30 were diarrhoic, of these 18 were due to Cryptospoidium, 6 Cryptosporidium and Candida, 2 Cryptosporidium and Hookworm with Trichuris, 2 Candida