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

12th World AIDS Conference

Abstracts 41122-41127 767

Conclusion: All those positive for HIV-1 also had sexual contacts. Given the
prevailing risk factors (such as multiple, sex partners and homosexuality) among
these children, appropriate action needs to be taken now to stem the spread of
HIV infection among them, otherwise religious, cultural and socioeconomic practices/factors coupled with illiteracy and ignorance could conspire to compound
the problem of HIV epidemic in this particular sub population.
41122 Sensitivity of HIV-1 group M Western Blot for the
confirmation of HIV-1 group O infections, according to
different interpretation criteria
Charlotte Ngansop, Seraphin Kuate, L. Zekeng, M. Kengne, L. Kaptue.
Haematology-Imunology Laboratory, Chu Yaounde, Cameroon
Objective: To evaluate the sensitivity of HIV-1 group M (HIV-1/M) western blot
for the confirmation of infections with HIV-1 group 0 (HIV-1/0) using different
interpretation criteria
Methods: HIV-1/O confirmed sera collected at CHU Yaounde between
1994-1997 were used for the study. The confirmation was made by PCR, Innolia
HIV-1/O (Innogenetics, Ghent, Belgium) and HIV-1/O V3 loop EIA (Research tools
from Behringwerke, Germany). All the samples were tested using Western blot
(Novapath HIV1 Immunoblot, Biorad) according the manufacturer's instructions.
Five interpretation criteria (CDC, WHO, USFDA, CRSS, ARC) were used for the
evaluation of the sensitivity of Novapath vis a vis anti-HIV-1/O sera.
Results: A total of 85 anti- HIV-1/O positive samples were used for the study:

Interpretation Numbers of samples
criteria tested

CDC
WHO
USFDA
CRSS
ARC

85
85
85
85
85

Positive
64 (75%)
44 (52%)
59 (69%)
65 (76%)
62 (73%)

Western blot results
Indetermnate
15(18%)
32 (3%)
20 (24%)
14(16%)
17(21%)

Negative
6 (7%)
9 (11%)
6 (7%)
6 (7%)
6 (7%)

The sentivity of this western blot, for the confirmation of HIV-1/O positive samples was as follows: CDC (75%); WHO (52%); USFDA (69%); CRSS (76%) and
ARC (73%).
Conclusion: In areas where HIV-1/O is endemic, the use of Western blot 1 as
reference confirmatory test of HIV infection can cause problems in the diagnosis
of HIV infections. More comprehensive tools (sensitive and specific) should be
developped for this purpose.
41123 Prevalence and control of STDs/HIV among commercial
sex workers (CSW)
Jyotsna Shrestha', V.L. Gurubacharya2. 1Microbiologist, SACTS GPO Box
10959 Kathmandu; 2Consultant Pathologist Kathmandu, Nepal
Objectives: To improve STD case management and reduce the STDs/HIV transmission rate in a population known for risky sexual behaviour.
Method: 103 CSW in Kathmandu, Nepal, were interviewed and clinical examination was done by genaecologist. After precouncelling, samples for laboratory
investigations were collected for syphillis, HIV, HBaAg, N.gonorrhoeae & other
STDs. After post councelling free treatment were provided as per syndromic
approach and/or laboratory tests. Condoms were also distributed for promotion
and safer sex.
Results: Out of 103 CSW cases, positive finding are -
30 cases positive for Syphilis.
21 cases positive for HIV
9 cases positive for HBsAg
10 cases positive for N. gonorrhoeae
13 cases positive for T. Vaginalis
12 cases positive for C.albicans
Conclusion: The prevalence rate of STDs/HIV among CSW seems high. This
type of study will be helpful to monitor the STDs/HIV and readjusting public health
programme for prevention and planning of specific intervention for CSW with
more negative CSW will receive HIV from positive clients & from positive CSW,
clients will take HIV home to their spouse and new borns.
141124 Modifications in the DTH reaction in HIV-infected
individuals
Kamen Plochev. Doctor of Medicine, Centre of Immunology Military Medical
Academy 3, George Sofiiski Str Sofia, Bulgaria
Objective: A comparative analysis of the changes in the cell- mediated immunity
of HIV-positive persons was carried out, using in vivo method (multitest CMI) and
in vitro flow cytometric analysis of CD3+, CD4+ lymphocytes.
Materials & Methods: There are 78 adults who had been proved to be HIV-positive by the WB techniques and were tested for Delayed Type of Hypersensitivity
(DTH) with multitest CMI, which is a product of Merieux Institute, USA. Simultaneously, immunophenotyping of lymphocytes and their subpopulations, with the
purpose of evaluating the modifications in the cell-mediated immunity, was carried
out in vitro. Monoclonal antibody Anti Leu-4 monoclonal antibody Anti Leu-3a and
a FacSort flow cytometer were used for the purpose of the analysis.
Results: The following groups of patients were defined in correlation with the
CD4-lymphocytes count: I-st group - from 37% to 15%; II-nd group - from 15% to

7%; III-rd group - less than 7%. Different sensitivity towards the different antigens
was detected in these three groups of patients.
Conclusion: 1. The progressive immune deficiency, interpreted on the basis
of percentage of CD4+-T lymphocytes in the contingent we examined does not
have the nature of a gradual process. It is characterized by three discreet groups.
This fact allows us to define three phases of the disease. 2. The dermal multitest
carried out by means of a plastic applicator is a productive and reliable method
of information as to the aggravation of the immune deficiency. That is why we
reccommend its use in routine clinical practice.
41125 Evaluation of a fast method (Hivsave) for serologic
diagnosis of HIV-1 and 2
Draurio Barreira1, G. Silval, H.M.V. Oliveira', Y. Bravin2. 'Health Secretariat of
the City of Rio De Janeiro, rua Casuarina, Humaita, Rio De Janeiro; 2Central
Laboratory Noel Nutels, Rio De Janeiro, RJ, Brazil
Objective: To evaluate the usefulness of a fast serologic method for diagnosis of
HIV 1 and 2 among tuberculous (TB) patients in the routine of the Health Public
Units in the City of Rio de Janeiro.
Design: Cross sectional study.
Methods: 396 patients from 18 health care units with tuberculosis had their
sera tested with the kit Hivsav", for fast detection of HIV 1 and 2 in the health
unit, in the moment they started their TB treatment. All samples were after sent
to the Central Laboratory and tested with ELISA method and the positive results
were confirmed by Western Blot. This result was considered the "gold standard".
Results: From the 396 results, 44 were positive (11.1%) and 352 negative
(88.9%) with the fast test. With the other test we found 39 (9.8%) positive samples and 357 (90.2%) negative. The concordance was 97.7%, the co-positivity
94.9% and the co-negativity 98%. The confidence interval was 86.8-100% (p <
0.05).
Conclusion: This tests showed high concordance and co-negativity, and the
co-positivity, although significant, must be considered if the purpose is to find out
all HIV+ patients among TB patients in order to get maximum benefits from early
starting of anti-retroviral drugs and other procedures. In the routine it showed
great practical value being so fast, while the result of the traditional method needs
about 30 days to be ready.
|41126 Immunological monitoring in HIV-infection
Yuri Mitin, E.I. Zmushko, A.N. Malkov. Lebedeva Str. 6 Saint-Petersburg 194044
AIDS Department, Military Medic. Academy, Saint-Petersburg, Russia
Immunological monitoring has showen the changes in immune system of 208
infected persons during the development of HIV-infection. In addition to well
known tests (T and B - lymphocyte subpopulations - CD3+, CD4+, CD8+,
CD19+, CD2-DR, NK-cells) level of gp120+ and p24+ HIV-infected lymphocytes, katabolic products of DNA, enzyme activity based on metabolic cycles in
lymphocytes - lactate dehydrogenase (LDG), succinate dehydrogenase (SDG),
superoxyde dismutase (SOD), nicotinamide adenine dinucleotide oxydase (NAD)
- were examined. Main indices in blood serum vary as follous: number of NK-cells
(0.31 x 109/1), level of cation proteins (1.58 + 0.13), katabolism DNA products
(82.3 + 4.61), cell receptors (14.22 + 0.61 log2). Enzyme activi ty in lymphocytes (LDH, SDH, NAD, SOD) correlates with changes in T and B-lymphocyte
subpopulations levels.
The immunological (lymphocyte gp120+ and p24+), immunogenetic (DNA products degradation) and metabolic (SDG, LDG, NAD, SOD level) criteria can be
additionaly used as diagnostic and prognostic tests of HIV-infection.
41127 Field evaluation of the HIV-1 Amplicor Monitor and
NucliSens quantitative HIV-1 RNA PCR assay in persons
infected with HIV-1 subtype A in Abidjan, C6te d'lvoire
John Nkenga Song', M. Kalou1, C. Bile', M.Y. Borget', M. Morokro,
E.R. Ekpini', P. Ghys', A.E. Greenberg2, S.Z. Wiktor2. 101 BP Abidjan 01,
Project Retro-CI, Abidjan, Cote D' Ivoire; 2Centers for Disease Control and
Prevention, Atlanta, GA, USA
Objective: To assess the performance of the standard and modified Amplicor
Monitor (Roche Diagnostics) and NucliSens (Organon Teknika) assays for the
quantitation of HIV-1 RNA viral load in persons infected with HIV-1 subtype A in
Abidjan.
Methods: Plasma samples were obtained from 54 HIV-1 seropositive individuals including 30 tuberculosis patients, 17 female sex workers, and seven pregnant
women. HIV-1 genetic subtyping was performed either by a restriction fragment
length polymorphism (RFLP) assay or by sequencing of the C2-V3 region of the
env gene. Plasma HIV-1 RNA levels were quantified by the NucliSens assay and
by both the standard and modified Amplicor HIV-1 Monitor test. The modification
consists of adding 20 p/ of a new primer set (Primer Mix 1, Roche Diagnostics)
into the master mix prior to amplification.

Results: Of the 54 persons, 53 (98%) were subtype A and one was subtype
G. Of the 53 subtype A samples, 34 (64%) were positive in the standard Amplicor
monitor, 41 (77%) in the NucliSens, and 51 (96%) in the modified Amplicor assay.
In concordantly positive samples, viral load was significantly higher in the modified
than the standard Amplicor assays (n = 34, mean logio HIV-1 RNA ~ standard
deviation [SD], 5.17 ~ 0.92 vs 3.8 ~ 1.01; paired t test, p < 0.001), and in the
modified Amplicor compared with NucliSens assay (n = 41, mean loglo HIV-1