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

12th World AIDS Conference

Abstracts 41164-41168 775

propagation of the viral clones in HeLa 4.5. cells which express CD4, CXCR4
and CCR5 but not LTR-/-Gal.
Conclusion; we established MAGIC-5 cells stablely expressing CD4, CXCR4,
CCR5 and tat-driven LTR-i-Gal. This cell line has versatile properties for infectivity
assay, isolation and cloning of HIV-1, HIV-2 and SIV.
41164 Plasma concentrations of IL-16, but not of 3-chemokines
change uniformly during triple combination-therapy of
HIV-1 infection
Klaus Cichutek1, P. Muller1, M. Engelstaedter1, S. Staszewski2, V. Miller2,
H.W. Doerr3, R. Kurth1. 1Paul-Ehrlich-lnstitut; Paul-Ehrlich-STR.51-59; 63225
Langen; 2Univ. Clinics, J. WG.-University Frankfurth/M.; 3Dept. of Virology,
J. W. G.-University Frankfurth/M., Germany
Aims: To analyse possible changes in the plasma levels of MIP-1I, RANTES
and interleukin(IL)-16 during anti-retroviral chemotherapy in relation to known
surrogate markers of therapy efficiency.
Patient cohort: Plasma levels (ELISA) were monitored in 21 patients undergoing anti-retroviral chemotherapy (3TC+AZT versus protease inhibitor (indinavir)
versus triple combination including indinavir).
Results: 36 weeks after initiation of therapy a 0.7 log (mean) decrease of
the virus load was observed in eight patients receiving the two nucleoside analogues. IL-16 concentrations decreased 6-fold, paralleled by a 50% decrease of
the mean MIP-1/ plasma levels. In the plasma of 6 patients undergoing indinavir
monotherapy, no uniform changes were observed. All 7 patients receiving triple
combination therapy showed a pronounced decrease of the virus load. Surprisingly, the IL-16 concentrations showed a uniform (3-fold mean) increase until
week 12 after initiation of therapy, followed by a decrease to levels below the
concentrations measured before initiation of therapy. This was paralleled by a
mean 1.5-fold increase of the MIP-1/ levels during the first 12 weeks of therapy,
followed by a drop to levels near baseline. Changes of the RANTES plasma
concentrations were not uniform.
Conclusion: In conclusion, triple chemotherapy including a protease inhibitor
was found to be associated with a uniform increase of the IL-16 plasma concentrations followed by a decrease to levels below the concentrations measured
before initiation of therapy.
Supported by grants #01 KV 9550 and #01 9406 KI of the BMBF to K.C.
41165 Evaluation of Western Blot criteria for confirmation of HIV
antibodies in saliva and urine specimens
Prudencio Martinez, R. Ortiz de Lejarazu, J.M. Eiros, A. Rodriques-Torres. Serv
Microbiologia Hosp. Universitario Ramon Cajal no3, Valladolid; Hospital
Universitario, Valladolid, Spain
Background: Saliva and urine had been used for HIV screening antibodies in
epidemiological studies. The volume of those samples that can be collected
allows the confirmation by Western blot (WB). There are several confirmation
criteria (FDA, CRSS, CDC, ARC and WHO) for serum WB but no one formally
accepted for other biological fluids such as saliva and urine.
Objetives: The aims of this work was to evaluate different WB serum criteria
for confirmation of HIV antibodies in saliva and urine samples.
Methods: One hundred and ninety paired samples of saliva and urine were
collected from 190 individuals at different stages of HIV infection, a WB (Bioblot
HIV-1 plus, Genelabs Diagnostic, Switzerland) was performed on each of those
samples.
Results: Two salivas and five urines meet only one criterion, 122 salivas
(66.7%) and 114 urines (61.6%) meet all the criteria applyed. Sensitivity results
of applyed criteria for saliva were as follows: WHO (100%), CDC (96.2%), CRSS
(94.6%), ARC (78.1%) and FDA (66.7%). For urine samples were WHO (96.8%),
CDC (91.4%), CRSS (89.7%), ARC (70.8%) and FDA (61.6%).
Conclusions: Saliva and urine can be alternative fluids to serum for HIV
antibodies confirmation in the context of epidemiological studies. The WHO criterion (at least two gp bands) is the most sensitive and could be proposed for
confirmation of HIV antibodies in saliva samples.
41166 WHO recommendations for HIV testing strategies:
Experience of Mozambique
Guillaure Guiraud1, R. Bastos2, S. Tembe3, E.V. Chicoville3, J.F. Langa4.
1Conissio Sida-Hospital Central Av. Agostinho Neto; 2Medico STD's Maputo;
3Technician, Maputo; 4Biologist, Maputo, Mozambique
Introduction: In Maputo, HIV prevalence is about 7%. The routine HIV antibody
screening test use for diagnosis one ELISA test and two different rapid test
following the WHO recommendations (March 1997). Due to poor conditions at
this moment at the province or district level, blood is not always analyzed as
precribed by WHO algorithms.
Objectives: To evaluate the performance of WHO recommendations for HIV

testing strategies for diagnosis in Mozambique and find an emergency alternative to assure the best results for the laboratories with scarcity of technical and
financial resources.
Method: A total of 223 positives sera were collected from different adult population groups in the blood bank of Maputo. 47 sera were from blood donors and
176 from patients hospitalised. All of them, positive with ELISA test (Genelavia
Mixt, SANOFI) and HIV SPOT (Genelabs) were tested with two other rapid test:

Capillus (Cambridge Biotech) and Multispot (SANOFI). 36 sera of them were
controled by Western Blot (HIV Blot 2.2, Genelabs).
Results: All specimens were positive for at least 3 tests and all 36 controls
sera were positive in Western Blot. With Capillus, 3 specimens were founded
negatives, one from blood donor and 2 from patients. All samples were reactive
in Multispot and those which were reactive for both HIV1 and HIV2 (or only for
HIV2) were confirmed in Western Blot. The results showed 218 HIV1, 4 HIV2 and
1 HIV1 and 2. Because of all samples were positive for at least 3 tests, we can
consider this 223 sera as positive against HIV antibodies.
Discussion: Because of the high specificity of HIV Spot and the high sensibility
of Genelavia Mixt, we preconise: (1) to use those 2 tests to give a positive result
for HIV for asyntomatic patients even if the prevalence is below than 10%; (2) at
the district level, to give a positive result for a syntomatic patient with only one
positive HIV Spot test with prevalence >15%. This alternative is a temporary solution before define a global strategy of blood bank organisation specially oriented
to the centralisation of technical and staff resources.
41167 Hairy leukoplakia: A clinical, histological, cytological and
immunohistochemical study
Arley Silva Junior, E.P. Dias, S.M.S. Ferreira. UFF UGF UFRJ Grupo Pela
Vidda, Rio de Jainero, RJ, Brazil
Objectives: To investigate clinical, histo and cytopathological and immunohistochemical aspects of oral lesions suggestive of Hairy Leukoplakia (HL). Verify the
hypothesis of histo and cytopathologic criteria for HL diagnosis and the value of
cytopathology technique in HL diagnosis.
Methods: A total of 26 HIV+ patients with HL were studied. Clinical HL diagnosis was based on literature criteria. Histopathologic samples were stained with
haematoxylin and eosin and the following aspects were examined: parakeratosis, acanthosis, ballooning degeneration cells (BDC), inflammatory infiltrate (II)
and nuclear changes as cow-dry A (CA), ground-glass nuclei (GG) and nuclear
beading (NB). PAS stain was used for Candida sp. (Csp) identification and an
immunohistochemic for EBV. A PAP stained was used in cytologic samples and
the following features were examined: epithelial cells arrangement, orangeophilic
cells, Csp and nuclear changes as described above.
Results: In 100% HL occured in the lateral border of the tongue, and most
lesions were flat and small. In most cases parakeratosis and acanthosis were
mild. In 73% BDC were arranged in tiers, 47% present Csp and 33% were noted
II. Nuclearchanges were found in all histologic samples. CA was present in 93%
and 67% in BDC and intermedia layers. NB was present in a 100% and 27% within
the parakeratotic and BDC layers. The GG was found in a 100% of BDC and
intermedia layers. Immunohistochemistry was not positive in one case because
the sample was improper. At cytology smears cells distribution were grouped in
67%, in 80% a highly orangeophilic cells were found and Csp was noted in 67%
of the cases. Nuclear changes were seen in all cases. NB was identified in all
cases and in 80% was numerous, GG and CA were not seen in 13% and 27% of
the cases. Nuclear changes were not seen at control group.
Conclusion: HL was commonly seen as flat and small. HL was frequently found
in the lateral border of the toungue. Immunohistochemistry shows to be a satisfactory tecnique. Considering nuclear changes both cytology and histopathology
are a reliable methods for the diagnosis. According with the importance of HL we
should consider cytology technique as a method of choice.
S41168 False positive enzyme-linked immunosorbent assay for
HIV in persons with autoimmune diseases and
macroglobulinemia
Lawrence A. Cone1, R.G. Byrd2, J.N. Hirschberg2. 139000 Bob Hope Drive,
Probst #308, Rancho Mirage, California 92270; 2Eisenhower Medical Center,
Rancho Mirage CA, USA
Objectives: Although the newer enzyme-linked immunosorbent assay (ELISA)
screening tests for HIV have excellent sensitivity and specificity, false positive
tests have been reported in patients who undergo immunization, experience DNA
viral infections, or have autoimmune disorders, alcoholic hepatitis or hemopoetic
malignancies. We recently reviewed our experience with false positive ELISA
tests for HIV.
Design: A retrospective review from 1992-1997.
Methods: The HIV ELISA assay utilized was the Abbott recombinant HIV-1 and
HIV-2 methodology. Routine screening of all pregnant women and preoperative
testing of all patients scheduled for cardiovascular or orthopedic surgery was
undertaken at Eisenhower Medical Center.
Results: Six low-risk patients for HIV tested positive for HIV by ELISA over the
5 year period. All tested negative for HIV by Western blot study. Two patients each
were found to have macroglobulinemia, polymyalgia rheumatica, or had recently
been immunized with influenza virus vaccine.
Conclusion: We believe that some patients with transient or permanent elevations of IgM globulins in serum may test positive for HIV by ELISA methodology.
When recent immunizations and DNA viral infections can be excluded, a search for

underlying autoimmune disorders and hematologic neoplasia should be initiated.