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

824 Abstracts 42254-42257

12th World AIDS Conference

Objective: To investigate policy and practice relating to management and
therapeutic interventions for HIV infected children across European centres.
Methods: A postal survey of 67 paediatric centres in 13 European countries.
These participate in the European Collaborative Study (ECS) and also include
the larger HIV paediatric centres from the Italian Paediatric HIV Register and/or
the Paediatric European Network for Treatment of AIDS PENTA. Additional data
relate to 299 infected children enrolled in ECS prospective study of children
born to HIV-infected mothers, with information on clinical progression, prophylactic and antiretroviral therapy use. The survey questionnaire includes questions
about: number of HIV infected children, their CDC classification, practice relating
to schedule and regimen for prophylactic treatment and antiretroviral therapy.
Information is sought on centre-specific therapy guidelines and availability of new
drugs.
Results: The findings of the survey will be presented with the ECS data showing changes that have occurred in the therapeutic management of HIV infected
children over a 10 year period and will highlight the current use and practice of
therapeutic interventions for HIV-infected children and variability across European
centres.
Conclusion: As many drugs are only available in some European countries, it
is important to bring together the experience of experts in paediatric HIV infection.
The results of this study will provide information that will be assist in the development of improved local and national guidelines and lead to a more universal
approach across Europe.
S42254 Cost and efficacy of anti-HIV drugs
Richard M. Grimes2, T. Sobhan. 1 School of Public Health, 2AIDS Education
and Training Center - University of Texas, PO. Box 20186, Houston, TX, USA
articles and abstracts with results from clinical trials using combination therapy
for HIV were reviewed. The trials were classified by the log reductions of viral
load. The drugs used for each trial were priced at wholesale cost to determine
the expected cost/month of using each drug combination. The results were:.3.0
2.5-2.99
2.0-2.49
1.5-1.99
1.0-1.49
0.5-0.99
-0.5
None/increase

Log Reduction
6
11
15
17
19
23
13
4

No. of Range of Costs/Trials month in US$
$701-1153
428-1170
428--1700
466-1170
466-1057
350-1518
410-1058
485-850

ing countries' scientific production in order to increase their active participation in
scientific events and publications.
S42256 Bacillary angiomatosis in HIV-infected patients -
An epidemiological and clinical study
Andreas Plettenberg1, H. Rasokat2, T. Kalibe3, H. Albrecht4, T. Mertensk6tter5,
J. Bogner6, H. Sch6fer7. 1AK St. Georg, Lohmuhlenstrasse 5 20099 Hamburg;
2 Universitits-Hautklinik Kdln Kdln; 3Frankenhaus Schwabing Mujnchen;
4 Universitatskrankenhaus Eppendorf Hamburg; 5Bernhard Nocht Institut
Hamburg; 6Med Poliklinik, Universitat MOnchen MOnchen; 7Universitatshautklinik
Frankfurt Frankfurt/Main, Germany
Objective: To analyse incidence, clinical manifestations, correlation with immunological parameters, diagnostic procedures, response to antibiotic therapy and rate
of relapses of bacillary angiomatosis (BA) in HIV-infected patients.
Methods: A retrospective study was conducted in 22 german HIV-centers
associated to the study-group IdKF/GASG. Data were collected about the histories of HIV-positive patients with histologically proven BA for the period 1990 to
1996. Demographic data were recorded as well as distribution of manifestations,
treatment regiments and clinical outcome.
Results: Data about 21 cases of BA were collected (19 male, 2 female). During
the observation period from 1990 to 1996 22 HIV-centers cared for 17.000 HIVinfected patients. Therefore a prevalence of 1.2 cases per 1.000 patients can be
assumed. In 18 patients the diagnosis was proven by histology (Warthin-Starry
staining), in 4 cases by PCR and in 4 cases by electron microscopy. The median
age was 39 years (26-73), the median CD4-cell count was 30c/il; however, 2
patients had more than 350 c//lJ. 19 BA were localised at the skin, in 5 cases
the bones were involved, 4 patients had manifestations at the liver. The mucous
membranes and the lymph nodes were striked each 3 times and one case manifested in the central nervous system. Out of 20 patients who received antibiotic
therapy, 13 had a complete remission. The median time of duration up to complete
remission was 32 days (9-82). During the follow up 6 relapses were observed.
Conclusion: BA is a rare disorder. The prevalence of BA in the presented
study was 1.2 cases per 1000 patients. Most of the affected patients had a
severe immunosuppression. The skin was the most preferred organ (90%) but
also bones and liver were often involved (24% respectively 19%). The rate of
complete remission was quite poor (65%), although antibiotic therapies had been
initiated in all premortal diagnosed cases. In 5 cases a relapse of BA occurred.
42257 Ritonavir (RTV) low dosages increases dramatically the
saquinavir (SQV-HGC) bioavailability: A PK study in
healthy volunteers (HV)
Roland Landman1, G. Peytavin2, J. Leibowitch3, M. Crivat4, Dohin4, E. Singlas5,
J.F. Bergmann6. 1'Maladies Infectieuses ET Tropicales Hopital Bichat 46 Rue
Henri Huchard 75018 Paris; 2Pharmacie-Bichat France/Paris;
3 Immuno-Virologie-Hopital Raymond Poincare Garches; 4 Produits Roche
Nevilly; 5Pharralie Hopital Recker Paris; 6Unite Recherche
Therapeutique-Lariboisiere, France
Study Design: The study was conducted in 18 healthy male volunteers (aged 18
to 45 years) using 200 mg HGC-SQV and 100 mg RTV capsules. The medication
was taken 30 minutes after a light standard breakfast. This randomised doubleblind single-dose study involved three doses of RTV (0, 100, 200 mg) in each of
the two HGC-SQV groups (600 & 1000 mg) using a crossover design. In blood
samples, SQV plasma was quantified by HPLC coupled with photodiode assay
detector.
Results: Saquinavir AUC in the two HGC-SQV dosing regimens (600 & 1000
mg) ~ RTV were not statistically different.
HGC-SQV 600 mg (n = 9) HGC-SQV 1000 mg (n = 9)
RTV 0 mg 100 mg 200 mg 0 mg 100 mg 200 mg
AUCsQV 279 279 8179 4161 20726 ~ 12009 237 ~ 228 10815 ~ 4598 16846 ~ 8198
CsQvlOh 5.2 6.6 276 _~ 140 940 ~ 581 3.2 ~ 7.0 349 ~ 187 677 ~ 365
Csov24 h BLQ 48 ~34 138 100 BLQ 38 ~ 26 84 ~ 75
Cmaxsov 78 ~72 1310 ~730 2549 ~1334 70 ~ 60 1661 ~ 617 2105 ~ 928
TmaxsQv 3.3 ~ 1.7 4.6 ~ 0.5 4.6 ~ 0.7 2.9 ~ 0.3 4.3 ~ 0.9 4.2 0 0.7
t sov 2.3 ~ 1.9 4.1 ~ 0.6 4.7 ~ 0.5 2.0 ~ 1.2 3.6 ~ 0.4 4.2 ~ 0.9
AUCsQv (o 10 h) for SQV alone and AUC SQV (0- 10 h) for SQV + RTV - Units: Cmin &
Cmax in tpg/I, AUC in tpg.h/l, Tmax & t- in Hours, BLQ = below limit of quantification.
Conclusion: This study clearly demonstrates that single low doses RTV can
dramatically increase the oral bioavailability of HGC-SQV. In this single dose PK
study in HV, greater plasma CSQV1Oh and AUCSQV were obtained with SQV
600 + RTV 200. Currently there are no data available on the activity, safety and
tolerability of 100 or 200 mg bid doses of RTV when combined with SQV in HIV
patients. Furthermore, the low RTV doses impact on the selection of viral mutants
with decreased sensitivity to RTV is not known.

Cost varies as trial allows choice of RTIs.
We will also report the different viral loads reductions for various using the
same drugs. Change in CD4+ counts will also be reported.
Results help determine the combinations that achieve best therapeutic effects
at the lowest cost.
S42255 "One world, one hope", an aim yet to be attained
Eleny Teixeira1 2, A. Trajman3, M.T.C. Belo2, L. Selig4, E. Belo Neto5,
N. Spector6, M.M. Castello Branco. 1 Rua Ailton Vasconcelos 220/103, Olhado
Governador 21941-070, RJ; 2U. Gama Filho, FTE Souza Marques, SMS-RJ, Rio
de Janeiro, RJ; 3U. Gama Filho, FTE Souza Marques, Faperj, Rio de Janeiro,
RJ; 4U. Gama Filho, FMT-FESO, Sec, Est. Saude-RJ Rio de Janeiro, RJ; 5U.
Gama Filho, FTE Souza Marques, Rio de Janeiro, RJ; 6Universidade Federal do
Rio de Janeiro, Rio de Janeiro, RJ, Brazil
Objective: To compare the scientific production from developing countries presented at the 1996 Vancouver International Conference on AIDS to the magnitude
of the AIDS epidemics throughout the world.
Methods: The number of abstracts published in both volumes of the Conference's book was counted according to the UNAIDS/WHO world division in
regions. This data was compared to the estimated number of persons living with
HIV/AIDS in July 1996 (UNAIDS/WHO).
Results: The total number of presented abstracts was 4186, distributed as
following: Africa - 329 (7.8%), Latin America + Caribbean - 455 (10.9%), Asia
- 489 (11.7%), Europe - 1203 (28.7%) and North America - 1710 (40.8%). The
percentages of the abstracts and of the persons living with HIV per region are
displayed below:
Africa
L.America
Asia+Oceania [I Abstracts
EuropeNi Persons with HIV
North America;
0 ( 20 30 40 50 60 70 80
Conclusion: Advances in the knowledge of the AIDS epidemics are still
produced mainly in the developed countries. However, AIDS patients are concentrated in the third world. This may lead to biases in understanding the
characteristics of the disease. There is an urgent need to stimulate the develop