Program Supplement [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

ll 11

their effective and potential contribution in strengthening
communities' capacity to address HIV/AIDS. HMIS are typically
recognized for their ability to increase access to treatment and
care. However, their potential also relates to their role in
strengthening the organization and mobilization of civil society
groups around health issues. HMIS are particularly well suited
to enable the groups to take action in prevention, including
VCCT, psychosocial support to PLWA and in breaking down the
stigma associated with HIV and AIDS. Their most unexplored
potential relates to the role they can play to channel support
to families affected by HIV/AIDS. Through these communitybased mechanisms, governmental and non-governmental
efforts addressing HIV/AIDS can reach individuals and
households most in need.
Lessons learnt: HMIS development and multiplication was
spurred thanks to participatory processes that enabled
nascent schemes to interact, test approaches and learn from
each other. Schemes are multiplying because of their success
in enabling members to access care. They have also served to
raise awareness on health issues and to channel subsidies
from NGOs to families affected by HIV/AIDS.
Recommendation: Support participatory processes that enable
existing HMIS to identify how they are already addressing
HIV/AIDS and how they could do more. Incorporate HIV/AIDS
as a standard component in support to initiators of HMIS.
Corresponding author: Moneti, Francesca, c/o unfpa, 220 East
42nd Street, 17th floor, New York 100oo17, United States,
Tel: [phone], Fax: [phone],
Email: [email protected]
[ LBPP2207I
Aspirin-like molecules that inhibit HIV-1 replication
Pereira, Candida', Paridaen, Judith', Rutten, Karla', Huigen,
Marleen', Bovenkamp, Mara', Middel, Jeena', Jastrzebski,
Johann', Schuurman, Rob', Marnett, Lawrence2, Verhoef,
Jan', Nottet, Hans' (The Netherlands; 2United States)
Background: Anti-inflammatory molecules are proposed in HIV1-associated dementia (HAD) therapy. Some anti-inflammatory
molecules are also known to possess anti-HIV activity. We
found that o-(acetoxyphenyl)hept-2-ynyl sulfide (APHS), a
recently synthesized non-steroidal anti-inflammatory molecule
can inhibit HIV-1 replication. Our aim is to clarify the
mechanism of action of APHS and to determine whether APHS
can act synergistically with other drugs.
Methods: HIV-1 replication was quantified by p24 ELISA.
Cellular viability was determined by a MTT assay. The IC5o and
TC5o and Combination Index (CI) values were determined
using the CalcuSyn program. HIV-i entry efficiency and HIV-1
RT activity in PBMC in the presence of APHS was assessed
using real-time PCR to quantify HIV-1 gag RNA or DNA,
respectively. The replication of drug-resistant HIV-i strains was
determined with a MTT-based drug susceptibility assay.
Results: When administered during the first steps of the
infection APHS is capable of inhibiting the replication of
several HIV-i strains (macrophage-tropic and lymphotropic) in
a dose-dependent manner in both peripheral blood
mononuclear cells (PBMC), monocyte-derived macrophages
(MDM) and peripheral blood lymphocytes (PBL) with IC~o
values of about io mM. APHS TC5o values were about 100-200
mM. After provirus insertion into the cellular genome, APHS
does not affect HIV-i replication. APHS does not inhibit HIV-1
entry into host cells. APHS inhibits the RT activity in PBMC.
APHS inhibits replication of all tested drug-resistant strains in

a MT-2 cell line. APHS showed synergistic interactions with the
RT inhibitors (RTI) AZT, 3TC and efavirenz (Cl <1), while additive
interactions were found between APHS and the protease
inhibitors (PI) indinavir and ritonavir (CI _ 1).
Conclusions: APHS inhibits HIV-1 RT activity in PBMC. APHS
works synergistically with RTI. APHS can inhibit replication of
common RTI and PI-resistant HIV-i strains.
Corresponding author: Pereira, Candida, Hp Go4.614, umcu,
Heidelberglaan 100oo, 3584 CX Utrecht, The Netherlands,
Tel: [phone], Fax: [phone],
Email: [email protected]
[LBPP22081
European and South American study of Indinavir, Efavirenz,
and Ritonavir (EASIER)
Stek Jr., Michael', Hirschel, Bernard2, Benetucci,
Jorge3, Reboredo, Garcielas3, Begovac, Josip4, Banhegyi,
Denes5, Stankova, Marie6, Duiculescu, Dan7, Patel,
Krupa', Shivaprakash, Malathi', Georgiou, Nikolaos', Menten,
Joris ('United States; 2Switzerland; 3Argentina; 4Croatia;
5Hungary; 6Czech Republic; ZRomania)
Objectives: To investigate antiviral activity (vRNA and CD4) and
safety of a compact nucleoside-sparing regimen of indinavir (IDV)
800oomg bid, ritonavir (RTV) loomg bid, and efavirenz (EFV) 6oo
mg qhs (Regimen A) versus IDV+RTV+EFV plus stavudine (D4T)
40mg bid if weight > 6okg or 30mg bid if <60kg (Regimen B).
Design: Multicentre, randomized, open-label, 48 week
comparative trial.
Baseline:

Regimen
IDV/RTV/EFV
IDV/RTV/EFV/D4T

N %Males vRNA logloCD4 cells/mm3

35
39

63
74

4-5 + 0.6 377 + 188
4.6 + 0.7 318 + 185

Results: 24 wk. Change from Baseline (latest data carried
forward)
vRNA loglo CD4 cells/mm3

Regimen

N Mean (95% CI) N Mean (95% CI)

IDV/RTV/EFV 32 -2.69
(-3.o01,-2.37)
IDV/RTV/EFV/D4T 37 -2.38
(-2.67, -2.08)
vRNA at 24 wks.

32 +143.2
(+91.1, +195.3)
36 +128.2
(+79.1, +177.4)

Observed

Regimen
IDV/RTV/EFV
IDV/RTV/EFV/D4T

<400 <50
28/28 22/28
(loo%) (79%)
27/33 19/33
(82%) (58%)

ITT- NC = F
<400
28/35
(80%)
27/39
(69%)

<50
22/35
(63%)
19/39
(49%)

At 24 weeks the following frequencies of adverse events were
reported for regimens A and B, respectively: drug-related (63 &
59%), nervous system (26 & 33%), psychiatric, i.e. depression
(6 & o%), renal colic/urolithiasis (6 & 5%), and rash (20 & 13%).
Discontinuations due to clinical and laboratory AEs for regimens
A and B respectively were: clinical (17% & 13%), laboratory (3% &
o%). Two cases of serious drug-related AEs in regimen A and 1
case in regimen B resulted in discontinuations. Using pill counts
XIV International AIDS Conference BARCELONA - JULY 7-12

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