Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

96 Abstracts WeOrC1379-WePpC2099

XIV International AIDS Conference

WeOrC1i379 HIV main risk factor for mother-to-child HCV
transmission
E. Marine Barjoan1, A. Bongain2, A. Berrebi3, H. Haas4, J. Tricoire5,
F Monpoux6, C. Laffont7, J. lzopet8, A. Tran9, C. Pradier1o. 1Feddration des
Maladies Transmissibles. CHU Nice, Fdddration des Maladies Transmissibles,
Hdpital de /'Archet, CHU de Nice, BP 3079, 06202 Nice cedex 3, France;
2Service de Gynecologie Obstetrique, H6pital de /Archet 2, CHU de Nice, Nice,
France; 3Services de Gynecologie Obstetrique, Hdpital de la Grave, CHU de
Toulouse, Toulouse, France; 4Service de Pediatrie, H spital de iArchet 2, CHU de
Nice, Nice, France; 5Service de Pediatrie, Hcpital Purpan, CHU de Toulouse,
Toulouse, France; 6Service de Pediatrie. CHU Nice, Nice, France; 7Laboratoire
de Virologie. CHU Nice, Nice, France; 8Laboratoire de Virologie.CHU Toulouse,
Toulouse, France; 9F~ddration des Maladies de/'AppareilDigestif. CHU Nice,
Nice, France; 10Fd6ration des Maladies Transmissibles.CHU Nice, Nice, France
Background: Mother-to-child HCV transmission is the most important mode of
infection among children. It is essential to know the factors involved in the transmission in order to implement preventive measures to reduce the risk of contamination for children.
Methods: Multicenter study in Southern France (Alpes Maritimes, Haute
Garonne, Herault departments) that concerns HCV positive women followed during their pregnancy at one of the public hospitals and who gave their consent to be
HCV-tested. Mother-to-child HCV transmission was analysed via questionnaire,
laboratory and virological data, in order to determine maternal, child and delivery
characteristics.
Results: Among 283 HCV positive women followed during their pregnancy, 261
(92%) have been included. So far, 144 (55%) mother-child pairs have completed
six months' follow-up after birth. Main characteristics are: mean age 33 years, first
pregnancy for 76%, living with a regular partner 86%, ALAT at delivery 37 UI/ml
and PCR positive in 63%; 27% of women are HIV co-infected, 54% have a past
history of IVDU and 19% of blood transfusion; 35 (24%) of the women included
discovered their HCV status at the time of inclusion. Among them, 14 (40%) were
suspected to be contaminated by others routes than IVDU or blood transfusion.
Mother-to-child transmission rate at six months' follow-up was 4.9% (95%CI[1.9%-9.8%] (7 children); 6 of them were born to HIV-infected women (15.4%,
95%-Cl [5.9-30.5]) and 1 to a HIV-negative woman (1.0%, 95%-CI[0.03-5.5]).
Among the 6 HCV-infected children born to HIV-infected women, 4 (67%) were
delivered by elective caesarean before membrane rupture. No child was HIVinfected.
Conclusions: HIV-infection appears to be the main risk factor for HCV mother-tochild transmission. In HIV-infected mothers, caesarean does not to prevent HCV
mother-to-child transmission.
Study financed by The National Agency for AIDS Research. France.
Presenting author: Eugenia Marine Barjoan, F6deration des Maladies Transmissibles, H6pital de I'Archet, CHU de Nice, BP 3079, 06202 Nice cedex 3, France,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePpC2097 Using behavioural and serosurvey data to
estimate national HIV prevalence: United Kingdom
1998 to 2000
P.A. Rogers1, C. Kelly2, C. McGarrigle2, A. Copas3, K.A. Fenton2,
A.M. Johnson3, S.J. Livingstone1, O.N. Gill2. 1PHLS Statistics Unit, PHLS
Statistics Unit, 61 Colindale Avenue, London, NW9 5EQ, United Kingdom;
2HIV-STI Division, PHLS Communicable Disease Surveillance Centre, London,
United Kingdom; 3 Centre for Infectious Disease Epidemiology, University
College London, London, United Kingdom
Background: Estimates of the numbers of adults living with HIV are required
for Public Health planning and the calculation of HIV incidence. It is particularly
important to know the extent of undiagnosed infection in the community.
Methods: Petruckevitch, Gieseke, et al originally developed the Direct Method of
estimating HIV prevalence. Total diagnosed infection is estimated by adjusting the
number of reported infections from the National Survey of Prevalent Diagnosed
Infections for under-reporting. Undiagnosed infection is estimated by applying HIV
prevalence estimates, obtained from the Unlinked Anonymous HIV Prevalence
Monitoring Program, to sub-groups of the population at different HIV risk levels,
calculated using data from the second National Survey of Sexual Attitudes and
Lifestyles and mid-year population estimates from the Office for National Statistics. The method has been improved over time, most recently by increasing the
precision of the estimates of undiagnosed infection.
Results: Overall prevalent HIV infections have risen from approximately 32000
in 1998, of which 40% were undiagnosed, to approximately 38000 in 2000, 35%
undiagnosed. In 1998 just over 50% of prevalent infections were attributed to
sex between men and 40% to heterosexual sex. By 2000 prevalent infections
attributed to sex between men and heterosexual sex were similar at around 45%.
Conclusions: Prevalent HIV infection has risen considerably between 1998and
2000: total prevalent HIV infections have risen by a fifth. The case-mix has also

changed: in 1998 there were about five homo/bisexual infections for every four
heterosexual infections whereas by 2000 there were almost equal numbers of
homo/bisexual and heterosexual infections.
Presenting author: Pauline Rogers, PHLS Statistics Unit, 61 Colindale Avenue,
London, NW9 5EQ, United Kingdom, Tel.: [phone], Fax: +44(0)20
8200 7868, E-mail: [email protected]

WePpC2098 Recent trends in HIV prevalence and diagnosis
among STI clinic attendees in the United Kingdom
using unlinked anonymous testing
O.N. Gill1, L.F Jordan 1, J. Njorogel, PA. Rogers2, J.V. Parry3, &
Collaborators. I PHLS Communicable Disease Surveillance Centre, London,
United Kingdom; 2PHLS Statistics Unit, London, United Kingdom; 3PHLS
Central Public Health Laboratory London, United Kingdom
Background: Large scale unlinked-anonymous (UA) testing is a major part of
HIV surveillance in the UK. Monitoring HIV prevalence in STI clinic attendees is a
priority as they are a sub-group at high risk.
Methods: From 1993 to 2000 over 522,000 leftover syphilis serology specimens
from 15 STI clinics (7 in London, 8 elsewhere in England) were UA tested for HIV
antibody. Data retained with each UA specimen included age group, sex, sexual
orientation, world region of birth, presence of acute STI, prior diagnosis of HIV
infection, and whether HIV tested at the attendance.
Results: From 1993 to 1996 the prevalence of previously undiagnosed HIV in
homo/bisexual men in London fell from 7.6% to 5.8%; however, since then this
prevalence has stayed constant at around 4.8% overall and around 2.5% in those
aged under 25. Of the HIV-infected homo/bisexual men in 2000 who were unaware of their HIV infection prior to the clinic visit, only 34% had their HIV infection diagnosed at the visit; 45% also had an acute STI, a rise from 31% in 1994.
HIV prevalence in female heterosexuals in London increased from 0.69% in 1993
to 0.88% in 2000. In 1999/2000 HIV prevalence in heterosexual men and women
varied greatly by place of birth: UK - 0.15%, East and SE Asia - 0.39%, South
Asia - 0.46%, Caribbean - 0.74%, Sub-Saharan Africa - 4.6%. The proportion of
HIV-infected heterosexuals first diagnosed at the clinic visit increased in London
from 31% in 1996 to 40% in 2000, and outside London from 35% in 1996 to 42%
in 2000.
Conclusions: Many HIV-infected persons were undiagnosed after STI clinic attendance even though many were concurrently infected with an acute STI. Most
heterosexual HIV infections are in those born in Sub-Saharan Africa. The UA
method is essential for obtaining necessary information on HIV prevalence. With
suitable additional data, the method may also be used to monitor the effectiveness of HIV testing policy.
Presenting author: Noel Gill, PHLS-CDSC, 61, Colindale Ave, London, NW9
5EQ, United Kingdom, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
WePpC2099 HIV among migrant populations in Europe
F.F. Hamers, J. Alix, A.M. Downs. EuroHIV InVS, EuroHIV InVS, 12 rue du Val
d'Osne, 94415 Saint Maurice cedex, France
Background: Migrant populations are often highly vulnerable to HIV, yet may encounter strong barriers to prevention and care. We aim to describe the burden
borne by migrants in the HIV epidemic in Europe.
Methods: European (WHO region) HIV/AIDS reporting data include an indirect
indicator of migration status ("origin from country with generalised epidemic")
for heterosexually acquired AIDS cases (all 51 countries) and HIV cases (22
countries). To complement this information, aggregate data on nationality or geographic origin of all HIV and AIDS cases, by transmission group and year (1997 -1999), were requested in a special survey Data were analysed by geographic
zone (West: EU, Israel, Norway, Switzerland; East: ex USSR; Centre: other countries) and country.
Results: In the West, among heterosexually infected persons, the proportions
from a country with a generalised epidemic increased between 1997 and 2000
from 23% to 29% among AIDS cases and from 60% to 66% among HIV cases;
proportions varied by country (up to 77% for HIV cases in the United Kingdom,
2000) and were much lower in the Centre and the East (HIV: <5%). In the survey
(24 countries), 26% of HIV cases reported in the West (1997-1999) were nonnationals vs 10% in the Centre and 2% in the East. However, in some countries
foreigners are not included in national statistics. The proportion of non-nationals
was 35% among heterosexually infected persons, 15% among homo/bisexual
men and 3% among injecting drug users. Among all non-national HIV cases,
46% were from sub-Saharan Africa and 24% from Europe.
Conclusions: Migrants, especially from sub-Saharan Africa but also within Europe, account for a disproportionate-and increasing-share of HIV infections in
Europe, particularly in the West. Better monitoring of HIV in migrant populations
is essential in order to improve targeting of HIV prevention and care, but care is
needed to avoid stigmatisation and discrimination.
Presenting author: Frangoise Hamers, EuroHIV, InVS, 12 rue du Val d'Osne,
94415 Saint Maurice cedex, France, Tel.: [phone], Fax: [phone],
E-mail: f.hamers@ invs.sante.fr
WePpC2101 Implementation of named surveillance for Human
Immunodeficiency Virus (HIV) infection in New

York City (NYC): Preliminary data on the first 18
months of HIV reporting
D. Nash, L. Jones, S. Ly, J. Sackoff, T. Singh, R. Shum, P. Thomas, I. Wiesfuse,
S. Forlenza. New York City Department of Health, New York City Department of
Health, 346 Broadway Room 706, New York, NY 10013, United States
Background: In June 2000, after 20 years of conducting active surveillance for