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

XIV International AIDS Conference

Abstracts WePeC6062-WePeC6064 99

Abstract WePeC6061 - Table
Predictor Disseminated TB Pulmonary TB
Univariate Multivariate Univariate Multivariate
Odds Ratio p-value Odds Ratio p-value Odds Ratio p-value Odds Ratio p-value
Education Beyond primary vs. primary or less.48 <.0001.54.006.60.001.60.003
Region
NE vs. SE.20 <.0001.34.013 NS NS NS NS
South vs. SE.25 <.0001.31 >.0001 NS NS NS NS
Number of Ols (linear) 1.4 <.0001 1.5 >.0001 - - - -
Transmission category (vs. blood borne)
MSM 3.65.026 NS NS.62.004.68.026
Hetero 3.67.022 NS NS.61.001.67.013
Sex Male vs. female.76.105 - -.80.108.72.057
- = not included in model. Number of Ols not included for pulmonary TB because other Ols were required for AIDS diagnosis. NS = not significant

selected 3370 adult cases in 16 cities representing Brazil's major regions. Trained
abstracters reviewed each medical record, determining dates of diagnosis, death,
and last contact, and confirming presenting diagnoses, transmission category,
and demographics.
Results: Of 2662 patients with complete information, 224 (8%) had disseminated
TB, 331 (12%) had pulmonary cavitary TB, and 147 (5%) had lymphatic, other or
nonspecified TB at the time of initial AIDS diagnosis; 702 patients (26%) presented with at least one TB diagnosis, 70% of these by bacteriology. Since only
disseminated TB is an AIDS-defining infection, other TB patients required additional diagnoses to be included. Multiple logistic regression gave the following
independent predictors of which AIDS patients are more likely to present with
either disseminated or pulmonary TB (see table above).
Mean CD4 count was 110 for patients with disseminated TB and 148 for pulmonary TB. Median survival time was 39.5 mos for patients without TB, 34.7 mos
with disseminated TB and 28.0 mos with pulmonary TB.
Conclusions: TB is a common diagnosis among Brazilian AIDS patients, especially in regions where TB rates are high. It is most likely to affect women, drug
users, the less educated, and those with multiple opportunistic infections.
Presenting author: Leda Jamal, R. Santa Cruz, 81, Vila Mariana, Sao Paulo,
CEP 04121-000, Brazil, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
WePeC6062 Survival trends of HIV pediatric patients in Mexico:
a treatment scheme comparison and the impact of
HAART thearpy (1986-2001)
M. L6piz-Aviles', M. Cashat-Cruz2, J.J. Morales-Aguirre2, H. Moreno-Macfias3,
D. Gmez-Barreto2. Hospital Infantil de Mxico, Instituto Nacional de Pediatrfa,
Harvard School of Public Health - Harvard University Schiller 310-201, Colonia
Polanco, Mexico D.F, 11560, Mexico; 2Hospital Infantil de Mdxico, Mexico City
Mexico; 31nstituto Nacional de Salud Pdblica, Mexico City, Mexico
The recognition of the enhanced potency of combined therapy and the identification of new viral targets and classes of antiretroviral agents has led to improvements in increased survival of HIV-infected children.The objective of this
study was to assess the impact diverse treatment regimens (mono, double, triple
and quadruple therapy) have had on the survival of children with AIDS in Mexico. Survival analysis was performed for AIDS cases diagnosed at the Pediatric
AIDS Clinic at the Hospital Infantil de Mexico from 1986 and reported through
2001. A longitudinal study of HIV-positive children(<18 years old) was analysed
and survival times estimated.The median survival was 2423 days.The cumulative
probability of the survival for the cohort was 83% at one year,74.5% at two years
and 57.5% at 5 years.The type of treatment group had a significant influence on
the survival of the cohort (p<.001 ):children without treatment had 57% probability of survival at 9 months; those given monotherapy had a 87% probability of
surviving during the same period, while patients treated with triple and quadruple
therapy had 92 and 94% probability, respectively.No children treated with quadruple therapy have died. Patients between 1 and 5 years of age have a significantly
greater probability of surviving (88%, p=0.001 7) in comparison to the rest of the
children: 57% for those under 1 year old and 79% for those over 5 years old. The
immunodeficiency category at diagnosis and gender were not factors related to
survival time.These results emphasize how evolving therapeutic standards affect
survival times, in addition to better clinical experience and diagnostic methods.
The importance of rapid changes in the availability anti-HIV therapy and the timing of its use are key factors in survival trends for these children.Given the strong
and consistent evidence that combined treatment confers a survival advantage,
antiretroviral therapy should be offered enthusiastically to these children.
Presenting author: Marlene LI6piz-Avilbs, Schiller 310-201, Colonia Polanco,
Mexico D.F., 11560, Mexico, Tel.: [phone], Fax: [phone],
E-mail: [email protected]

WePeC6063 Gender differences in HIV progression from
seroconversion
M. Garcia de la Hera', RP. Garcia de Olalla2, C. Ferrer Villar3, J. Del Amo4, J. Del
Romero5, R. Guerrerer6, A. Sanvisent7. 'University Miguel Hernndez,
Department of Epidemi/ogya and Public Health, University Miguel Hernandez,
San Jun e an de Alicante, Spain; 2nstitut Municipal de Salut Pblica de Barcelona,
Barcelona, Spain; 3Escola Valenciana d'Estudis per aIa Salut, Valencia, Spain;
4 Plan Nacionaldel SIDA, Madrid, Spain; 5Centro Sanitaro Sandoval, Madrid,
Spain; 6Departmento de Justicia (DGSPiR), Barcelona, Spain; 7Hospital
Germans Trias i Pujol, Badalona (Barcelona), Spain
Background: Gendrerdifference in HIV progression is a controversial issue. The
objective of this paper is to study potential differences in progression to AIDS and
death between men e and women in Spain in persons with well estimated dates of
seroconversion
Method: Pooled data from 1102 individuals with well-documented HIV seroconversion dates belonging to 5 cohorts integrated in GEMES, Spanish Multicentric
Study Group of Seroconverters and recruited from 1980s up to 2000 were analysed. Risk of AIDS and death in persons infected for the same length of time were
compared between men and women through Kaplan-Meier and Cox regression
adjusting for age, transmission category and calendar period.
Results: 226 (20%) were women, the majority of whom, 90%, were intravenous
drug users (IVDU) and 6% had been infected heterosexually. Out of the men,
74% were IVDU, 20% had been infected through sex between men and 0.5%
heterosexually. Women were younger at seroconversion (median age 24. years)
compared to men (median age 26 years). Median year of seroconversion was
1993.3 for both men and women. A higher proportion of women (36.4%) were
prescribed antiretroviral medication compared to 31% of men. Pre-AIDS mortality
in women was 37.5% and 35.4% in men. Median year of initiation of antiretroviral
medication was 1996.4 for women and 1997 for men. Univariate and multivariate
analyses showed slower progression to AIDS in women (HR:0.70 95% Cl 0.49 -1.00 and HR: 068 95% Cl 0.46-0.99, respectively). Progression to death AIDS
was also marginally slower in women univariate analysis (HR: 0.71 95% CI 0.45 -1.10) but reached statistical significance in multivariate analyses (HR: 0.53 95%
Cl 0.33-0.87)
Conclusions: Progression to AIDS and death is slower in this group of women.
This could be due to higher pre-AIDS mortality and/or the earlier initiation and
higher uptake of medication in IVDU women compared to men.
Presenting author: Manoli Garcia de la Hera, Department of Epidemilogya and
Public Health, University Miguel Hernandez, San Juan de Alicante, Spain, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
WePeC6064 AIDS-related Kaposi's sarcoma (KS): Evaluation of
the AIDS clinical trial group (ACTG) staging
classification (TIS) prognostic value in the era of
HAART
G. Nasti, F. Martellotta, D. Galloni2, A. Smorfa3, C. Mussini4, A. Cioppi5,
A. D'Arminio Monforte6, E. Vaccher7. ICentro di Riferimento Oncologico,
Divisione di Oncologia Medica a, Centro di Riferimento Oncologico, Via
Pedemontana Occidentale 12, 33081 - Aviano (pn), Italy; 21stituti Ospitalieri,
Cremona, Italy; 30spedale di Cisanello, Pisa, Italy; 4Universita degli Studi,
Modena, Italy; 5Ospedale S. Salvatore, Pesaro, Italy; 60spedale Sacco, Milano,
Italy; 7Centro di Riferimento Oncologico, Aviano, Italy
To prospectively evaluate the relationship between survival and potential prognostic variables (i.e., sex, age, TIS variables, HAART, visceral involvement, previous AIDS, HIV-RNA viremia), in the era of HAART, we enrolled all consecutive
pts diagnosed with KS from january 1996 within two large italian cohorts: GICoAT
(italian cooperative group on AIDS and tumors) and ICONA (italian cohort naive
antiretroviral). One hundred andn sixty-three pts were enrolled (119 GICAT and
45 ICONA). General characteristics of all pts were the following: predominantly
males (90%), median age of 38 yrs (range 38-74 yrs), 38 pts (27%) were on
HAART at KS diagnosis, and 112 (90%) of the remaining pts started HAART at
KS diagnosis. Median follow-up was 19 mos (range 1-67 mos). Association between survival time and prognostic variables were evaluated by both univariate
(log-rank test) and multivariate (Cox proportional hazard regression) analyses.
Results: Non significant survival prognostic factors are shown in Table 1.
Significant survival prognostic factors. Univariate and multivariate analyses are