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

392 Abstracts ThPeB7220-ThPeB7224

XIV International AIDS Conference

ThPeB7220 The Spectrum of opportunistic infections in HIV
-AIDS patients in a tertiary care hospital in New
Delhi, India
S.K. Agarwal1, A. Makhija', S. Anuradhal, NP. Singh1, U.K. Baveja2.
SDepartment of Medicine, maulana Azad Medical College, Delhi, India;
2National Institute of Communicable diseases, Delhi, India
Background: The spectrum of opportunistic infections in HIV -AIDS patients in
presenting to a major tertiary care hospital of New Delhi, India was studied.
Methods: Eighty patients with confirmed HIV infection were screened for the
presence of opportunistic infections by clinical, laboratory and radiological methods. The CD4 cell counts were assessed in all these patients and the correlation
of the various opportunistic infections and CD4 cell counts was evaluated.
Results: Of the 80 HIV patients screened, 55 i.e. 68.25% had evidence of an
opportunistic infection. The commonest opportunistic infection seen was tuberculosis (31/80). Pulmonary tuberculosis was more common than extrapulmonary
disease (25 compared to 6 patients). Chronic diarrhea was the next common
opportunistic infection seen in 10 / 80 (12.5%) patients. Cryptosporidium (4),
Cyclospora (1), Isospora (1), E. histolytica (1) were the responsible organisms.
Candidal infection (7), recurrent Herpes Zoster (3 / 80 - 3.75%), cryptococcal
meningitis (2 / 80 - 2.5%), pneumocystis carinii pneumonia (1/ 80 - 1.25%), CNS
toxoplasmosis (1/ 80- 1.25%) were the other observed infections.
A statistically significant difference in the CD4 cell counts was found between
the patients with opportunistic infections (177.4 - 145.37) compared the those
without any opportunistic infections (362.5 - 176.2).The patients with tuberculosis had significantly higher CD4 cell counts (mean CD4 cell counts 155.6 _ 120)
compared to those with the other infections who had a significantly lower CD4 cell
counts.
Conclusions: This study demonstrates that tuberculosis is the commonest opportunistic infection seen in HIV patients in India. A high prevalence of the disease
in the general population may be contributory to this. Hence early detection and
prompt management of tuberculosis is of paramount importance in order to prevent the further immune dysregulation.
Presenting author: S K Agarwal, F 24 / 5 Mandir Marg, Krishna Nagar, Delhi
-110051, India, Tel.: [phone], Fax: [phone], E-mail: dranu55
@hotmail.com
ThPeB7221I Women of Coastal Andha (India) are
non-progressors of HIV disease - A cohort study
K.S.R. Kutikuppala1, R.D. Pilli2, M. Gurulaxmi2. 1SHARP - School of HIV/AIDS
Research & Prevention, CF, D.No.36-46-51, Kancharapalem, Sri Surya Clinic,
Visakhapatnam-530 008, Andhra pradesh,; 2SHARP - School of HIV/AIDS
Research & Prevention, CFI, Visakhapatnam, India
Background: The family system in India is very strong and the wife and husband
usually live together even with HIV infection. It is found some of the spouses continued to be negative and husbands died earlier than the wives, which prompted
to undertake a long term study on the progression of HIV disease among the
positive couples of coastal Andhra Pradesh, India.
Methods: Hundred (100) couples were enrolled in the cohort after following scientific ethical guidelines, out of the referred cases from various districts of Andhra
Pradesh and neighbouring State of Orissa to the Referral center of Sri Surya
Clinic at Visakhapatnam, from October 1998 to December 2001. Long term studies of HIV infected and high risk couples have been performed in the group of 100
couples
Results: Sixty (60%) HIV positive wives have not progressed to AIDS disease.
12(12%) wives were negative for three years inspite of having sexual exposure
with their positive husbands. 72(72%) husbands died of AIDS within three years
after diagnosis while their wives keeping reasonably good health even after three
years. The CD4, CD8 counts are more than 800 - 1300 4/L and Viral loads are
around 4000 - 20000 copies per ml., in the wives, while in four wives the virus
was at non detectable levels, whereas the CD4 counts are 200 to 70 /L and
the viral loads are around 95000 - 250000 copies per ml., among the husbands
studied.
Conclusion: HIV infected long term non-progressors wives (women) indicate that
they have better immune protection than the husbands (men). There is a need to
sustained follow up to identify the factors preventing those HIV positive wives to
develop AIDS disease even after three years and which immune response protected these wives (women) against HIV is to be established. However it is evident
that the women of coastal Andhra, India are non progressors of HIV disease.
Presenting author: Surya Rao Dr.Kutikuppala, D.No.36-46-51, Kancharapalem,
Sri Surya Clinic, Visakhapatnam-530 008, Andhra pradesh, India, Tel.: [phone]; 558637, Fax: [phone], E-mail: kutikuppala @eth.net

ThPeB7222 Polymorphisms of coreceptor-related genes
associated with HIV-1 disease progression and
infection in Japanese hemophiliacs
X.W. Deng1, H. Terunuma1, R. Handema1, H. Hanabusa2, M. Taki3, H. Kasai',
A. Yamashita', T. Shioda4, M. Ito1, J. Mimaya5. 1 Department of Microbiology,
Yamanashi Medical University, Department of Microbiology, Yamanashi Medical
University Yamanashi 409-3898, Japan; 2Department of Hematology Ogikubo
Hospital, Tokyo, Japan; 3Department of Pediatrics, St.Marianna University,
Kawasaki, Japan; 4Department of Viral Infection, Research Institute for Microbial
Disease, Osaka University, Osaka, Japan; 5Division of Hematology and
Oncology, Shizuoka Children's Hospital, Shizuoka, Japan
Background: The impact of host factors such as CCR5- and CXCR4- related
genotypes on the induction of long-term non-progressor (LTNP) status among
Asians remains undocumented. We therefore studied DNA polymorphism of
these genes in HIV-1 infected LTNPs in Japanese hemophiliacs.
Method: The frequencies of CCR5- and CXCR4-related genes polymorphism in
Japanese LTNPs were compared with other groups, who had CD4 count more
than 500/E I and no symptom without anti-retroviral treatment for 13 years.
Results: One hundred percent linkage between the CCR5-59653T and CCR2 -641 polymorphic variants was identified. The frequencies of CCR5-59653T/CCR2 -641 and RANTES-28G in LTNPs were significantly higher compared with the
healthy control groups (p=0.013 and 0.023, respectively). Furthermore, HIV-1 uninfected hemophiliacs who might have been exposed to HIV-1 through contaminated blood products had a significantly high prevalence of CCR5-59653T/CCR2 -641 (p=0.017). This suggests that CCR5-59653T/CCR2-641 and RANTES-28G
had protective effects on the disease progression and that the polymorphism of
CCR5-59653T/CCR2-641 may also be important for resistance to HIV-1 infection.
Conclusions: CCR5-59653T/CCR2-641 may not only protect against HIV-1 disease progression, but also against HIV-1 infection in Japanese hemophiliacs.
Presenting author: Xuewen Deng, Department of Microbiology, Yamanashi Medical University, Yamanashi 409-3898, Japan, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeB7223 Ultrastructural liver alterations among HIV-infected
children
M. Della Negra, C.L. Yu, W. Queiroz, A.P.G. Pochini, C. Soraggi-Neto,
D.RP. Pacola. Instituto de Infectologia Emilio Ribas, Rua Pamplona, 356, 110
Andar, Sao Paulo - SP CEP 01405-000, Brazil
Objectives: Liver disorders and alterations in liver enzymes are frequent in the
course of HIV infection among children. Despite its importance, ultrastructural
studies in liver tissue of HIV-infected children are scarce. There are some significant data regarding these disorders among HIV infected adults. The aim of this
study is to verify the ultrastructural liver alterations in children and if this aspects
are the same observed among adults or even if the pediatric population may show
any particular difference.
Methods: Twelve HIV-infected children followed at the 2nd Inpatients Unit at Instituto de Infectologia Emilio Ribas - Brazil were studied. All presented with hepatomegaly and/or altered liver enzymes. This group was submitted to a percutaneous liver biopsy and the samples were submitted to histologic, immunocytochemical and ultrastructural analysis.
Results: The most frequent finding was mitochondrial structural and related disorders. In hepatocytes and Kupffer cells. Kupffer cells hypertrophy and hyperplasy were observed in all patients. Virus-like particles at the mitochondria were
found in 2 patients and concentric membranous bodies (CMB) in seven. Cytomegalovirus disease was diagnosed in one patient.
Conclusions: The study revealed that mitochondria are frequently damaged during HIV infection. The disorders were similar to those observed among adults and
may be present in early stages of the natural history of pediatric AIDS even in patients without treatment. This lead us to believe that many factors are implicated in
the pathogenesis of these alterations, including HIV itself. Strategies for sparing
mitochondria from this damage may delay the progression of HIV disease.
Presenting author: Marinella Della Negra, Rua Pamplona, 356, 11~ Andar, Sao
Paulo - SP, CEP 01405-000, Brazil, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeB7224 Nutritional status at admission is a prognostic
marker of disease progression in infected children
in Belo Horizonte, Brazil
JA. Pinto1, IR. Carvalho1, A. Luchesi', V. Lobato1, F Kakehas1, D.B. Greco2.
1Department of Pediatrics, Federal University of Minas Gerais, Av. Alfredo
Balena 190/4~ andar, Belo Horizonte, MG, 30130-100, Brazil; 2Department of
Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil

Objective: Nutritional status at admission was assessed as a prognostic marker
for disease progression or death among a cohort of HIV-vertically infected children in a referral center in Belo Horizonte, Brazil.
Methods: Weigth-for-age Z-score (WAZ) at the initial visit was correlated with
risk for progression to Category C or death in a retrospective cohort study. WAZ
< - 2 was evaluated in univariate (Kaplan-Meier) and multivariate analysis (Cox
Regression), as a prognostic factor for disease progression or death among
vertically-infected children.