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

410 Abstracts ThPeB7299-ThPeB7302

XIV International AIDS Conference

hyposalivation and xerostomia in HIV and HIV-free subjects with a well-controlled
consumption of medications, (2) to identify factors associated with hyposalivation and xerostomia, and (3) to correlate hyposalivation and xerostomia and the
presence of oral candidiasis.
Methods: 135 subjects were enrolled (56 HIV-positive, mean age 34.5 yrs, and 79
HIV-negative, mean age 29.5 yrs). A measurement of saliva flow rate comprised
both unstimulated and wax-stimulated whole saliva using the draining method.
The effect of HIV status, stage of HIV infection, and medications on the flow rates
were analyzed.
Results: The unstimulated flow rates in the HIV-positive subjects and HIVnegative controls were 0.19 and 0.33 (P< 0.05). For stimulated flow rates the
corresponding figures were 1.45 and 1.62 (p> 0.05).
With respect to medication, both unstimulated and stimulated saliva flow rates
were found to be statistically significant lower in the groups of subjects with xerostomia inducing drugs compared with those without any medication (P< 0.05).
It was found that the following factors were significantly associated with hyposalivation; sex, stage of HIV infection, risk group, systemic disease, medication,
smoking, and alcohol consumption. Hyposalivation was found to be significant
associated with the colony forming unit of Candida.
Conclusions: This study indicated that various medication used among
HIV-infected individuals affects their salivary flow rate.
Presenting author: Wipawee Nittayananta, Department of Stomatology, Faculty
of Dentistry, Prince of Songkla University, Haadyai, Songkhla 90112, Thailand,
Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeB7299I Opportunistic enteric parasites in AIDS mexican
children
N.M. Pavfa-Ruz1, D. Jarillo1, M.R. Muhoz1, C. Cardenas1, M.L. Ramirezl,
M. Ortega1, J.I. Santos2. 1Med School-UNAM-General Hospital of Mexico,
Dept Med.Exp./UNAM Dr Ba/mis 148, co/. doctores CP06726 Mdxico, D.F,
Mexico; 2Med. Schoo-UNAM, Programa Nacional de Atencidn a la Salud del
Nito, CNSIA,SSA, Mexico City, Mexico
Background.Chronic diarrhea (CD) is an important complication of HIV infection
resulting in significant morbidity. A variety of opportunistic of gastrointestinal tract
may be the causative agent. We present the frequency of opportunistic and nonopportunistic intestinal parasites in Mexican children with AIDS associated or not
to CD.
Methods: In a prospective study we collected stool samples from 3 groups:
A) AIDS children (n=47), B) healthy children in contact with AIDS patients (n=
39), C) healthy children without contact with AIDS patients (n=92). We analyzed
three fresh stool samples for parasite identification: saline wet mount, concentration methods, modified trichrome blue stain, kinyoun-modified stain, indirect
immunofluorescence assay anti-Encephalitozoon sp Mab 3B6 (IFA).
Results: In-group A we had 26 children (55.3%) with CD and 19 (73%) of them
were Microsporidia positive by IFA, four children had CD and Cryptosporidium,
one child with G. lamblia. In group B we had 16 children positive for Microsporidia
by IFA, only three patients had CD and two of them with Cryptosporidium; two
children with Ascaris lumbricoides and one children with G. lamblia and another
with T. Trichiura. In group C we had 22 patients positive for Microsporidia by IFA;
four children with G. lamblia and two children with A. lumbricoides.
Conclusions: The frequency of Microsporidiosis in this cohort of children HIVinfected is higher than others reports. The Cryptosporidium frequency was 8.5%
similar to others publications. We observed relative lower frequency of nonopportunistic intestinal parasites in AIDS children.
Presenting author: Noris Pavfa-Ruz, Dept. Med.Exp./UNAM Dr. Balmis 148,
col. doctores CP06726 Mexico, D.F, Mexico, Tel.: [phone], Fax: +52
[phone], E-mail: [email protected]
ThPeB7300 Real-time PCR for clinical management of
HIV-infected patients with visceral leishmaniasis
S. Bossolasco, D. Ochini, L. Martello, G. Gaiera, A. Lazzarin, C. Uberti-Foppa,
P. Cinque. Clinic of Infectious Diseases, San Raffaele Hospital, Milano, Italy
Background: Viscearal leishmaniasis (VL) is a severe and frequent disease in
HIV patients living in the Mediterranean basin. Its treatment is difficult because
of the frequent relapse that occur in HIV patients. The objective of this study was
to determined if a quantitative PCR for Leishmania DNA might be a useful tool in
the diagnosis and follow-up of HIV patients with VL.
Methods: Leishmania DNA was quantified in peripheral blood drawn from 13 HIV
patients with suggestive clinical signs/symptoms for VL by real-time PCR. VL was
diagnosed in 8/13 patients by microscopic demonstration of amastigotes in bone
marrow aspiration. Patients were treated with amphotericin B (3 mg/kg) from day
one to 5 and at day 10, 17, 24, 31 and 38. Peripheral blood was drawn at the time
of VL diagnosis and weekly during the treatment.
Results: At the time of clinical signs/symptoms, Leismania DNA was detected

in the peripheral blood of patients with confirmed VL with a median of 663 parasites/mL (range 112-41875), while in none of the other patients did PCR disclose
a positive finding. After treatment, a clinical response (fever remission, improvement of haematological values and regression in the size of the spleen) was obtained in 6/8 patients with VL. Low parasite levels (4 parasites/mL, range 2-17)
were detected in 4 of these patients at the end of the treatment. These patients
relapsed after a median of 60 days (range 30-90), while 2 patients with unde
tectable parasite levels never relapsed after a follow-up of 4 years. Treatment
failed in 2/8 patients and high parasite load was found at the end of therapy (714
parasites/mL, range 185-1243).
Conclusion: Quantification of Leishmania DNA by real-time PCR seems to correlate with clinical course of VL and might be useful in the clinical management
of HIV patients affected by this complication.
Presenting author: Simona Bossolasco, Division of Infectious Diseases,
San Raffaele Hospital, Via Stamira d'Ancona, 20, 20127, Milano, Italy, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
ThPeB7301I Clinical and morphological description of the
CMV-damage of adrenal glands among HIV-infected
patients
V.I.S. Shakhqildian1, O.A.T. Tishkevich2, Y.G.P. Parhomenko3. IRussia Federal
AIDS Center, Moscow, Russian Federation; 22nd Infection Hospital of Moscow,
Moscow, Russian Federation; 3Institute of Morphology, Moscow, Russian
Federation
Background: The CMV-infection (CMVI) is still one of the most frequent concomitant diseases among AIDS patients in Russia. CMVI was accounted for 35,7% if
deceased AIDS patients in Moscow in 2000. Despite the gravity and high frequency of the CMV-damage of adrenal glands among HIV-infected patients this
particular patology has not been sufficiently studied yet.
Objective: To determine morphologiical peculiartities of the CMV-damage of
adrenal glands among AIDS patients and to compare the data received with the
clinical data of the disease.
Methods: From 1996 till 2000 there were made 85 patologicoanatomic examinations of adult deceased AIDS patients. CMV-patology of adrenal glands was
revealed in 42 cases. The diagnosis confirmation were characteristic itracellular
inclusions and CMV DNA in autopsy speciments.
Results: CMV-adrenalitis is accounted for 49.4% of the deceased AIDS patients and for 62.9% of CMV-disease patients. ND4+lymphocyte count - 24.0+0.2
cells/ul. 7 out of 42 patients had only damage of adrenal medulla, 23 - of adrenal
medulla e deep layers of adrenal cortex, 12 - of both medulla and all layers of
adrenal cortex with almost total destraction of the organ parenchyma. In all cases
the patological process was double-sided. These particular patients developed a
set of symptoms probably connected adrenal glands patology: advancing general and muscular weakness, considerabl loss of weight, anorexia, hypotension,
dyspepsia, fever, a number of mental deviations.
Conclusion: The CMV-damage of adrenal glands among HIV-infected patients
has a sequence of stage in its development. Almost total destruction of the organ tissue is possible without etiotropic therapy. An HIV-infected patient with active CMV-infection (CMV DNA in blood), ND4+ lymphocyte count < 50 cells/ul,
hyperkalemia, hyponatriemia and definite clinical symptoms requires a hormon
examination to rule out adrenal deficiency.
Presenting author: Vasily Shakhgildian, Russia Federal AIDS Center, Bd. 2-15,
8-ya Ulitsa Sokolinoy Gory, 105275, Moscow, Russian Federation, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeB7302 Tenofovir in the treatment of individuals
co-infected with HIV and hepatitis B
M. Nelson1, A. Barr1, M. Fisher2, G. Matthews1, B.G. Gazzard'. 'Chelsea &
Westminster Hospital, Chelsea and Westminster Hospital, Fulham Road, SW10
9NH, United Kingdom; 2Royal Sussex Hospital, Brighton, United Kingdom
Aim: To investigate the activity of tenofovir for the treatment of hepatitis B in individuals co-infected with HIV.
Methods: Prospective review of individuals receiving tenofovir as part of their HIV
antiviral regimen who are co-infected with chronic hepatitis B and HIV
Results: 14 individuals received tenofovir at a standard dose of 300mg od as part
of their HIV antiviral regimen. 11 patients were HIV viral load undetectable at time
of commencement of tenofovir. 13 had previously received 3TC with evidence
of continuing hepatitis B replication. All but one patient continued 3TC as part of
their antiviral regimen. Median ALT at commencement of therapy was 59iu (range
20 to 286) and median hepatitis B DNA was 1.3 x 108 genome equivalents (GE)
per ml (range 9.4 x 104 - 2.7 x 109). Undetectability was defined as a hepatitis B
DNA < 1 x 104 GE per/ml
Week 4 Week 12 Week 24
n 10 7 4
Normal ALT 1 2 2
Mean log decrease Hep B DNA 2.48 2.47 3.15
Hep B DNA < 10 GE/ml 4 (40%) 4 (57%) 3 (75%)
No patient converted to e antibody positive during the study period. No patient lost

HIV virological control as a result of switching or adding tenofovir. All individuals
continue on tenofovir at the present time.
Conclusions: Tenofovir has activity against hepatitis B when used in HIV positive individuals. Individuals who reach criteria for initiation of HIV antiviral therapy,
who have evidence of hepatitis B replication, should consider tenofovir as part of
their antiviral regimen. The role of dual therapy with tenofovir and 3TC remains
unclear.