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

XIV International AIDS Conference

Abstracts ThPeB7312-ThPeB7316 413

ThPeB7312 IInvasive cervical cancer in women with and without
AIDS in 15 European countries
D. Serraino1, L. Dal Maso2, P. Piselli1, C. La Vecchia3, S. Franceschi4. IlNMI
Spallanzani IRCCS, Epidemiology INMI L. Spallanzani, IRCCS, INMI L.
Spallanzani IRCCS, 00142 Roma, Italy; 21RCCS -CRO, Aviano, Italy;, 3Mario
Negri Institute, Milan, Italy; 41ARC, Lyon, France
Background: To evaluate the frequency and correlates of invasive cervical cancer (ICC) as an AIDS-defining illness (ADI) in Europe and its relationship with
incidence rates in the general population.
Methods: Statistical analysis of data from: i) national AIDS surveillance systems of 15 European countries with at least 50 AIDS female cases and, ii) from
population-based cancer registries of the same nations. AIDS cases notified between 1993 (when ICC was included among ADIs) and 1999 in women aged 20
to 49 years were taken into consideration. The association between the presence of ICC as ADI and potential determinants was assessed through odds ratio
(OR) and 95% confidence interval (CI). Country-specific incidence rates of ICC
in women aged 20 to 49 years were correlated with selected AIDS-associated
variables by means of the Pearson correlation coefficient [r].
Results: The OR of having ICC as ADI increased with age and was significantly
elevated in southern (3.1) and central (2.5) compared to northern Europe. It was
also increased among intravenous drug users (IDUs) (1.5). The proportion of ICC
as ADI was inversely correlated with incidence rates of ICC in the general female
population, but directly correlated with the proportion of IDUs among AIDS female
cases.
Conclusions: The frequency of ICC as ADI in Europe was independent from the
background risk of ICC in the general population. It was higher where IDUs predominate among AIDS female cases and where population-based ICC screening
programs were less effective.
Presenting author: Diego Serraino, Epidemiology INMI L. Spallanzani, IRCCS,
INMI L. Spallanzani IRCCS, 00142 Roma, Italy, Tel.: [phone], Fax:
+39/06/5582825, E-mail: serraino@ spallanzani.roma.it
ThPeB7313 Multicentre cohort study of testicular cancer in
men with HIV
T. Powles1, M. Nelson1, T. Oliver2, M. Fisher3, J. Stebbing4, M. Johnson5,
B.G. Gazzard 1, M. Bower1. 1Chelsea & Westminster Hospital, Chelsea and
Westminster Hospital, Fulham Road, London, SW10 9NH, United Kingdom; 2St
Bartholomew's Hospital, London, United Kingdom; 3Royal Sussex Hospital,
Sussex, United Kingdom; 4Royal Free Hospital, London, United Kingdom;
5Royal Free Hospital, I, United Kingdom
Introduction: Both HIV and testicular cancer commonly occur in young males.
There have been conflicting reports as to the frequency and nature of HIV related
testicular cancer (HT) and its treatment.
We present a large series of HT addressing its presentation, therapy and prognosis.
Patients and methods: Between 1989-99, 22 cases of HT were identified at
4 large HIV treatment centres, 19 with seminomas and 2 with mixed germ cell
tumours.
Median age was 35 yrs (23-60) and median CD4 count 275/mm3 (90 -922/mm3).The median duration of HIV prior to diagnosis of HT was 35 months
(0-55).
Histology & Stage n Prior CD4 Treatment Follow up HIV Cancer
AIDS count deaths deaths
Stage I Seminoma 15 39% 275 Orch & Surv/adj 62 mnth 39% 0%
Stage II Seminoma 4 25% 190 Orch & chemo 39 mnth 25% 25%
Stage III Seminoma 1 0% 320 Orch & chemo 115 mnth 0% 0%
MGT Stage I 2 0% 413 Orch & Surv/adj 77 mnths 0% 50%
Surv/adj=surveillance or adjuvant therapy; MGC=mixed germ cell tumour Orch= orchidectomy
Discussion: The excess of seminoma in this series supports the findings of large
cohort studies from the United States, although other series from Europe have
suggested an excess of mixed germ cell tumours and teratomas. HT presents
and should be treated as in the HIV negative population. Chemotherapy and radiotherapy are well tolerated, but do adversely effect the CD4 count, and the
majority of the mortality relates to HIV disease.
Presenting author: Tom Powles, Chelsea and Westminster Hospital, Fulham Road, London, SW10 9NH, United Kingdom, Tel.: [phone], Fax:
[phone], E-mail: -tompowles @ yahoo.com
ThPeB7314 Vaginal shedding of HHV8 is rare in women with
HIV infection
D. Serraino1, M. Capobianchi1, G. Ippolito1, P Piselli1, M. Peroni1, F. Carletti1,

C. Pavia1, G. Nurra1, S. Zaniratti1, C. Angeletti1, S. Calcaterra1, G. Rezza2.
1 INMI Spallanzani IRCCS, Epidemiology INMI L. Spallanzani, IRCCS, INMI L.
Spallanzani IRCCS, 00142 Roma, Italy; 21st Sup. Sanita, Rome, Italy
Background: Infection with the human herpes virus type 8 (HHV8) is a necessary cause for the development of Kaposi's sarcoma (KS) and some types
of non-Hodgkin's lymphoma. Some modalities of HHV-8 transmission are still to
be clarified, particularly as regards the female-to-male and the mother-to-child

transmission. We have thus conducted a cross-sectional study to quantify HHV-8
shedding in HIV-infected women.
Methods: Serum samples and cervical smears were taken from 182 women attending the gynaecological outpatient clinic of the National Institute for Infectious
Diseases Lazzaro Spallanzani, Rome. These 182 women signed the informed
consent and were consecutively enrolled between October 1999 and December
2000. Antibodies to lytic antigens of HHV-8 were detected using an immunofluorescence assays based on BCBL-1 cell line: samples reactive at >1:20 dilution
were considered positive.
Results: The 182 HIV-infected women had a median age of 36.3 years (range
24-54), and they acquired HIV infection through injection of intravenous drugs
(47.6%) or through heterosexual intercourse (52.4%). Overall, 29 (15.9%) of the
182 women were seropositive for anti-HHV8 antibodies; HHV-8 seroprevalence
was not associated with age, number of CD4+ cells or with viral load. Only 2 of the
29 women seropositive for HHV8 antibodies (6.9%) had HHV8-DNA sequences
detectable (by means of the PCR) in the cervical smear.
Conclusions: Our data indicate that vaginal shedding of HHV8 is rare, thus suggesting a low efficiency for the mother-to-child transmission and for the femaleto-male sexual transmission of HHV8.
Presenting author: Diego Serraino, Epidemiology INMI L. Spallanzani, IRCCS,
INMI L. Spallanzani IRCCS, 00142 Roma, Italy, Tel.: [phone], Fax:
+39/06/5582825, E-mail: serraino @ spallanzani.roma.it
ThPeB7315I5 Favorable impact of HAART on rsponse to therapy
and survival in patients with AIDS-related
Hodgkins's disease (ARHD)
J.M. Ribera1, J.T. Navarro1, A. Oriol1, A. Lopez-Guillermo2, E. Abella3,
J.A. Hernandez-Rivas4, A. Sureda5, E. Feliu1. 'Hematology Department
Hospital Universitari Germans Trias 1 Pujol, Badalona, Spain; 2Hematology
Department Hospital Clinic, Barcelona, Spain; 3Hematology Department
Hospital Del Mar, Barcelona, Spain; 4Hematology Department Hospital De
Mataro, Mataro, Spain; 5Hematology Department Hospital De La Santa Creu I
Santa Pau, Barcelona, Spain
Background: and Objective. HAART has been associated with improvement of
response to therapy and survival in AIDS-related systemic non-Hodgkin's lymphomas and in primary CNS lymphomas. However, its effect in patients with
ARHD has not been evaluated.
Patients: 45 patients with ARHD diagnosed in 5 hospitals from Catalonia (Spain)
between 1989 and 2001. Two groups of patients were considered. Group 1: Patients without previous HAART when ARHD was diagnosed (n=33). Group 2: Patients receiving HAART at the time of ARHD diagnosis and subsequently (n=12).
Results: Patients from Group 1 had a lower frequency of HD as first AIDSdefining event (22% vs. 58%, P=0.03) and a higher frequency of lymphocyte depletion (LD) histologic subtype (56% vs. 8%, P=0.001). No other epidemiological,
clinical or biological differences were observed between the two groups. COPP
or COPP/ABV were the most frequent chemotherapy schedules given to Group
1 patients (25 out of 34), whereas ABVD was the predominant chemotherapy for
Group 2 (9 out of 12 cases). CR rate was 41% for Group 1 and 80% for Group 2
(P=0.01). Medians for disease-free survival (DFS) and overall survival (OS) were
not achieved in patients from Group 2 and were 5 mo. and 11 mo. for patients from
Group 1 (P=0.002 and P=0.001, respectively). By multivariate analyses HAART
therapy was the only variable with favourable influence on CR attainment (OR 5.3,
95%CI 1.2-23.2). HAART (as protective) and LD subtype influenced on DFS (OR
11.2 [1.2-102.0] and 6.5 [1.0-41.4]). HAART (as protective) and hypoproteinemia
(OR 8.6 [2.3-32.7] and 10.6 [3.2-34.6], influenced on OS.
Conclusions: HAART is associated with improvement of response to therapy
and survival in patients with AIDS-related Hodgkin's lymphoma.
Presenting author: Josep-Maria Ribera, Hematology Department Hospital Universitari Germans Trias I, Pujol, Badalona, Spain, Tel.: [phone], Fax: +34
934978995, E-mail: [email protected]
ThPeB731 6 Risk factors for Cervical Squamous Intraepitelial
Lesions in HIV-1 positive women in Porto Alegre -
Brazil
R. Kreitchmann. STD/AIDS Municipal Program, Porto Alegre, Rio Grande do
Sul, Brazil
Background: The objective of the study was to characterize the prevalence and
risk factors associated with pap smear abnormalities in HIV positive women.
Methods: Study participants were submitted to pap smear, CD4 count and viral
load as part of their medical care in STD/AIDS Municipal Center of Porto Alegre. We analyzed the results of those collected during the first contact with the
gynecologist and evaluated the use of antiretroviral therapy.
Results: From January 1998 to December 2001, 367 HIV positive women had
their baseline pap smear collected. The prevalence of abnormalities was 21%

(Squamous Intraepitelial Lesion (SIL) low grade:11.7%, SIL high grade: 3.3%,
Invasive cancer: 0.3% and Atypical Squamous Cells of Indeterminate Significance(ASCUS): 5.7%) The women characteristics were: white colored: 68%,
median age: 29 years, median CD4: 487 cels/mm3, median Viral Load: 2100
copies/ml, 35.4% are not using antiretroviral drugs, 32% are using HAART. The
frequency of abnormalities in the Pap smear was higher in women using antiretroviral therapy; R.R: 1.94 [CI95% 1.18-3.17] and even HAART therapy: RR: 1.98