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

XIV International AIDS Conference

Abstracts ThPeB7373-ThPeB7377 427

parents, and opposition from public. 41.02% of the respondents told that learners
had misconception on AIDS like 'AIDS spread through air, sputum, socialcontacts
with HIV/AIDS patients and mosquitoes. Majority of the students were ignorant on
sexuality and conception. All the respondents imparted messages on HIV/AIDS
to peer members, friends, relatives and public. 84.61% respondents feel that the
programme has not affected their studies.
Presenting author: Visuvathas Jeyasingh, 32, casa major road, Egmore, Chennai, TamilNadu, India, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeB7373 Nephropathy and HIV infection
M. Aldamiz, J. Portu, M.J. Martin, I. Minguela, B. Aurrekoetxea, I. Gimeno,
R. Ruiz de Gauna, A. Chena. Hospital Txagorritxu, Jose Achotegui s/n, 01009 -
Vitoria, Spain
Background: HIV patients present multiple glomerular diseases, being the most
frequent focal and segmentary glomerulosclerosis as well as the one caused by
inmunocomplexes. We present here three cases of HIV nephropathy in caucasian
patients.
Patients: Case 1: 35 year-old male with no acceptance to HAART for the last
years, who starts with anasarca, proteinuria of 16576 mg/24h and with creatinine clearance of 28 ml/min. CD4 account were 43 (10.9%) and the viral load
> 500000 copies/ml. The renal biopsy showed collapsing focal and segmentary
glomerulosclerosis with 4% of the glomeruli sclerosed. This has been controlled
with HAART and ACEI until now.
Case 2: 39 year-old male with HIV CDC C3 infection with adherence to HAART
history. The patient presented CD4 341 (15.5%) and undetected viral load in
february 2001. CD4 218 (15.6%) and 72000 viral load in june 2001. In october 2001 he was diagnosed as having candidiasic espondilitis and nephropathy
with creatinine clearance of 32 ml/min and proteinuria of 2278 mg/24h. The renal
biopsy showed a membranous nephropathy in initial state (I-l/IV) with crescents
in 11% of glomeruli. After the specific antibiotic treatment and antiretroviral rescue
therapy the symptoms resolved.
Case 3: 38 year-old female with HIV CDC C3 infection and HAART withdrawal
history for the last 2 years. In october 2001 she suffered from edema and proteinuria 6500 mgrs/24h, microscopic hematuria as well as creatinine clearance of 42
ml/min, CD4 of 172 (14.3%) and viral load of 211600. The renal biopsy showed
segmentary and collapsing focal glomerulosclerosis with a 25% of the glomeruli
sclerosed. The symptoms were resolved with HAART and ACEI.
Conclusions: HIV nephropathy, in our casuistry, is associated with advanced
disease, high viral load, no HAART adherence history and/or the appearance of
opportunist diseases in the context of HIV infection. The response to HAART and
ACEI was efficient and nephropathy did not progress.
Presenting author: Mikel Aldamiz, Jose Achotegui s/n, 01009 - Vitoria, Spain,
Tel.: [phone], Fax: [phone], E-mail: [email protected].
net
ThPeB7374 Oral cavity manifestations among HIV patients
V.A.N. Vinogradova. Novocherkassky prH.41/14 Apt.82, StPetersburg 195112,
Russian Federation
Background: Oral cavity is often both a common site of infection among immunodeficient persons and often a source of considerable discomfort. Oral infections
tend to be recurrent, severe, sometimes resistant to treatment and may spread
systemically from the mouth. Microbial flora is highly complex.
Methods: We examined 27 patients, 21 males and 4 females, who were on treatment at infections diseases hospital. 19 of the 27 patients were intravenous drug
users, who got infectected parenterally, the others were infected via sexual route.
The age of eleven patients was from 17 to 25, the other age group was from 25
to50 years old.12 of the examined patients had viral hepatitis C or B or B and C,
2 had septical endocarditis and pnemonia. We took bacteriological test of smears
from the tongue and mucous.
Results: On careful examination of the oral cavity of HIV infected drug users
we found that 16 persons had hyperemia, 11 had ulcers, haemorrahage spots,
white leasons of thrush on cheeks, palate of the mucous, 3 had hairy leukoplakia.
These three patients had AIDS and CD 4 T-cells were less than 200 mm3.
Some appeared to have no manifestation, but according to results of their smears
showed N.albicans. In all persons Candida albicans was revealed, in addition six
had P.aeroginosa, S.pyogenes, E.coli, Klebsiella.
However, it would only just to say that all of them had poor oral hygiene. During
talks everyone of the group admitted that they did not clean their teeth regularly
and did not use additional cleaning material. Due to it oral manifestations were
severe and recurrent.We did not find the correlation between viral load and oral
manifestations. But patients who had viral load more than 1mil cop.RNA.HIV/ml
plasma had manifestations and disseminated candidasis.
Conclusion: Poor and non-regular care of oral cavity increase colonization of

wide variety of microorganisms and leads to oral manifestations especially among
HIV infected persons.
Presenting author: Anna Vinogradova, Novocherkassky pr.H.41/14 Apt.82,
St.Petersburg 195112, Russian Federation, Tel.: [phone], Fax: +7 812
528 83 93, E-mail: [email protected]

ThPeB7375 Heart Rate Variability (HRV) in
Human-immunodeficiency virus (HIV) positive
individuals
C.M. Mittal, N. Wig, S. Mishra, K.K. Deepak. All// India Institute of Medical
Sciences, New Delhi, India
Background: Heart Rate Variability (HRV) is a marker of cardiac autonomic tone.
Depressed HRV has been reported in patients of Acquired Immuno-deficiency
Syndrome (AIDS). We conducted this study to find out if HRV is depressed in HIV
positive individuals without AIDS.
Methods: We studied prospectively HRV by spectral analysis of short term Electrocardiography (ECG) monitoring in 21 HIV positives (33+11years) and in 18
healthy volunteers (31~9years). None of the HIV positives had any clinical evidence of autonomic or cardiac dysfunction. Echocardiography was also performed in HIV seropositives to rule out left ventricular (LV) systolic dysfunction.
All these individuals did not have any evidence of AIDS.
Results: Mean CD4+ lymphocyte count was 426+166/mm3. The Ejection fraction (EF%) of HIV patients was 62.4~6.4. The HRV was reduced significantly in
HIV positive individuals.
HRV prameters (ms2) HIV seropositives (n=21) controls (n=18) p value
total power 642~462 2004+1044 <0.00001
VLF component (0.01- 0.04 Hz) 320~331 608~361 <0.0005
LF component (0.04- 0.15 Hz) 164~139 638~424 <0.00005
HF component (0.15-0.40 Hz) 157+200 756+693 <0.0005
All values in mean+S.D. VLF (very low frequency), LF (low frequency), HF (high frequency),
Hz= Hertz
Conclusions: HRV is depressed in HIV seropositive individuals in early stages
of infection as well without any clinical evidence of autonomic dysfunction. This
may serve as early marker of future global sympatho-vagal imbalance. It may
predispose these patients to arrhythmias and risk of sudden death.
Presenting author: Chander Mohan Mittal, Room No. 3/76, Gents Hostel,
All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
ThPeB7376 Deep venous thrombosis and pulmonary embolism
in HIV patients
J.E. Fishman, R.B.H. Hulen, M. Patino-Bajayo. University of Miami, Dept. of
Radiology, Miami, FL, United States
Background: Studies have suggested an increased risk of venous thromboembolic disease among HIV-infected patients. We assessed the incidence, presentation, clinical factors, and outcome of deep venous thrombosis (DVT) and pulmonary embolism (PE) in HIV patients.
Methods: Retrospective review of hospital discharge diagnoses was performed
for the period October 1999 through September 2000 to identify all HIV patients
with a diagnosis of DVT, PE, or both. Subsequently, individual medical records
were reviewed to definitively document the presence of one or both conditions,
as well as patient demographics, CD4 count, method by which the diagnosis was
made, concurrent diagnoses, and mortality.
Results: DVT or PE was present in 40 (3.3%) of 1,204 HIV individuals admitted.
Mean age was 42 years; mean CD4 count was 122 cells/pli, with 7 patients having
greater than 200 cells/pl. Thirty-six patients had DVT, including 27 of the lower
extremity veins, 7 of the upper extremity veins, and 2 of both lower and upper
extremities. All 9 of the patients with upper extremity thrombosis developed it as
a result of venous catheter placement or complications, compared to one patient
with lower extremity thrombosis (p< 0.0001). Eight (22%) of DVT patients died
during the admission. All DVT cases were diagnosed using Doppler ultrasound.
Three patients had PE, significantly fewer than had DVT (p<.01). Two PE cases
were diagnosed by CT and one by VQ scan. PE patients had a mean CD4 count
of 99 cells/pll. None of the three had documented DVT.
Conclusions: Thromboembolic disease, particularly DVT, occurred in a substantial number of HIV patients admitted to the hospital during the study period.
Thromboembolic disease can occur in both severely immunosuppressed HIV patients and in patients with relatively high CD4 counts. As it is associated with a
high mortality rate, prevention and diagnosis of thromboembolic disease should
be emphasized in the HIV population.
Presenting author: Joel Fishman, Dept. of Radiology, JMH West Wing 279, 1611
N.W. 12th Ave., Miami, FL 33136, United States, Tel.: [phone], Fax: [phone], E-mail: jfishman @ med.miami.edu
ThPeB7377 Heart compromise in AIDS. Results from the first
peruvian multicentric cohort
G.V. Valenzuela1, O.E. Guerra2, F Medina2, F Samalvides2, R. Castillo1,

R. Salazar1, E. Gotuzzo2. 1Hospital Nacional Guillermo Almenara Irigoyen,
Jiron San Diego 552, Surquillo Lima 34, Peru; 21nstituto de Medicina Tropical
"Alexander Von Humboldt", Lima, Peru
Background: The heart is the worst organ studied in people with AIDS, probably
because its affectation had a long clinical course. Perhaps, some of their pathologies like Pericardial Effusions (PE) and Dilated Cardiomyopathy (DCM) had been
associated with a higher morbidity and mortality.