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

428 Abstracts ThPeB7378-ThPeB7381

XIV International AIDS Conference

Methods: We carried out from August 2001 to January 2002, the first study in
our country in two centers of reference, from social security and health ministry
respectively, using echocardiographic measurements to evaluate ambulatory patients in AIDS stage.
Results: 114 persons were included. The mean age was 35.9 years (SD 8.5).
67.5% were male. The mean count of CD4 was 152.5 (cell/UI) and 78.4% had
counts below 200. 45.9% were receiving antiretroviral therapy. In functional study
we found Diastolic Disfunction (DD) in 28.9%, restrictive pattern in 1.71% and
systolic dysfunction in 1.71%.
The morphologic study showed PE in 9.64%, Mitral Valve Prolapse (MVP) in 20%
and DCM in 1.71%. Doppler study showed mitral insuficiency in 34.2%, tricuspideal insuficiency in 52.6%, pulmonary insuficiency in 48.2% and aortic insuficiency in 26.3%
Conclusions: Our dates are the first reported in our country. We found a 28.9%
with DD and their clinical evolution must be investigated. MVP was found in 20%
and is recognized as a risk factor of endocarditis. On the other hand, insuficiency
of heart valves are higher than the reported in epidemiological studies. We suggest the evaluation and follow up using echocardiography of people with HIV infection, specially of those in AIDS stage.
Presenting author: German Valenzuela, Jiron San Diego 552, Surquillo Lima
34, Peru, Tel.: [phone], Fax: [phone], E-mail: gvalenzuela@terra.
com.pe
ThPeB7378 Facial implants with Polymethylmethacrylate
(PMMA) for lipodistrophy correction: 36 month
follow up. Serra, M. CTA-AIDS/CREMERJ, Rio de
Janeiro, Brazil
M. Serra. CTA-AIDS/CREMERJ, Rio de Janeiro, Brazil
Background: Facial atrophy, an unaesthetic condition due to lipodistrophy, has
been a challenge on HIV treatment, interfering on therapy adherence and patient self-esteem, thus compromising psychological status and quality of life, with
some anecdotal suicidal reports. Temporary implant, like collagen and fat implants, couldn't change this situation. PMMA implants have been largely used
in Brazil for years and is used for correction of facial atrophy in AIDS patients.
Methods: Clinical analysis of patients who were submitted to facial implants with
PMMA, with a minimum follow up of 12 months and a maximum of 36 months. Implants were performed with a 30% PMMA solution in a vehicle containing hydroxyethylcellulose and lidocaine. Patients were questioned about changes in their
status of life, allergic reactions or any other event related with implants. Biopsies
were randomly performed.
Results: 200 patients were included in this study. Facial implants with PMMA
demonstrated to be lasting, easy to be perfromed, safe, and with good aesthetic results. No imflammation, infection, granuloma or allergic reactions were
observed. Histopathology showed diffuse granulomatous infiltrate in the subcutis, with extracellular vacuoles of different sizes but uniformly round shape. No
change on CD4 count viral load was related with the procedure. PMMA demonstrated to be longer lasting and have better cost effectiveness when compared
with collagen or fat implants. All Patients were satisfied with the result and referred a terrific improvement in their quality of life.
Conclusion: PMMA facial implants showed to be safe, lasting, cost effective, very
well tolerated and with no side effects when compared with temporary implants.
The implants had a positive influence on patients psychological status, recovering
their self esteem and improving quality of life.
Presenting author: Marcio Serra, Praca Serzedelo Correa 15 / 1001, Rio de
Janeiro, Brazil, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeB7379 Deleterious impact of tobacco use on respiratory
infections in HIV infected individuals with and
without HAART
M.J. Migluez-Burbano1, D. Ashkin2, A. Pitchenik1, H. Archer1, A. Rodriguez1,
X. Burbano1, G. Shor-Posner1. 1 University of Miami School of Medicine,
University of Miami School of Medicine, Dept. of Psychiatry (D21), 1400 N.W
10th ave., 6th floor, Miami, Florida 33136, United States; 2A.G. Holley State
Hospital, Lantana, United States
Background: Although HAART has been decreased morbidity and mortality
rates by up to 80% respiratory infections (RI) are still responsible for a large
number of hospitalizations and deaths in HIV disease. The clinical relevance of
tobacco use on RI in HIV/HAART is unknown.
Methods: Medical history and CD4 count were obtained in 106 HIV infected subjects consecutively hospitalized at Jackson Memorial and enrolled in a tobacco
study (9-12/2001).
Results: A high proportion of HIV+ hospitalized men and women reported current tobacco use (61% 7+12 cigarettes/day). Respiratory tract compromise ac
counted for 46% of the total admissions: 56% pneumonias (CAP) 22% PCP, 12%
TBC and 10% pneumonitis or bronchitis. Furthermore, 82% of the PCP, 80% of
the bronchitis and 57% of the CAP occurred in smokers. Almost half of these
cases (48%) were on HAART for >6 months and 42% were using Bactrim. The
mean CD4 cell count of the total group was 112+133; only 17% had>200 cells.
Of interest, 66% of HAART-treated patients with >200 cells still developed a respiratory infection and 2/3 occurred in smokers. In HAART treated individuals CAP

was the most prevalent RI. After controlling for HAART, significant correlations
were observed between being hospitalized for a RI: and being a smoker (r=.287,
p=0.008); years of cigarette use (r=.287, p=0.004) and quantity (r=-.193, p=0.03).
Additional analyses indicate that without HAART, HIV+ smokers were 8 times
more likely to develop a RI (p=0.0009) and HAART-treated smokers were still at
high risk of hospitalization for a RI as compared to non-smokers (OR=3 95%CI
1.1-6.3, p=0.01).
Conclusion: These data demonstrate the deleterious impact of cigarette smoking on RI in both individuals with (pneumonias) or without HAART (PCP, bronchitis). Support: Florida Tobacco Research and NIH-Fogarty
Presenting author: Maria Jose Miguez-Burbano, University of Miami School of
Medicine, Dept. of Psychiatry (D21), 1400 N.W. 10th ave., 6th floor, Miami, Florida
33136, United States, Tel.: [phone], Fax: [phone], E-mail: m.
miguez @ miami.edu
ThPeB7380 Lidocaine patch 5% - a novel, effective therapeutic
approach to the treatment of HIV-associated painful
peripheral neuropathy
SM. Berman, J.C. Justis, M.I. Ho. VA Long Beach Healthcare System, 5901 E
7th Street, mail code 11/111-D, Long Beach, California 90822, United States
Background: Both HIV infection and antiretroviral medications are associated
with the development of painful peripheral neuropathy (PPN). Many agents have
been used to treat PPN with partial success and frequent side effects. A nonsystemic topical treatment was evaluated for efficacy and potential side effects in
treating PPN.
Methods: A small, open-label pilot study of Lidoderm~ (lidocaine patch 5%) was
conducted in HIV-infected patients. Patients applied the patch to affected areas for
12/24 hours each day. To assess symptoms, 2 questionnaires were administered
every 2 weeks [11 question Brief Pain Inventory (BPI) & 9 question Neuropathy
Pain Scale (NPS)]. A short Quality of Life questionnaire was administered at first
and last visits.
Results: Nine patients were enrolled. One discontinued the patch due to increased burning sensations in his feet; no local skin reaction was noted. At week
6, patients reported their pain as very much improved (1/8), much improved (5/
8), or minimally improved (2/8). Individual scores varied on the assessment tools.
Using % change in scores, there was an overall 27.2% decrease in symptom
severity on the BPI by week 4. Similarly, there was a 33.7% decrease in symptom
severity on the NPS. The range of symptom improvement on individual questions
was 18.4 to 62%. As quantified by the NPS, patients reported an overall 26.7%
decrease in intensity of pain. Of particular note is the BPI question pertaining to
the effect of pain on enjoyment of life. Patients reported an overall 34.8% improvement on this item. Tolerance and acceptance of the patch were excellent.
Conclusions: Lidoderm~ in this small pilot study appeared to be very effective
in reducing symptoms of PPN in HIV+ individuals. The product was well tolerated with little or no potential for systemic adverse effects. A large double-blinded
placebo controlled trial to further document efficacy is justified.
Presenting author: Stephen Berman, 5901 E. 7th Street, mail code 11/111-ID,
Long Beach, California 90822, United States, Tel.: [phone], Fax: +1 -
562-494-5889, E-mail: stephen.berman2 @ med.va.gov
ThPeB7381 Once-weekly epoetin alfa corrects hemoglobin and
improves quality of life as effectively as three times
weekly dosing in HIV+ patients
H. Grossman1, G. Leitz2, P Bowers2. 1Col/umbia University College of
Physicians and Surgeons, Columbia University College of Physicians and
Surgeons, 155 West 19th Street, FL4, New York, NY 10011-4121, United States;
20rtho Biotech Products, LP, Raritan, United States
Background: Improving patient quality of life (QOL) is an essential component
of the management of HIV+ patients. Anemic HIV+ patients present symptoms
that diminish one's QOL. Correcting anemia may alleviate these symptoms and
patients may have more energy to accomplish daily tasks. Also, previous studies
indicate that anemia is an independent risk factor for survival and disease progression. This study evaluates the effects of once-weekly (QW) and three-timesweekly (TIW) dosing of recombinant human erythropoietin (epoetin alfa, Procrit~)
on energy, activity, and overall QOL in this patient population.
Methods: Anemic (hemoglobin [Hb]<12 g/dL) HIV+ patients receiving stable antiretroviral therapy were randomized to either 100 U/kg epoetin alfa TIW SC or
40,000 U epoetin alfa QW SC for 16 weeks. Endpoints included changes in Hb
and patient-reported assessments of energy, activity, and overall QOL, as measured by the Linear Analog Scale Assessment (LASA).

Hb (g/dL)
LASA Activity (mm)*
LASA Energy (mm)*
LASA Overall QOL (mm)*

Mean BL Value
QW TIW
n=91 n=83
10.5~1.3 10.5~1.2
n=89 n=78
44.4~25.4 44.3~26.6
40.3~124.1 39.9~23.4
50.3~25.5 47.2~25.1

Mean Change (Final)
QW TIW
n=88 n=81
2.8~1.9 2.4~2.4
n=75 n=67
22.3~33.2 23.9~31.2
24.1~30.6 25.6~28.7
19.7~31.8 21.5~27.0

*100 mm scale: 0 (worst)- 100 (best).