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

XIV International AIDS Conference

Abstracts ThPeB7400-ThOrC1391 433

mal biopsies and all abnormal biopsies were low grade lesions in this population
with only moderate immune compromise (median CD4 430 in HIV+,1039 in HIVat baseline). The likelihood of abnormal biopsy after a normal pap was significantly greater for HIV+ visits (6.5%) as compared to HIV- visits (0.7%); rate of
abnormal biopsy after atypical cells or squamous intraepithelial lesions did not
differ by HIV status. In univariate and multivariate analyses only CD4<500/mm3
was a significant predictor of abnormal histology with normal cytology (P<.01, OR
7.5, Cl 1.7-33.0); current antiretroviral use, HPV risk categories, and presence of
undetectable viral load were not associated.
Conclusion: HIV+ women with CD4<500/mm3 are more likely to have false negative pap smears and screening at shorter intervals may be warranted. Further
evaluation in a prospective fashion and with alternative screening technologies is
needed.
Presenting author: jean anderson, harvey 319, 600 n wolfe st, baltimore, maryland, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeB7400 Prevalence of autoantibodies and cryoglobulinemia
in HIV-infected patients
F. Bonnet1, J.J. Pineau1, A. Feyler2, J.L. Taupin3, M. Bonarek1, S. de Witte1,
N. Bernard 1, D. Lacoste 1, J. Beylot', P. Morlat'. 'Hospital Saint-Andrd,
Bordeaux, France; 2INSERM U330, University Bordeaux 2, Bordeaux, France;
3Immunology laboratory, Hospital Pellegrin, Bordeaux, France
Background: Auto-immune diseases could constitute one emerging cause of
morbidity in HIV-infected patients due to the chronicity of the infection and to the
high level of B cell stimulation induced by HIV.
Methods: We conducted a transversal study investigating the clinical and biological signs of dysimmunity in HIV-infected patients followed in Saint-Andre Hospital, Bordeaux, France. We studied the plasma immunological data evaluable
in routine: antinuclear antibodies (AAN) and soluble factors, antiphospholipids,
anticardiolipids, antineutrophil cytoplasmic antibodies (ACA), rheumatoid factor
(RF), cryoglobulinemia, total complement (TC) and C4 factor. HIV-RNA, CD4+
cell count, serological status for hepatitis B (HBV) and C virus (HCV) were also
available. Clinical signs of auto-immune diseases were notified.
Results: 97 patients were investigated (men 74%). Median age was 38 (20-64).
Median CD4+ count and HIV-RNA were 150/mm3 and 1662 copies/ml respectively. Coinfection by HBV and HCV was noticed in 7 and 64% of the patients.
AAN > 1/250 were present in 19% of patients, anticardiolopids in 47%, antiphospholopids in 13%, ACA > 1/20 in 16% (mostly type C) and RF in 23%. Cryoglobulinemia was present in 33% of patients. Total complement below 70% was notified
in 28% and C4 below 0,2g/l in 55%. Thirty patients presented at least one clinical signs compatible with autoimmune diseases (neuropathy n=18, arthralgias
and arthritis n=9, myalgias 7, cutaneous n=6). HCV coinfected patients had a
higher prevalence of cryoglobulinemia (42 vs 17%, P=0.01) than HCV free patients. Prevalence of other immunological abnormalities were not different between the two groups. Patients with cryoglobulinemia were more often coinfected
by HCV (81 vs 55%, P=0,01), and had a higher HIV-RNA (4142 copies/ml vs
560,P=0.06).
Conclusion: Humoral immunological abnormalities are frequent in HIV-infected
patients but at present rarely associated with severe clinical signs.
Presenting author: Fabrice Bonnet, Hbpital Saint-Andre, 1, rue Jean Burguet,
33075 Bordeaux cedex, France, Tel.: [phone], Fax: [phone], Email: [email protected]
ThPeB7401 Pulmonary hypertension in hiv infected patients.
Report of seven cases
M. Penaranda, A. Salas, E. Sala, M. Riera, C. Delibes, M. Villalonga, M. Sanz,
C. Villalonga. Son Dureta Hospital, andrea doria 55, hospital son dureta, 07014
palma, balearic islands, Spain
Objective: Report of HIV infected patients with primary pulmonary hypertension
(PPH) diagnosed in the last ten years in a tertiary care Hospital.
Methods: Retrospective study (1991-2001). Patients were diagnosed of PPH by
means of echocardiogram or cardiac catheterization after excluding secondary
causes.
Results: From 2445 HIV patients cohort, seven patients met the criteria (6 males
and one female). Median age 37.1 (32-41) all were smokers, 3 IV consume of
cocaine and heroin. 3 were former drug users. HIV status: 5 were C3, one B2,
one Al and one A2. CD4: median at diagnosis 623 cells/mm3 (304-1130). Four
patients were not on therapy. Clinically: three had progressing shortness of breath
and PPH was suspected during clinical or X-ray examination(for others causes) in
five. Two patients had hypoxemia. Chest X-ray showed central pulmonary arteries
enlargement in all. Electrocardiogram:in all the patients showed right ventricular
hypertrophy and T waves inversion in V1-V3, and right bundle branch block in
two. Echocardiogram: median of pressure gradient VA was 55.4 mm Hg (40 - 90).

Pulmonary function test (in six patients) showed abnormal diffusing capacity for
carbon monoxide and KCO. Pulmonary thromboembolic disease was ruled out
by perfusion lung scan and pulmonary angiogram. Epoprostenol test was made
in two patients: only one was responder. Outcome: one patient was lost for followup, One is actually on treatment with nifedipino 80mg/day and acenocumarol
(walking test has improved), the no responder patient to epoprostenol test is
on acenocumarol therapy alone (functional class II-NYHA). Three patients were

dead (pneumococcal sepsis one, bilateral pneumonia two) The other patient is
under study
Conclusions: PPH is not an infrequent associated disease in HIV patients. Males
and drug users are in higher risk. Is independent of the inmune state. Most patients have no symptoms. Mortality is high.
Presenting author: maria penaranda, andrea doria 55, hospital son dureta,
07014 palma, balearic islands, Spain, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
ThPeB7402 HLA molecules in patients with AIDS who
developed cytomegalovirus retinitis
E.A. Donadi, J.F Figueiredo, E. Romao, N.V. Souza, N.H.S. Deghaide,
M.L.V. Rodrigues. Faculty of Medicine of Ribeirdo Preto - USP, Ribeirao Preto -
SP Brazil
Background: Studies carried out in United States and Australia showed that
there is association between HLA haplotypes (HLA2B44, B51 or DR7 and HLA2,
B44 and DR4), or one or more of these subtypes, with cytomegalovirus retinitis
(CMV-R) and/or manifestations of other opportunistic infections in patients with
AIDS who had not received HAART The objective of the present study is to verify
if also in Brazilian patients these associations occur.
Methods: Class I antigens (typed by the microlymphotoxicity method) and class
II alleles (characterized by the polymerase chain reaction) were analyzed in
25 patients with AIDS and CMV-R, who never received HAART. The diagnosis
of HIV infection was made by an immunoenzymatic method (Abbott Recombinant HIV-1/HIV-2 lEA) and confirmed by the gelatin particle agglutination tests
(SerodiaTM, Fujerebio Inc., Tokyo, Japan). CMV-R retinitis was diagnosed clinically
using indirect binocular ophthalmoscopy Fundoscopic lesions were documented
by retinography.
Results: Twenty-one (84%) patients presented one or more subtypes; 10 patients
(44%) presented two subtypes and one patient (4%) has the complete haplotype:
HLA-A2, HLA-B44 and HLAB1*07.
Conclusion: Also in Brazilian patients might be association between the presence of the subtypes HLA-A2-HLA-B44, HLA-B51 and HLA-DRB1*07, HLADRB1*04 and ocular manifestations of opportunistic infections in patients with
AIDS who had not received HAART.
Presenting author: Jose Fernando Figueiredo, Rua Guaranta, 64, Jardim
Recreio, 14040-190, Ribeirdo Preto - SP, Brazil, Tel.: [phone], Fax: +55
-16-6336695, E-mail: [email protected]
ThOrC 391 Predictors of HIV transmission among street youth
E. Roy', N. Haley2, RP. Leclerc3, L. Cedras3, J.F. Boivin4. 'Montreal Regional
Public Health, McGill University, Montreal Regional Public Health, 1301
Sherbrooke street east, Montreal, Quebec, Canada; 2Sainte-Justine Hospital,
Montreal Regional Public Health, McGill University, Montreal, Canada; 3Montreal
Regional Public Health, Montreal, Canada; IMcGill University Montreal Regional
Public Health, Montreal, Canada
Background: To identify predictors of HIV seroconversion among Montreal street
youth cohort participants.
Methods: This analysis was restricted to participants who were HIV-negative at
study entry, recruited between 01/1995 and 03/2000, and had completed at least
one follow-up questionnaire by 09/2000. Predictors of HIV seroconversion were
identified using Cox regression analysis. Two series of analysis were conducted:
the first included only the youth's characteristics; the second also included the
characteristics of the youth's sexual partners.
Results: Among the 862 selected subjects (575 boys, 287 girls), 16 seroconversions were observed by 09/2000 for an HIV incidence rate of 0.69 per 100
person-years (95% CI: 0.39-1.12). Age at seroconversion ranged from 17 to 27
years. Eleven seroconverters were boys. Fifteen were born in Canada and one in
Western Europe; none had ever received blood/blood products or medical treatments outside Canada. In univariate analysis, sex (p=0.91), age less than 19
years (p=0.44), and being a boy having had same sex partners in the past 6
months (p=0.41) were not associated with seroconversion. However, involvement
in survival sex (Hazard Ratio=4.0; 95% CI: 1.4-11.1) and drug injection (HR=7.0;
95% Cl: 2.2-21.7), both in the past 6 months, were significant predictors. In the
first series of multivariate analyses, drug injection during the past 6 months was
the only variable retained in the final model. In the second series of multivariate
analyses (n=14 seroconversions due to missing data), drug injection during the
past 6 months (adjusted HR=6.4; 95% Cl: 1.8-23.6) and having had a male sexual partner involved in survival sex in the past 6 months (adjusted HR=4.9; 95%
Cl: 1.5-16.4) were independent predictors of HIV seroconversion.
Conclusions: Injection drug use is the strongest predictor of HIV seroconversion
among Montreal street youth. Sexual transmission also appears to play a role in
HIV seroconversion in this population.

Presenting author: Elise Roy, Montreal Regional Public Health, 1301 Sherbrooke street east, Montreal, Quebec, Canada, Tel.: [phone], ext. 3604,
Fax: [phone], E-mail: [email protected]