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

448 Abstracts ThPeC7440-ThPeC7443

XIV International AIDS Conference

cases/100 person year after one year follow-up compared to 36.5 cases/100 person year for the CRF-BC cohort. HIV-1 viral loads among people infected with
CRF-AE were not statistically different from those people infected with CRF-BC
HIV-1.
Conclusions: There was a trend suggesting that CRF-BC recombinant HIV-1
may be more infectious than CRF-AE in our study population. Additional studies are needed to determine factors that may cause differential spreading of HIV
strains.
Presenting author: Xiao-Fang Yu, Department of Molecular Microbiology and
Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St,
Baltimore, MD 21205, United States, Tel.: [phone], Fax: [phone]
0105, E-mail: [email protected]
ThPeC7440 Effectiveness of long-term HAART regimens in
treatment naive and experienced patients in a large
observational cohort (ATHENA)
M.A. Van de Wiel1, A.I. Van Sighem1, A.C. Ghani2, F. De Wolf1. IDept. of
Human Retrovirology Academic Medical Centre of the University of Amsterdam,
Amsterdam, The Netherlands; 2Dept. of Infectious Disease Epidemiology,
Imperial College School of Medicine, London, United Kingdom
Background: To compare long-term effectiveness of several first-line highly active anti-retroviral therapies (HAART) for 1289 therapy naive patients and 268
patients pre-treated with zidovudine+lamivudine in an observational cohort.
Methods: A time-dependent, multivariate hazards model was fitted to determine
the best marker for disease progression. Therapy effectiveness was defined by
changes in this marker over 48 or 96 weeks. Two-level linear models were used
to assess the effectiveness of nucleoside reverse transcriptase inhibitor (NRTI)
and non-nucleoside reverse transcriptase/protease inhibitor (NNRTI/PI) therapy
components, adjusting for baseline marker values and lost-to-follow-up.
Results: The hazards model suggested the natural logarithm of the most recent
CD4+ T-cell count as a marker. We distinguished between patients with low and
high baseline CD4+ T-cell counts (> 200/mm3). For most therapy naive patients,
therapy effectiveness is predominantly determined by the choice of NNRTI/PI.
In the low baseline group, ritonavir and saquinavir were significantly (p<0.05)
less effective than the best combination (indinavir+ritonavir). In the high baseline group, ritonavir and nevirapine were significantly less effective than the best
combination (saquinavir+ritonavir). For low baseline patients pre-treated with zidovudine+lamivudine, zidovudine+lamivudine including HAART is less effective
than stavudine+lamivudine including HAART (p<0.001).
Conclusions: Significant differences in effectiveness of commonly prescribed
therapies were observed in a large observational cohort. Some of our results confirmed results from short-term randomised controlled trials, whereas others have
not yet been observed. Whilst it is not possible to remove all potential sources of
bias, the results provide a useful "real-life" confirmation of trial results and suggest
further potential trials.
Presenting author: Frank De Wolf, Dept. Human Retrovirology, AMC University
of Amsterdam (K3-113D), Meibergdreef 15, 1105 AZ Amsterdam, The Netherlands, Tel.: [phone], Fax: [phone], E-mail: [email protected].
ni
ThPeC7441I Estimated and projected demographic impacts of
AIDS mortality
K.A. Stanecki. US Census Bureau, International Programs Center, US Census
Bureau, Washington, DC 20233-8860, United States
Background In countries with high levels of HIV prevalence, AIDS mortality will
have major demographic impacts on populations. By the year 2010, crude death
rates will increase significantly in those countries. One-third of all children born to
HIV infected mothers will themselves become HIV positive resulting in increasing
infant mortality rates. Since many children who are infected with HIV are expected
to live past their first birthdays, child mortality rates will also be affected by the
HIV/AIDS epidemic.
Methods Since 1994, the US Census Bureau has incorporated the impact of
HIV/AIDS mortality in the population projections prepared for the Bureau's International Data Base. Using iwgAIDS, unique HIV epidemic scenarios are modeled for each country. With each biennial revision, additional refinements and
additional epidemiological data are incorporated into the methodology and input
data. In the 2002 revision, HIV/AIDS mortality in incorporated explicitly in the
projections for 50 countries, including 37 in Africa, 10 in Latin America and the
Caribbean, and 3 in Asia.
This paper describes the epidemiological background of the status and trends in
HIV/AIDS epidemics around the world. We focus on the devastating impacts of
AIDS mortality that are estimated to occur particularly in Southern Africa. Population growth, infant mortality, and life expectancies are compared under AIDS and
non-AIDS scenarios.

Results As a result of high levels of AIDS mortality and reduced total fertility rates,
Botswana, South Africa and Zimbabwe will soon be experiencing negative population growth. As of the year 2002, female population in Zimbabwe has already
started to decline.
ConclusionThe HIV/AIDS epidemics continue to have significant impacts on
populations around the world. Based on current levels of HIV prevalence these
impacts will continue over the next decade.

Presenting author: Karen Stanecki, International Programs Center, US Census
Bureau, Washington, DC 20233-8860, United States, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
ThPeC7442 Evaluating current epidemic, some estimations of
HIV/AIDS prevalence in India with special
emphasize to Mumbai city so-called AIDS capital of
India
S. Srinivasan. Mumbai District AIDS Control Society Internationational Institute
for Population Sciences, Deonar, Mumbai, C/O Dr. G.Ramarao, Interrnational
Institue for Population Sciences, Deonar, Mumbai-88, Maharastra state, India
Background: Since epidemic started in India so far 31000 AIDS cases (NACO,
2001) reported among 1440 AIDS cases reported from Mumbai in 2001. HIV
prevalence in India is 0.59 percent, in Mumbai having high prevalence (.57 percent). Despite some available reported data, it doesn't show the country's actual
epidemic level, and even several epidemiological, observational studies shown
an exponential increase found in prevalence of HIV Infection in India. This study
has attempted to appraise the epidemic, estimate actual prevalence and depth
analyze for current situation of country and Mumbai. Methods: HIV/AIDS data
borrowed from regional and National AIDS control Organizations. The overall estimation has done with using demographic data from latest Census reports, STD,
HIV prevalence among ANC women from sentinel surveillance data. The current
re estimation of HIV prevalence has done with using curve fitting, extrapolations,
assumptions, and indicators from earlier studies used.
Results: Age distribution of HIV/AIDS converged among adult population belonging to 15-49 years. This study estimated that HIV prevalence among general
population (12 Million) in Mumbai has found 1.66 percent. The prevalence has
categorized as low, medium, high among different states. The states Manipur,
Maharastra, Tamil Nadu found high prevalence states of India. The HIV prevalence among STI patients is 33.6 percent where as 56 percent has found among
commercial sex workers compared to other risk group. But the estimation of over
all STI prevalence among general population is about 10 percent.
Conclusions: The country's epidemic has not decreased but it stabled, mortality
has converged to the adult population, epidemic will be control among the high
prevalence regions and increase among low prevalence regions. Mumbai City
having high prevalence of HIV/AIDS contributing high proportion to nation. Accurate estimates to be needed to establish AIDS control programmes to carry out
the goals.
Presenting author: Srinivasan S, C/O Dr. G.Ramarao, Interrnational Institue for
Population Sciences, Deonar, Mumbai-88, Maharastra state, India, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeC7443 Trends in spread of HIV infection and drug
addiction in Russia
V.M. Kolesov. Medical Analytical Center, 14A, Chernishevskogo Street, Vologda,
160012, Russian Federation
Background: According official data 35 % of new HIV-infections in 2000 in Russia have no clearly defined way transmission of HIV and about 60% of new HIVinfections are revealed in the midst of IDU. Therefore, there is the need to analyze
the mutual dynamics of spread of HIV-epidemic and drug addiction.
Methods: The time series of cumulative numbers of registered HIV cases and
morbidity of drug addiction in Russia since 1991 are approximated by cubic polynomials with coefficients of determination very close to 1. The corresponding
models allow construct the short-term forecasts of these processes.
Results: The mutual behavior of spread HIV-epidemic and drug addiction very
similar. It permitted us to account that the most of 35%-undefined way HIVinfections are explained by fast spread of drug addiction in Russia. At the same
time, what especially potentially dangerously - the rates of growth of registered
heterosexual transmission of HIV in Russia, that are varying from 70% to 140%
per year. Maybe it is not evident now against a background of growth of drug addiction and blood transmission of HIV in Russia, but such rates are the way of
epidemic in Africa.
Conclusions: If the tendencies of HIV-epidemic in Russia will be kept then by
the end 2003 it is necessary to expect, that the cumulative number of registered
HIV-infections will be about 550 thousands. Taking into account the latency of HIVinfection can be spoken about appropriate real cumulative number in 2,5 millions
HIV-infections to this time.
Presenting author: Viktor Kolesov, 14A, Chernishevskogo Street, Vologda,
160012, Russian Federation, Tel.: [phone], Fax: [phone], E-mail:
vkolessov@ mail.vcom.ru
ThPeC7445 Differences on HIV spread in five cities of
Dominican Republic

E. Gomez1, J. Feliz2, A. Ramirez2. 1Universidad Autonoma de Santo Domingo,
Escuela de Salud Publica, Miguel Angel Monclus #65, Mirador Norte, Santo
Domingo, Distrito Nacional, Dominican Republic; 2Direccion General de Control
ITS/SIDA, Secretaria de Estado de Salud Publica, Santo Domingo, Dominican
Republic
Background: Sentinel surveillance of HIV-1 in pregnant women has been used