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

XIV International AIDS Conference

Abstracts ThPeC7471-ThPeC7474 455

19.8% of cases, respectively; HHV8 was detected occasionally (1.1%). Shedding of multiple viruses was observed in 36% of women analyzed. Particularly,
the most frequent association was CMV+HPV (29.8%), followed by TTV+HPV
(23.9%), HSV-2 +HPV (20.9%), and HSV-1+HPV 17.9%. In 12.1% of cases concomitant shedding of more that 2 viruses was detected.
Conclusions: High/middle risk HPV types in the genital tract of HIV-positive
women are more frequently detected than low risk types. Concomitant shedding
of other DNA viruses is very common, indicating that in the immunosuppressed
women population reactivation of multiple persistent virus infections can occur.
Presenting author: Maria R. Capobianchi, Laboratory of Virology, National
Institute for Infectious Diseases, Via Portuense 292, 00149 Rome, Italy, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
ThPeC7471I Disseminated histoplasmosis in hiv/aids in a
reference center in Sao Paulo
T.M. Sales, R. Del Bianco, A. Araujo, G.M.A. Vasconcelos. CRTA/DS-Hospital,
Sac Paulo, Brazil
Objectives: High index of suspicion is necessary for early diagnosis of disseminated histoplasmosis in patients with acquired immunodeficiency syndrome. We
designed an analysis to examine patterns and reasons for hospital admissions
over time and to identify clinical features and laboratory in disseminated histoplasmosis. We review the epidemiological findings, clinical caracteristics, radiological
findings, CD4 counts at presentation (CD4), opportunistic infections associated,
and LDH levels.
Methods: From June 99 to Dec.2001 records of 10 HIV patients found to have
disseminated histoplasmosis in a Reference Center Clinic in Sao Paulo, Brazil.
Results: 08 male,02 female.Heterosexual(3),homosexual(4),UDI(2).Prolonged
fever (10), weight loss (5), lymphadenopaty (2),respiratory synptoms (9), gastrointestional synptoms (6), hepatomegaly (7), splenomegaly(4),cutaneous lesions
(3), CD4 rate: 40/ml, LDH levels >1000UI/L had 60% in patients. 04 patients
were probably using highly active antiretroviral therapy but 01 didn't have compliance. Opportunistic infections associated were: tuberculosis (5), hepatite C (2),
CMV (3), toxoplasmosis (1), candidiasis (6), PCP (2), MAI (1). A total of 10 disseminated histoplasmosis hospitalizations, 07 death and 03 cured.
Conclusions: HIV infected patients with prolonged fever, weight loss, hepatomegaly and respiratory synptoms should raise the suspicion on probable disseminated histoplasmosis, more so they have much lower CD4 counts (40/mi)
and LDH levels above 1000UI/L are highly specific for disseminated histoplasmosis.
Presenting author: Taciana Sales, Cardoso de Almeida St,817/82 zip 05013 -001, Sdo Paulo, Brazil, Tel.: [phone], Fax: [phone], E-mail: fivan
@uol.com.br
ThPeC7472 Influence of HIV and other sexually transmitted
diseases in the presence of oral mucosal lesions
L. Esquivel-Pedraza1, L. Fernandez-Cuevas2. linstituto Nacional de Ciencias
Medicas y Nutricion Salvador Zubiran, salmon no.6 MZ 84, col.del mar Mexico,
D.F CP 13270, Mexico; 2Universidad Intercontinental, Mexico City, Mexico
Background: The risk for development of oral lesions (OL) through the presence
of sexually transmitted diseases (STD) is scarcely known. The purpose of the
study was to evaluate the impact of HIV infection and other STD in the development of oral mucosal lesions, as well as the influence of sexual practices.
Methods: Cross-sectional study performed from 1997 to 2000, in subjects who
attended to a HIV-screening center of the National Council on AIDS, in Mexico
City. Oral exams were performed. Epidemiological and clinical data, as well as
sexual behaviour and laboratory results concerning to STD, were considered in
the study Odds ratio (OR) and 95% confidence intervals (CI) were calculated. X2
and Fisher's exact tests were used, and multivariate analysis was done.
Results: A total of 277 subjects were included (70.4% were men). The median age of subjects was 25 yr. (range 16-73 yr.). A higher (p<0.001) frequency of oral infectious processes was observed in subjects with STD (OR=6.5;
IC=3.1-13.4) than in those without STD. The total of oral infectious processes (OR=11.9; IC=4.5-31.0), hairy leukoplakia (OR=92.1; IC=10.8-788.0),
oral (OR=72.0; IC=20.6-252.2) candidosis (OC), and exfoliative cheilitis (OR=6.8;
IC=2.7-17.5) were highly related (p<0.01) specifically to HIV-infection. OC was
also associated to patients infected (p=0.008) with HBV (OR=7.1; IC=2.0 -25.5).Through logistic regression analysis, the association of OC and the pres
ence of HIV-infection remained significant (p=0.008), independently of confounding factors.
Recurrent aphthae were observed more frequently (p<0.05) in subjects with homosexual practices (OR=4.5; IC=1.6-12.3) and in subjects with unprotected vaginal sexual practices (OR=1.1; IC=1.0-1.1). The association of aphthae and homosexuality remained unchanged (p=0.004) in the multivariate analysis.
Conclusions: In this study, the presence of some STD and the practice of certain
sexual activities increased the risk for development of OL.
Presenting author: lilly Esquivel-Pedraza, salmon no.6 MZ 84, col.del mar Mexico, D.F. CP 13270, Mexico, Tel.: [phone], Fax: [phone], E-mail: lillyep
@ hotmail.com
ThPeC7473 Opportunistic illnesses in the era of HAART occur
despite controlled viral replication and higher CD4
cell counts
B. Rodriquez, H. Valdez, B.M. Gripshover, G. McComsey, R.A. Salata, S. Fulton,
M.V. Lisgaris, J. Cline, M.M. Lederman. Case Western Reserve University and
University Hospitals of Cleveland, 2061 Cornell Rm 401B, Cleveland, OH,
44106, United States
Background: While highly active antiretroviral therapy (HAART) has reduced the
incidence of HIV-related opportunistic infections the relationship between immune
restoration, HIV replication and the occurrence of OI in the HAART era is incompletely defined.
Methods: We identified all AIDS Defining Illnesses (ADIs) occurring between
1996 and 2001 among HIV-infected patients followed at the Special Immunology Unit of University Hospitals of Cleveland, and recorded the most proximate
CD4 cell count and plasma HIV RNA levels.
Results: 150 ADIs occurred among 111 patients between 1996 and 2001. Yearly
incidence decreased from 4.1% in 1996 to 2.2% in 2001 (p=0.028). 18(12%)
cases occurred in patients with an undetectable plasma HIV RNA for a median(interquartile range, IQR) of 5(6) months. 39(26%) cases had HIV RNA levels
below 5000 copies/mL. Median CD4 cell counts were significantly higher among
patients with undetectable HIV RNA (median[IQR], 140[180] vs. 20[70] cells/uL,
p<0.05). Age, gender, and types of ADIs were similar in the groups with and without detectable HIV RNA. The incidence of different ADIs was similar from year to
year. The table summarizes the most commonly observed ADIs and proximate
CD4 cell counts in the groups with and without detectable HIV RNA.
Conclusions: Although their incidence is declining, ADIs continue to occur
among HIV-infected patients, including patients with complete viral suppression
of HIV replication, in whom ADIs occur at higher CD4 cell counts. The spectrum
of ADIs has not changed significantly during the HAART era.
Presenting author: Rodriguez Benigno, 2061 Cornell Rm 401B, Cleveland, OH,
44106, United States, Tel.: [phone], Fax: [phone], E-mail: [email protected]
ThPeC7474 Crytococcal infection in HIV patientes A report of
55 cases
S. Braz, M. Toscano Rico, P. Rodrigues, J. Machado, F. Maltez, A. Morgado,
R. Proenca. Hospital de Curry Cabral, Lisbon, Portugal
Background: AIDS is the major predisposing factor in cryptococcal infections
(CI) and meningitis is their leading fungal infection of the central nervous system
(CNS). Clear-cut meningitis symptoms are not frequent and the cerebrospinal
fluid (CSF) may show little abnormalities.
Methods: Retrospective analysis of all HIV infected patients hospitalised in our
department with Cl confirmed by laboratory and/or histopathological data.
Results: From January 1985 to January 2002, 1600 patients were hospitalised
with HIV infection. Fifty-five patients (3.4%) had CI; 38 cases were diagnosed between 1985-96 and 17 after the introduction of highly active antiretroviral therapy
(HAART).
Fifty-three patients were HIV1 + and 2 HIV2+. The risk for HIV infection was sexual
behaviour in 72.7% of the patients, 20% were intravenous drug users and 7.3%
were haemophilic.
In 18 patients (32.7%) Cl revealed HIV infection and in 30 (54.5%) was the first
AIDS defining illness.
Only 18 patients (32.7%) were adherent to antiretroviral medication and the mean
CD4+ cell count was 61.1/mm3.
CNS involvement was present in 53 patients. Ten patients had disseminated

Abstract ThPeC7473 - Table
Illness N CD4 cell count, median (IQR) cells/lL, CD4 cell count, median (IQR) cells/pL,
(%) HIV RNA <5000 copies/mL HIV RNA >5000 copies/mL
Pneumocystis carinii pneumonia (PCP) 32(21.3) 110(250) 30(140)
Candida esophagitis 30(20) 210(230) 20(50)
HIV wasting/encephalopathy 19(12.6) 60(160) 30(230)
Mycobacterium avium (MAC), disseminated 18(12) 370(-)* 10(50)
Kaposi's sarcoma (KS), mucocutaneous 11(7.3) 190(240) 20(50)
Cytomegalovirus (CMV) retinitis 8(5.3) 250 10(1)
Cryptococcosis 5(3.3) 60(-)* 270(-)
Non-Hodgkin's lymphoma (NHL) 5(3.3) 240(-)* 230(430)
Others (&#61603;3 cases each) 22(14.6) 140(280) 30(30)