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

XIV International AIDS Conference

Abstracts ThPeC7524-ThPeC7527 467

Method: Swasthay Kalyan Blood Bank is first Blood Bank in Rajasthan in voluntary sector and providing services with no profit/loss basis. As per Drug act of
India five tests are mandatory for every collected unit. These tests are Malaria,
VDRL, Hepatitis -B and C and HIV. In last 5 years 43604 blood units has collected
in the blood bank. All Blood units were subjected to Hepatitis-B test.
Result: The test results shows that Hepatitis-B was found positive in 1386 samples (3.18 %) while Hepatitis C and HIV were only 0.69 % (299) and 0.52 %
(228).
Conclusion: Data of blood banks clearly indicate that Hepatitis-B infection is
more common that HIV and HCV. Hepatitis-B virus has same route of transmission as HIV. The virus of Hepatitis-B is more virulent and less susceptible than
HIV. These results should attract the attention of public health experts nationally
and internationally to declare it as public health problem. Since the vaccine is
available so control on this disease can be achieved. The only requirement is
that this disease should also get place in National Health Programmes. In other
words WHO should look into this and countries may be advised to initiate National
Hepatitis-B Control Programme in their territories.
Presenting author: Shyam Sunder Agrawal, D-32 Chikitsalay Marg, Bapunagar,
Jaipur-302015, India, Tel.: [phone], Fax: [phone], E-mail: txamit
@datainfosys.net
ThPeC7524 Hepatitis B and Hepatitis C infections among
young men who have sex with men. The Baltimore
young men's survey
F. Sifakis, J.B. Hylton, D.D. Celentano. The Johns Hopkins School of Public
Health, 3507 North Charles St., Apt # 302, Baltimore 21218, Maryland, United
States
Background: Hepatitis B (HBV) and Hepatitis C (HCV) infections often occur as
co-infections with HIV in men who have sex with men, although the prevalence in
non-drug users is generally not specified.
Methods: The Young Men's Survey was a cross-sectional, venue-based sample
of young men who have sex with men (MSM} aged 15-29, who frequented public venues in Baltimore, MD (USA). A questionnaire was administered and blood
specimens were drawn for HIV and HBV testing (1996-2000). Stepwise logistic
regression was utilized to determine correlates of HBV and HCV infection.
Results: There were 863 participants (33.4% African American, 53.7% white;
76.5% homosexual, 19.9% bisexual; median age of 23). Prevalence of HCV was
5.6% and of past or present HBV infection was 14.4%, whereas the proportion
HBV susceptible participants was 66.9%. HIV co-infection was 34.7% for HBV
and 27.1% for HCV. Multivariate risks for HCV were: African American (OR=2.8;
95%CI:1.5,5.3), Asian (OR=5.4;1.4,19.9), injection use (OR=9.2;4.3,19.9); and
for HBV: HIV positivity (OR=3.4;2.0,5.8), African American (OR=2.4;1.5,4.0),
Asian (OR=3.7;1.1,11.9), Hispanic (OR=5.6;2.4,13.2), and having over 20 male
lifetime partners (OR=2.9; 1.6,5.5).
Conclusions: HCV (5.6%) and HBV (14.4%) infection are quite high among
YMSM, particularly affecting HIV infected individuals and minorities. HCV infection is primarily explained by injection drug use. Absence of serologic markers for
HBV is very high (66.9%), whereas report of HBV immunization only marginally
predicts the potential for spread of HBV. Prevention and education programs
need to address HCV and promote HBV immunization, especially targeting ethnic
groups and high-risk YMSM.
Presenting author: Frangiscos Sifakis, 3507 North Charles St., Apt # 302, Baltimore 21218, Maryland, United States, Tel.: [phone], Fax: [phone],
E-mail: [email protected]
ThPeC7525 Prevalence of Human Immunodeficiency Virus and
Hepatitis B virus co-infection in a specialized HIV
university care center in Sao Paulo - Brazil
Y.L. Ho1, M.O. Fonseca2, A.C.S. Santos1, M.H. Lopes1. 1Departamento de
Doencas Infecciosas e Parasitarias - FMUSP- University Sao Paulo, av. paulista,
1195, apt 161, s~o paulo, cep 01311-200, Brazil; 2Nucleo de Extensao e
Atendimento a Pacientes HI V/AIDS - Hospital das Clinicas - University of Sao
Paulo, Sao Paulo, Brazil
Background: The HIV and HBV share similar epidemiologic characteristic of
transmission and risk factors which lead to co-infection of these two viruses. This
raises the issue of whether one can protect HIV infected individuals with HBV
vaccines.
Objective: To determine the prevalence and describe the epidemiologic characteristic of co-infected patients referred in a specialized HIV university care center
in Sao Paulo city.
Methodology: We have evaluated the serological markers for HBV infection and
age, gender, HIV risk factors of all patient admitted from January 1st to May 30th
of 2000 in their first visit.
Results: During the study period 232 patients were admitted. Mean age was

37.5 years (16-58), 168(72.6%) male. According with HIV risk factors, 83(36%)
were heterosexual, 65(28%) homosexual, 28(12%) intravenous drug users (IDU),
21(9%) bisexual, 35(15%) were without information. The serological markers
for HBV infection were available for 191(82%) patients. The anti-HBc marker
was positive in 80(42%) patients: 40(50%) with anti-HBs positive, 16(20%) with
AgHBS positive and 24(30%) without Anti-HBs and Ag-HBs. According with HBV
risk factors, the higher prevalence of anti-HBc was among homosexual patients

(45%), followed by heterosexual (16.25%), bisexual (13.75%) and IDU (10%), and
others 12%.
Conclusions: We find serological markers for HBV infection in 42% of these
patients and the co-infection prevalence in this population was 20%, rater than
general population (5-10%).
The higher prevalence of anti-HBc marker was between men who have sex with
men as described in literature. We found a lower prevalence among IDU, may be
associated with a lower proportion of IDU patients in our sample.
The co-infection prevalence in this population was high, reinforcing the need for
HBV investigation in HIV patients. The HBV vaccination should be recommended
for those without previous exposure.
Presenting author: yeh li ho, av. paulista, 1195, apt 161, s.o paulo, cep 01311 -200, Brazil, Tel.: [phone], E-mail: [email protected]
ThPeC7526 HIV and other viral infections in men who have sex
with men in Buenos Aires, Argentina
M.M. Avila1, M.A. Pandol, S. Maulen2, J. Rey3, S. Montano4, H. Salomon5,
J. Sanchez4, M. Weissenbacher 5. 1National Reference Center for AIDS. Univ of
Buenos Aires, Paraguay 2155 p.11, 1121 Buenos Aires, Argentina; 2NEXO
Asociacion Civil, Buenos Aires, Argentina; 3Hemoterapia, Hospital Universitario
San Martin, Buenos Aires, Argentina; 4US Naval Medical Research Center
Detachment, Lima, Peru; 5National Reference Center for AIDS, Univ of Buenos
Aires, Buenos Aires, Argentina
Background: The aim of this work was to determine evidence of past infection
with HIV, HCV, HBV, HTLV-I and HTLV-1I viruses in a population of men who have
sex with men (MSM) in Buenos Aires and to examine potential behavioral and
epidemiologic risk factors which may predispose to transmission.
Methods: MSMs 18 years of age or older from the Buenos Aires and surroundings were included in the study Informed consent and a questionnaire on epidemiologic data were confidentially obtained. Blood was collected for determination of HIV, HCV, HBV, HTLV-I and HTLV-II infection by serologic testing.
Results: A total of 694 MSMs were studied. Infection with HIV was detected in
96 (13.8%) of them. HIV infection was significantly associated with history of STD
(p<0.002), age over 30 years (p<0.003), and unemployment (p<0.01). HCV infection was detected in 8 (1.6%) of 511 individuals, 4 (50%) of them were found
to be HIV-positive. Higher HCV prevalence was related with commercial sex work
(p<0.0001) and drug use (p<0.001). HBV infection was detected in 146 (34.8%)
of 420 individuals tested; 39 (27%) were also found to be HIV-positive. HBV prevalence was significantly associated with STD (p<0.000). In 3 patients we detected
HIV-HBV-HCV co-infection. Infection with HTLV-I was detected in only 2 of 667 patients, one of whom also had HIV, HCV and HBV infection. No evidence of HTLV-II
infection was detected. HIV-positive MSM, evidenced a higher risk of infection with
HCV (OR= 6.68, 95% CI, 1.2-36.5) and HBV (OR=3.8; 95% CI, 2.1-6.9).
Conclusions: HIV-HBV coinfections were found to be very common whereas
HIV-HCV coinfections were not. This is probably related to the higher degree of
infectiousness of HBV, purported sexual transmission of HIV and HBV (but not
necessarily HCV), and the low frequency of injecting drug use (0.4%) among
MSMs in this population. Infection with HIV appears to be closely associated to
infection with both HBV and HCV but not with HTLV-I or HTLV-II.
Presenting author: Maria Mercedes Avila, Paraguay 2155 p.11, 1121 Buenos
Aires, Argentina, Tel.: [phone], Fax: [phone], E-mail: mavila
@fmed.uba.ar
ThPeC7527 Tenofovir Disoproxil Fumarate (TDF) suppresses
Lamivudine-Resistant HBV replication in patients
co-infected with HIV/HBV
R. Tubiana1, Y. Benhamou1, M. Bochet', V. Thibault', L. Suffisseau1,
M. Sullivan2, J. Rooney2, C. Brosgart2, F. Bricaire1, C. Katlama1, T. Poynard'.
GH Pitie-Salpetriere, Paris, France; 2Gilead Sciences, Foster City United States
Background: Lamivudine-resistant HBV occurs in approximately 15%-32% of
both immunocompetent HBV and HIV/HBV co-infected patients after one year of
lamivudine (LAM) therapy. TDF has potent in vitro activity against both wild-type
and lamivudine-resistant HBV.
Objective: To evaluate the safety and efficacy of TDF 300mg qd for the treatment
of lamivudine-resistant HBV in HIV/HBV co-infection.
Methods: Eleven serum HBV DNA positive HIV/HBV co-infected patients receiving LAM (150 mg bid) as a part of their current anti-retroviral therapy (ART) were
enrolled. TDF 300mg qd was added to their concurrent LAM containing ART. Sixteen week interim data are presented.
Results: Eleven males with a mean age (~SE) of 43.9+4.6 years were enrolled. All patients had confirmed YMDD mutant; 10/11 were HBeAg positive;
median ALT was 80.0~50.6 IU/L. Median change in serum HBV DNA concentration (Roche Amplicor PCR, log,ocopies/mL) from baseline (8.10~1.41) was
-2.23~0.85 at week 4 (p<0.005), -2.72~1.17 at week 8 (p<0.005), -3.11~1.25

at week 12 (p<0.005) and -3.67 ~1.25 at week 16 (p=0.01). There were no significant changes in mean serum ALT from baseline and no ALT flares (at least
3 x baseline level). No significant changes in serum electrolytes, HIV RNA and
CD4 cell count were observed. TDF was well tolerated. One patient discontinued
treatment at week 12 for reasons not considered treatment related.
Conclusion: TDF 300 mg once daily significantly suppresses lamivudineresistant HBV replication in HIV/HBV co-infected patients.