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

XIV International AIDS Conference

Abstracts ThPeC7612-ThPeC7615 487

In our study, one case was positive for HIV, syphillis and Rubella (IgM antibodies)
infection.
Conclusion: Due to increase in seroprevalence of HIV, Syphillis and TORCH
group of infections all antenatal cases with bad obstetrical history should routinely
be screened for these infections, for early diagnosis and appropriate interventions
which helps in proper management of these cases.
Presenting author: Mhisti Rele, 25/102, Varun Coop Hsg Soc, Behind Shantivan,
New Link Road Extension, Oshiwara, Andheri(West), Mumbai: 400053, Maharashatra, India, Tel.: [phone], Fax: [phone], E-mail: mhisti@vsnl.
com
ThPeC7612I HIV & leprosy: clinical aspects and progression
A.R Gomes1, J.A.C. Nery2, E.R Sampaio2, M.C.G. Galhardo2, A.M. Salles2,
E.N. Sarno2. 'Rio de Janeiro State Healt office, Rio de Janeiro, Brazil; 21nstituto
Oswaldo Cruz, Rio de Janeiro, Brazil
Background: Hanseniasis is an important public health problem around the
world. In Brasil, we still have a endemy with high number of cases. There are
little works of co-infection HIV/Mycobacterium lepra in literature, so we decide
research this issue in our leprosy outpatient clinic.
Methods: This is a case series study, a descriptive study, that have been review
data registered at the Leprosy Outpatient Clinic, Oswaldo Cruz Foundation, Rio
de Janeiro, Brazil, about patients HIV-reators and with leprosy We review the
follow-up of 30 patients. This investigation aims to estimate the evolution of leprosy in co-infected patients. Statistics analyses were realized by EPIINFO 2000
(CDC). We realize "Qui-square Test" and Fisher Exact Test.
Results: We observed that HIV is not a factor of risk for the development of
multibacillary forms (our patients are in 60% of cases paucibacillary). We also
observed the ocorrence of reactional states in 70% of patients (57,1% reversal
reaction) and the capacity of reactivation of the cell-mediated immune response
in spite of CD4+ levels. At this sudy all patients responded satisfactorily to multidrug therapy, despite their being infected and immune state (AIDS/HIV), and it
is not observed any relapse.
Conclusions: Increased of susceptibility to M. leprae and progression toward a
severe and fulminant form of leprosy is not a reality in our patients. HIV have not
been altered the progression of immune response to M. leprae, even in AIDS.
Presenting author: Andr6ia Gomes, Av. Alberto Torres, 1400 / 206 - Teres6polis
- Rio de Janeiro - Brasil, Brazil, Tel.: [phone], E-mail: andreiapgomes
@aol.com
ThPeC7613 Outpatient spectrum of opportunistic infections
among HIV-1 subtype C infected adults in
Botswana
A. Avalos1, W. Wester1, H. Bussmann1, H. Moffat2, G. Lesetedi1, M. Lethswitil,
M. Mabusel, R. Marlink3. 1Botswana-Harvard Partnership, FXB-310, 651
Huntington Avenue, Boston, MA 02115, Botswana; 2Princess Marina Hospital,
Gaborone, Botswana; 3Harvard AIDS Institute, Boston, United States
Introduction: Opportunistic infections (Ol's) and cancers associated with HIV-1
subtype C cause significant morbidity and mortality in Botswana, a country with
extremely high HIV-1 prevalence. To offer comprehensive case management and
build infrastructure in Botswana, a public outpatient HIV Infectious Disease Care
Clinic (IDCC) was established in a major referral hospital with support from "Secure the Future"/BMS.
Methods: In preparation for the national antiretroviral program, confirmed HIV-1
positive adults were referred to the IDCC and evaluated for the presence of Ol's,
for immune status and for ARV treatment.
Results: Of 237 outpatients (57% female, 43% male) seen, the most prevalent
active/recent Ol's and cancers were as follows: 73 (30.8%) with TB (16% extrapulmonary); 70 (29.5%) with Wasting Syndrome (WS) (20% with chronic diarrhea);
46 (19.4%) with Peripheral Neuropathy (PN) (all but one being grade 1-2); 24
(10.1%) with Kaposi's Sarcoma (KS) (79% with advanced, debilitating disease),
and < 5% of outpatients with Cryptococcal Meningitis and CMV Retinitis. The
mean and median CD4 cell counts and interquartile ranges (IR), respectively, for
the major Ol's were as follows: TB (CD4 131 / 89, 39-170); WS (CD4 97 / 57, 13 -125); PN (CD4 116 / 61, 28-149); and KS (CD4 120 / 87, 35-200). All patients with
each major O had mean/median plasma HIV-1 RNA levels > 350,000 copies/ml.
Conclusions: At the IDCC, referred patients were usually those with very advanced HIV disease based on their CD4 and VL values. The prevalence of chronic
diarrhea (as part of the WS definition) in these outpatients was lower than expected compared to other studies in Africa. The level of immunosuppression for
major Ol's in these outpatients was similar to that described in persons infected
with HIV-1 subtype B. As diagnostic capacity expands and wide-scale ARV treatment is introduced, the ability to detect and manage Ol's earlier will significantly
improve overall patient care.

Presenting author: Vladimir Novitsky, FXB-310, 651 Huntington Avenue, Boston,
MA 02115, United States, Tel.: [phone], Fax: [phone], E-mail:
[email protected]

ThPeC7614 Chagas' Disease And Aids Co-Infection - Brazil
J.N. Lima1, R.J. Pedro2, E. Lages3, F.H. Aoki2, M. Jodelis4, E.A. Almeida2.
1 STD/AIDS Programme - MOH, SON 107, Bloco E - apto 619, Asa Norte,
Brasflia - DF, CEP 70.043-050, Brazil; 2State University of Campinas,
Campinas/S, Brazil; 3Federal University of Tringulo Mineiro, Uberaba/MG,
Brazil; 4STD/AIDS Programme - MOH, Brasfia/DF Brazil
Background: Chagas' disease, or "South American Trypanosomiasis", is caused
by the protozoan parasite Trypanosoma cruzi, transmitted to man mainly by blood
sucking insects and through blood or his products transfusions. It has been estimated that in Latin America this chronic infection occurs in between 16 and 18
million people (3 to 5 million in Brazil). Reactivation of the disease can occur in
immunosuppressed individuals with serious clinical manifestations, as has been
observed in a number of Aids patients.
Methods: The aim of the present study is to evaluate the frequency of individuals
infected with T. cruzi and HIV (co-infection), treated at the Hospital das Clinicas
of UNICAMP over the period from March 1994 to March 2001. This hospital, in
the city of Campinas (Sao Paulo State) has a medical catchment area of 4 million
inhabitants.
Results: Among the 969 HIV patients, 1707 sorological tests were carried out for
Chagas' disease (IFI and/or ELISA and/or RFC) and 22 reagent tests were found
for 13 in dividuals, therefore producing a frequency of 1.3% people co-infected.
There was no difference between the co-infected and the non co-infected with
respect to race, place of birth and residence, T CD4+ cell and HIV Viral Load
counts. Women predominated in the group of co-infected patients. The average
age of those co-infected was higher than in the other group.
Conclusions: Although in Brazil to date the co-existence of these two diseases is
small, in the other countries of Latin America the frequency could well be higher.
There is in addition the possibility of appearance of cases of co-infection in developed countries, owing to the large number of immigrants from regions where
Chagas' disease is endemic. Sorological tests for Chagas disease, even when
they are indeterminate, should be taken fully into account and the relevant parasitological tests must be carried out.
Presenting author: Josub Lima, SQN 107, Bloco E - apto 619, Asa Norte,
Brasilia - DF, CEP 70.043-050, Brazil, Tel.: +55+61+4488008 or 4488009, Fax:
+55+61+4488057, E-mail: [email protected]
ThPeC7615 Seroprevalences of HIV, HCV, HBV and HTLVI/II
among Injecting Drug Users (IDU) from Northeast
to South in Brazil - The AjUDE-Brasil II Project
W.T. Caiaffa1, F.A. Proiettil, A.C.M. Reis 1, D. Gandolfi2, D. Doneda3,
TH.E. AjUDE-Brasil Project4. UFederal niversity of Minas Gerais, Rua Monte
Alegre 797 apto 302, 30240-230 Belo Horizonte, Minas Gerais, Brazil; 2Ministry
of Health, Brasilia, Brazil; 3Minstry of Health, Brasilia, Brazil; 4Brazilian
Aids/STD Program & UFMG, Belo Horizonte, Brazil
Background: The spread of Human Immunodeficiency Virus (HIV) and other
blood borne infections related to IDU has became an important public health problem in Latin America. This study aimed to determine the seroprevalence of HIV,
Hepatitis C Virus (HCV), Hepatitis B Virus (HBV) and Human T-Lymphotrophic
Virus I and II (HTLVI/II). and HBV in Brazil among IDU.
Methods: The AjUDE-Brasil II Project is a cross-sectional multicity study carried
out in 869 outreached IDU attending six Brazilian Syringe Exchange Program
(SEP) from Northeast to South of the country, from May, 2000 to February, 2001,
using interviews and fingerprint blood collection for HIV, HCV, HTLVI/II and HBV
determinations, after a serologic study aiming at standardization of the technique
using paper filter. Data analysis included descriptive statistics.
Results: About 722 males (83.3%) and 145 females (16.7%) were interviewed.
The great majority were interviewed on the streets or in their neighborhood
(45.4%). The average age was 28.5 years old, women (29.9 years) were older
than men (28.6) (p=0.05). 74.8% reported heterosexual practices and 76.8% injected cocaine in the last six month. Global seroprevalence and the range by SEP
was 36.9% for HIV (ranging 6.4-64.8%), 61.9% for HCV (30.4-79.4%), 2.3% for
HBV (1.7 - 4.3%), and 25.2% for HTLV I/II(ranging 10.0 - 47.7%). All seroprevalence rates differed substantially by SEP site exception for HBV. Looking at IDU
with any infection, only 35.8% had no virus infection, 23.5% had single infection,
19.3% had two infections, 20% had three infection and 1.5% had four infections
simultaneously.
Conclusions: Seroprevalence rates for HIV, HCV and HTLVI/II were high among
IDU in a SEP context, but varied according the site. Also, co-infections were very
common, suggesting exposure to multiple different risk factors. Multiple strategies
in prevention based on specific groups could be applied.
Presenting author: Waleska Caiaffa, Rua Monte Alegre 797 apto 302, 30240 -230 Belo Horizonte, Minas Gerais, Brazil, Tel.: [phone], Fax: [phone], E-mail: wcaiaffa@ medicina.ufmg.br