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

XIV International AIDS Conference

Abstracts WePeB5992-WePeB5995 77

completed visit 12 and returned within two months to each corresponding visit
(n=32), maintained stable CD4 cell counts (p=0.04) and NK (p=0.04) and had
lower CD8 cells (p=0.03). The placebo-compliant group (n=62) exhibited a significant decrease in CD4 cells (>50 cells), p=0.03. Although more of the seleniumsupplemented (78%) than the placebo group (53%) used antiretrovirals (ARV),
36% of the ARV-placebo group showed a CD4 decline, versus 12.5% of the ARVtreated selenium group (p=0.04). Further, viral burden (>1500 copies) tended to
be higher in the ARV-treated placebo than the ARV-selenium group (p=0.06).
Conclusions: These findings support an important role for selenium in maintaining immune function, and indicate a potential additional beneficial effect as an
adjuvant therapy in those receiving antiretroviral treatment. Support: NIDA and
NIH-Fogarty
Presenting author: Gail Shor-Posner, University of Miami School of Medicine,
Dept. of Psychiatry (D21), 1400 N.W. 10th ave., 6th floor, United States, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
WePeB5992 Longitudinal assessment of growth among
children born to HIV-infected mothers, in Sao
Paulo, Brazil
W. Queiroz1, M. Della Negra1, J.A.C. Taddei2, F. Colugnati2, C.L. Yu1,
A.P.G. Pochinil, C. Soraggi-Netol, D.P. Pacolal. lnstituto de Infectologia Emilio
Ribas, Rua Paulo Franco, 230, Apartamento 112, Sao Paulo - SP, CEP
05305-030, Brazil; 2Universidade Federal de Sao Paulo, Sao Paulo, Brazil
Objective: To determine the effect of maternal HIV-infection on the growth of their
offspring during the first two years of life.
Methods: From 1986 to 1992 379 children born to HIV-infected mothers were
followed from birth up to 2 years of age. Anthropometric data (weight and height)
were collected at birth and at each monthly medical visit. Measurements were
converted to age-specific z scores (NICH). Children were divided into 3 groups:
uninfected, asymptomatic and symptomatic (AIDS). Mean anthropometric indexes for each group were put into a chart and the curves were compared.
Results: Of the 379 children, 61 (16.1%) developed AIDS during their first two
years of life (symptomatic), 116 (30.6%) remained HIV-infected, but asymptomatic
and 202 (53.3%) were seroreverters. There was no statistical differences in birth
weight (p=0.346) or length (p=0.658) between infected and uninfected children.
The mean weight-for-age (WAZ) z scores curves revealed that the 3 groups
showed the lowest indexes at 6 months of age followed by a recovery. After 6
months of age the 3 groups established the same curve pattern, but at distinctive levels. The mean WAZ scores for uninfected, asymptomatic and symptomatic
children were respectively -1.71, -0.84 and +0.03. The same was observed concerning the mean height-for-age (HAZ) z scores curves, with mean values, respectively, -2.03, -0.88 and -0.47. The mean weight-for-height (WHZ) z scores
curves showed that both symptomatic and asymptomatic children presented the
same pattern, with mean z score = -0.50, whereas uninfected children's mean
score was +0.36.
Conclusion: In our settings, maternal HIV infection does not alter birth weight or
height, regardless the child's HIV status. HIV infected children experience lower
WAZ and HAZ scores, more pronounced after the development of AIDS. WHZ
is the least affected parameter keeping a quite harmonious proportion between
weight and height.
Presenting author: Wladimir Queiroz, Rua Paulo Franco, 230, Apartamento 112,
Sao Paulo - SP, CEP 05305-030, Brazil, Tel.: [phone], Fax: [phone], E-mail: 563@ uol.com.br

Results: Patients in groups 1 and 2 had no significant changes in body composition. Patients in group 3 gained body weight (median= 8.7 kg), MM (median= 6.1
kg), FFM (median= 3.5) and FM (median= 2.5 kg) (p<0.05). The maximum recovery of these compartments occurred in week 13. Viral load was suppressed in all
groups to undetectable levels. CD4+ cell counts increased in all groups (p>0.05).
TNF alpha serum levels were not above of reference values.
Conclusion: Treatment significantly improved body composition parameters in
patients with WL. It promoted a significant and rapid MM gain only in patients
with WL greater than 10%. TNF alpha serum levels were not associated with
weight loss in this study.
Presenting author: Karla Zuniga-Roiz, l1a. cda. alborada 21, Parques del Pedregal, 14010, Tlalpan, Mexico, Tel.: [phone], Fax: [phone], E-mail:
[email protected]
WePeB5994I Longitudinal growth assessment in HIV exposed
infants in Belo Horizonte, Brazil
C.A. AraOio, M.S.A. Barbosa, C.M.N. Oliveira, R.M. Pereira, M.A. Vasconcelos,
L.J. Melo, J.A. Pinto. Federal university of Minas Gerais, Avenida Alfredo Balena,
190 (Terceiro Andar- Laboratdrio DIP), Bairro Santa Efig6nia CEP: 30.130-100,
Belo Horizonte, Minas Gerais, Brazil
Objective: It has been shown that impairment in growth parameters is an early
event in HIV infected children. This study aimed to assess longitudinally the
growth of HIV-exposed infants during the first 12 months of life and to determine
whether growth impairment was an early indicator of HIV infection in Brazilian
children.
Methods: HIV-exposed term infants admitted at the Pediatric AIDS Referral Center of Federal University of Minas Gerais with less than 3 months of age were
included between January/98 to June/00 and followed with monthly weight and
height measurements until 6 months and every 3 month thereafter. Weight-forage (WA), height for-age (HA) and weight-for-height (WH) Z scores were calculated using World Health
Organization growth reference data, for infected and serorreverters infants.
Results: 119 infants were enrolled, 12 infected and 107 serorreverters. The mean
number of clinic visits was 7.1 and 7.8 for infected and serorreverters, respectively. Infants from the two groups had similar length and weight at birth. Compared to serorreverters, infected infants presented significantly lower WAZ and
HAZ beginning at three months of age. WHZ was similar in the two groups.
Conclusions: In this Brazilian cohort of HIV-exposed infants growth impairment
an early event and a useful clinical marker of infection. Nutritional intervention
should be instituted precociously in these infants in order to minimize the effects
of undernutrition in disease progression.
Presenting author: Claudete Aratjo, Avenida Alfredo Balena, 190 (Terceiro
Andar- Laborat6rio DIP), Bairro Santa Efig6nia CEP: 30.130-100, Belo Horizonte,
Minas Gerais, Brazil, Tel.: +(31)3344-1747 and 9991-8988, Fax: +(31)3273-0422,
E-mail: [email protected]
WePeB5995 Increased risk of developing cervical dysplasia in
HIV infected women in the HAART era
X. Burbano, M.J. Miguez-Burbano, R. Hernandez, A. Rodriguez, P. Ruiz,
R. Lecusay, G. Shor-Posner. University of Miami, University of Miami, 1400 NW
10th Ave (D21), Dominion Towers, 6th floor, Miami, FL 33136, United States
Background: Cervical Dysplasia (CD) has been associated with low selenium
levels in HIV (-) women. We investigated the prevalence of CD in HIV+ women in
a selenium (Se) therapy trial.
Methods: 92 women were enrolled in a double-blind, randomized, placebocontrolled Se study and completed a 6-month visit which included clinical and
immune evaluation. Medical history, and cytological reports were obtained.
Results: Twelve cases of CD developed during the study; 8 women were on
HAART, 2 on combination therapy and 2 without antiretrovirals (ARV). Seven
were in the placebo, and 5 in the Se arm. Baseline Se level was significantly
lower in the CD group (1 28+10 i~g/L), than the non-CD group (1 35+22, p=0.05).
All patients who developed CD had Se levels <1451tg/L (p=0.03). No significant
differences in Se levels were observed at the 6th month visit between the groups,
nor the Se and placebo arms in the CD group. Baseline CD4 was significantly
lower (237~181) in the CD than the non-CD group (501~326, p=0.006) and NK
levels were higher at baseline (CD 7.5+6 vs.5.4~3.5) and at the 6th month visit
(CD 9.7 ~6.3 vs.6.6+2.9, p=0.03). After 6 months of ARV, CD4 counts continued to be significantly lower (CD 186~134 vs. 559~393, p=0.03). No significant
differences in viral load were observed between the 2 groups. Anova analyses
indicated that only Se levels at baseline significantly predicted the development
of CD.
Conclusions: The risk of CD development appears to be affected by selenium
status, but not by HAART treatment. Supported by NIH-Fogarty and NIDA

Presenting author: Ximena Burbano, University of Miami, 1400 NW 10th
Ave (D21), Dominion Towers, 6th floor, Miami, FL 33136, United States, Tel.:
[phone], Fax: [phone], E-mail: [email protected]

I WePeB5993]

Highly active antiretroviral therapy based on a
protease inhibitor -sparing regimen, reconstitutes
muscle mass in HIV-infected individuals with
wasting syndrome but not in those with moderate
or no weight loss

K. Zuniga-Roiz, A.C. Hernandez-Daly, K.J. Torres, J.A. Zuniga,
M.E. Mayar-Maya, G. Reyes-Teran. Unit of Infectious Diseases for
Immunocompromised Patients, Instituto Nacional de Enfermedades
Respiratorias, la. cda. alborada 21, Parques del Pedregal, 14010, Tlalpan,
Mexico
Background: Weight loss (WL) in HIV infected patients is characterized by a progressive loss of muscle mass (MM). Despite the widespread use of HAART, WL
remains as an important clinical finding in patients with HIV infection. Moreover,
recent studies have not found beneficial effects of HAART on MM. Objectives:
to evaluate the effect of a PI-sparing regimen of HAART on weight, fat mass, fat
free mass and MM and to evaluate the role of TNF alpha in the pathogenesis of
weight loss.
Methods: Twenty seven HIV- infected individuals were enrolled and classified
in 3 groups: Patients with no WL (Group 1; n=10), patients with 5 - 10% WL
from usual weight (Group 2; n=8), patients with WL greater than 10% from usual
weight (Group 3; n=9). All participants where HAART naive and had no active
opportunistic infections. Patients underwent a baseline evaluation before the initiation of HAART. Their nutritional (body composition analysis by anthropometry
and BIA), virologic, and immunologic status were evaluated. Patients were reevaluated every 2 weeks for 3 months and monthly thereafter. TNF-serum levels
were measured at baseline and at the end of the study. All patients received
HAART during the 6 months of the study.