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

78 Abstracts WePeB5996-WePeB6000

XIV International AIDS Conference

WePeB5996I Strategies for Immune Reconstitution: Selenium
Cytokine Action in HIV/AIDS
M.J. Miguez-Burbano, P. Ruiz, A. Rodriguez, X. Burbano, G. Castillo,
L.M. Pineda, R. Lecusay, G. Shor-Posner. University of Miami School of
Medicine, University of Miami School of Medicine, Dept. of Psychiatry (D21),
1400 N. W 10th ave., 6th floor, Miami, Florida 33136, United States
Background: Both low selenium and high IL8 levels have been associated with
immune dysfunction, and increased HIV-1 replication. The mechanisms mediating these actions are mainly unknown. The interaction between selenium and IL8
levels in relationship to immune response during HAART was investigated.
Methods: Selenium status and immune parameters were evaluated every 6
months in a randomized subsample of 30 participants from a cohort of 259
HIV+ subjects enrolled in a randomized, double blind, placebo-controlled selenium study. Pills were dispensed monthly.
Results: Of the 30 subjects, 10 were without antiretrovirals and 20 had HAART
Unblinding indicated that 15 of the participants received selenium (200 rg/daily)
and 15 placebo. After 6 months, participants with selenium levels <145 [ig/L had
significantly higher IL8 levels (90.7~20.4), than those with selenium >145 [[g/L
(29.9~9 p=0.001). No significant differences in IL8 or selenium levels were observed between HAART (IL8 75.5~26.7; Se 133~40) vs. non-treated (50.7~18;
127.7~35.3, p=0.4). Significant positive correlations were demonstrated between
IL8 levels and viral load (r=0.596, p=0.007) and CD56 percentage (r=-.385,
p=0.05). Those with plasma selenium levels <145 itg/L had significantly higher
viral load levels (61861.5~137822) than those with plasma selenium levels >145
[tg/L (22006.5~75317, p=0.03).
Conclusions: These findings and the negative relationship between selenium
and IL8 suggest that selenium's effects on HIV disease could be partially mediated by a reduction of IL8 circulating levels; and independent of HAART administration. Support: NIH-Fogarty.
Presenting author: Maria Jose Miguez-Burbano, University of Miami School of
Medicine, Dept. of Psychiatry (D21), 1400 N.W. 10th ave., 6th floor, Miami, Florida
33136, United States, Tel.: [phone], Fax: [phone], E-mail: m.
[email protected]
WePeB5997 Anthropometric equations select HIV+ men and
women with distinctly abnormal fat accumulation
and distribution
D.P. Kotler', N. Muurahainen2, P. Chang2, E.S. Engelson', J. Wang1,
S.B. Heymsfeld', J.M. Gertner2. 'St. Luke's-Roosevelt Hospital Center, st. luke's
roosevelt hospital center, 421 west 113th street, new york, ny 10025, United
States; 2Serono, Inc., Rockland, MA, United States
Background: Patients (pts) with HIV-associated Adipose Redistribution Syndrome (HARS) have excess visceral adipose tissue (VAT), dorsocervical fat,
and/or other upper body subcutaneous fat. To enter a multi-center trial of growth
hormone (Serostim~) in HARS, HIV pts were required to have increased waist
circumference (WC) and waist-hip ratios (WHR) by criteria of Chang et al (2001,
2002). In this analysis, baseline body composition of HARS pts was compared
to that of healthy male (M) and female (F) controls (C) from the SLRHC Program
Project DK 42618 database.
Methods: All subjects underwent anthropometric measurements, DXA scans,
and imaging of VAT and subcutaneous abdominal tissue (SAT) at the L4-5 level
by CT scan in HARS pts and MRI in C. Data from first 53 HARS pts (24.5% female) who met eligibility criteria were compared to that of healthy M (n= 85) and
F (n=96) of similar age and height using two-sided Wilcoxon rank-sum tests.
Results: Compared to C, HARS pts did not differ significantly in weight, body
mass index, or hip circumferences. However, HARS M and F had significantly
greater chest circumferences, WC, WHR, and VAT than C (all p < 0.0007). Mean
VAT in HARS M & F was 338 ~ 76 and 246 ~ 33 cm2, respectively, compared to C (81 ~ 47 and 59 ~ 50 cm2). HARS pts also had significantly greater
DXA trunk/limb fat, abdominal VAT/SAT, and VAT/TAT ratios than C. Mean VAT,
trunk/limb fat, VAT/TAT, and SAT/VAT ratios in HARS were two standard deviations (SD) above means for respective C. SAT and SAT/TAT ratios in HARS were
significantly lower and >2 SD below the mean for those measured in C.
Conclusion: The equations of Chang et al. selected HIV+ persons with distinctly
increased VAT and abnormal fat distribution, with upper body fat accumulation
and subcutaneous fat depletion, compared to healthy persons of similar gender,
age, weight, and height.
Presenting author: donald kotler, st. luke's roosevelt hospital center, 421 west
113th street, new york, ny 10025, United States, Tel.: [phone], Fax:
[phone], E-mail: dpkotler@ aol.com
WePeB5998 Vitamin E levels increase with antiretroviral
i i treatment without additional supplementation

FJ. Vilar1, A.C. Stalford2, W. Taylor3, A. Shenkin3, B.K. Park2,
M. Pirmohamed2. ' Department of Infectious Diseases & Tropical Medicine,
North Manchester General Hospital, 16, Devonshire Road, Manchester, M21
8XB, United Kingdom; 2Department of Pharmacology and Therapeutics, The
University of Liverpool, Liverpool, United Kingdom; 3 Department of Clinical
Chemistry, The University of Liverpool, Liverpool, United Kingdom
Background: Vitamin E deficiency is known to occur in HIV-positive adults, and

may increase the rate of disease progression. Vitamin E decreases HIV replication in cell culture. Supplementation with vitamins E and C in HIV positive patients
may lower HIV viral loads, although this needs further study. The effect of highly
active antiretroviral treatment (HAART) on vitamin E levels has not been studied.
Methods: We recruited 33 symptomatic HIV patients due to start on HAART. The
levels of vitamins A and E, interleukin 6 and TNF-alpha soluble receptor II were
measured before and 6 weeks after starting treatment. Seventeen HIV negative
controls were also sampled 6 weeks apart. Those patients who were taking or
had taken multivitamins (or modified doses) during the previous 6 months were
excluded. Acute illness was also an exclusion criterion.
Results: Patients had a significant difference in vitamin E levels before and 6
weeks after starting HAART [median difference -7 (95% CI -10 to -3), p=0.002].
There was no difference in vitamin E levels in the control group between the two
time-points (95% CI -3 to 6, p=0.6), and vitamin E levels at 6 weeks were similar
in controls and patients (95% CI -2 to 6, p=0.39). There was a significant difference between patients and controls at week 0 [median difference -6 (95% CI -10
to -2), p=0.007]. There was no difference in vitamin A levels in both patients and
controls at both time-points. TNF soluble receptor II, but not IL-6, levels showed a
significant difference before and after starting HAART (p=0.025), while there was
no difference in controls between the two time-points.
Conclusions: Vitamin E levels improve after starting HAART, and thus although
supplementation with vitamin E might be an interesting approach in countries
were HAART is unaffordable, its supplementation does not seem to be necessary
with HAART. Whether micronutrient supplementation reduces long-term complications of HAART remains unknown.
Presenting author: F Javier Vilar, 16, Devonshire Road, Manchester, M21 8XB,
United Kingdom, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeB5999 The availability of the UNAIDs recommended
conditions for the safe practice of formula feeding
and actual mothers' infant feeding practices in
Botswana
B. Mdumal, M. Phegelo 1, K. Mompati 1,0 O. Ntshebe 1, J. Sibiya 1,
L. Gabaitsewe1, T. Baile 1, Pr Mazhani1', C. Luo2, NC. Rollins3, FJ. Willumsen3
S. Kleintjes2. 'IFood and Nutrition Unit, MOH, Food and Nutrition Unit, Family
Health Division, MOH, PD. Box 992, Gaborone, Botswana; 2UNICEF Gaborone,
Botswana; 3University of Natal, Durban, South Africa
Background:. The UNAIDs guidelines for artificial feeding of infants of HIVinfected mothers recommend artificial feeding when in addition to un-interrupted
formula supply for at least six months, there is access to safe drinking water and
means to boil water for preparing formula and sterilizing utensils. An assessment
of the availability of these UNAIDs conditions was conducted in Botswana in July
2001.
Objectives: To describe the availability of conditions to practise safe formula
feeding and suggest ways to improve the feeding practice support in the Prevention of Mother to Child Transmission (PMTCT) programme. Methods: A semistructured pre-tested questionnaire was administered to HIV infected mothers (78
urban and 80 rural) of infants aged 0-6 months with written consent, to participate
in the study in four PMTCT districts. Factors that might contribute to unsafe formula feeds preparation namely frequency of preparation, storage of feeds and
sterilization of utensils were elicited.
Results: Safe water supply was universal, 55% inside house, 45% stand pipes
in urban as compared to 37% and 64% respectively in rural sites. Some mothers
(20% rural and 6% urban) lacked toilet facilities. Firewood was the main source of
fuel in rural (81%) as compared to urban sites (27%). Majority (93% urban, 90.7%
rural) used a feeding bottle; 65% urban and 60% rural cleaned the bottles with
every feed with 67.0% sterilizing the bottles adequately. Prepared formula was
stored at room temperature by 70% of urban and 40% of rural mothers. Maternal
literacy rate was high, with 67% and 56% urban and rural respectively, having two
years of secondary education.
Conclusions: In Botswana, availability of the UNAIDS conditions for safe formula preparation is higher in urban than rural areas. The observed weaknesses
in mothers' adherence to safe formula preparation should be addressed through
intensified health workers and mothers' training.
Presenting author: Benedicta Mduma, Food and Nutrition Unit, Family Health Division, MOH, P.O. Box 992, Gaborone, Botswana, Tel.: [phone], Fax: +267
302092, E-mail: [email protected]
WePeB6000 Acupuncture cross-over trial: can acupuncture
effectively control side-effects of HIV-combination
therapy?
EAS. Sommers, K.E.P Porter. AIDS Care Project, AIDS Care Project, 140
Clarendon St. 7th floor, Boston, MA, 02116, United States

Background: The study examines whether acupuncture can minimize digestive
side-effects of highly active antiretroviral therapy (HAART) and affect adherence
to medication protocols.
Methods: A 6-week cross-over clinical trial was designed to examine whether a
set of 4 symptom-specific acupuncture points can be more effective than a set of
4 non-specific nearby comparison points in controlling digestive symptoms such
as nausea, vomiting, and bowel upsets associated with use of HIV-combination