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

82 Abstracts WePeB6013-WePeB6016

XIV International AIDS Conference

WePeB6013 Trends in the use of antiretrovirals in the south of
Spain, 1996-2000
F Lozano1, M.A. Colmenero2, M. Marquez3, F. Guerrero 4,
J. Hernindez-Quero5, J. Pasquau6, A. Terr6n7, J.J. Hernandez-Burruezo8,
V. Guti6rrez-Rav69, M. Delgado1o, A. Arco11, B. Valera6. 1H.U. de Valme,
Seccidn Enfermedades Infecciosas, Hospital Universitario de Va/me, Carretera
de Cddiz s/n, 41014 Sevilla, Spain; 2H.U. Virgen Macarena, Sevilla, Spain; 3H. U.
Virgen de la Victoria, Mdlaga, Spain; 4 H. U. Puerta del Mar, Cjdiz, Spain; 5 H. U.
San Cecilio, Granada, Spain; 6 H. Virgen delas Nieves, Granada, Spain; 7H. de
Jerez, Jerez (Cadiz), Spain; 8H. Ciudad de Jaen, Ja6n, Spain; 9H. Motril, Motril
(Granada), Spain; 10H. de Poniente, El Ejido (Almeria), Spain; 1H. Costa del
Sol, Marbella (Milaga), Spain
Background: To describe the use and trends of antretroviral treatment (ART) in
out-patients followed-up in public hospitals of Andalusia (south of Spain) during
1996-2000.
Methods: 5 cross-sectional surveys of HIV-infected adults attended in the outcare facilities of 23 public hospitals of Andalusia in 1996-2000. Demographic, epidemiological, clinical and therapeutical data were collected. A descriptive analysis
of the use of ART was performed using the Epi-Info program.
Results: 4.295 patients were included.The mean age was 35,3 years, 77% were
males and 64% were intravenous drugs users (IDU). 33% had AIDS, 43% were
asymptomatic and 31% had < 200 CD4/uL at survey-time; the median CD4 lymphocyte count was 319/uL. 3.424 (80%) out-patients received antiretroviral treatment at the time of the survey The proportion of patients on ART who received
Protease Inhibitors (PI) increased from 33% in 1996 to 84% in 1998 and fell to
60% in 2000, while that of patients with Non-Nucleoside Reverse Transcriptase
Inhibitors (NNRTI) rose from the 1,2% in 1996 to 45% in 2000. In 2000, the most
used combination was two Nucleoside Analogues (NA) and one PI (39%), although an increasing number of patients are being switched to other combinations: 37% of patients received two NA and one NNRTI, and 14% were being
treated with 4 o more drugs. There has been a marked immunological and virological improvement of the patients from 1996 onwards. In 2000, the median
lymphocyte count of the patients was 3
79/uL (372/uL in those on ART) and 52% had a viral load below 200 copies of
HIV-RNA/mL by PCR or equivalent (58% in those on ART).
Conclusions: Cross-sectional surveys are useful to monitor trends in the use of
antirretrovirals in the HIV-infected population.HAART is widely used in Andalusia,
and in recent years there has been a decrease in the use of IP and an increase
in the prescription of NNRTI.
Presenting author: Fernando Lozano, Secci6n Enfermedades Infecciosas, Hospital Universitario de Valme, Carretera de Cadiz s/n, 41014 Sevilla, Spain, Tel.:
[phone], Fax: [phone], E-mail: [email protected]
WePeB6014 HIV and HBV coinfection in patients attending
some hospitals in Douala and Yaounde Cameroon
C.RL. Ngansop Kenmogne Kaptue. University of Yaoundel, PO Box 1937,
Yaounde, Cameroon
Objectives: To determine(1) the seroprevalence of HIV and HBV infections
among patients attending some hospitals in Douala and Yaounde (2) the seroprevalence of HIV and HBV cinfection among these patients
Method: A cross sectional study was carried out among patients admitted in
medicine ward, chest and STDs clinic in Yaounde and Douala. After a verbal
consent socio-demograpic data were collected by the means of a questionaire
and 10 ml of blood drawn into EDTA tubes. Plasma was srcreened for HIV antibodies using a third generation EIA (Enzygnost anti HIV plus, DADe Berhing).
Reactive samples were confirmed by strategy II recommanded by WHO using an
HIV1 compeitive EIA (Welcozyme, Murex,Abbott). Plasma was also screened for
HbsAg using EIA(Enzymum, Boerhinger Mannhein).
Results: From January 1999 to June 1999 709 patients aged 11 to 65 mean age
38 years were enrolled 409(57,7%) of them were male and 300(42,3%) female.
They were distributed as follow 241(32,4%), 233(33%) and 235(33,1%) from the
chest, STDs and medicine ward respectively. The overall HIV seroprevalence was
23% with HIV1M,HIV1 o and HIV account for 156(95,7%) 5(3,06%) and 2(1,22%)
respectively. Prevalence was found higher among patients from medicine ward
(29%) and STDs patients (12%) P<0,001. The overall HbsAg seroprevalence
was 9%. Patients attending STDs clinic had highest rate (12%) compared to the
rest. At total of 12 out of 709(1,7%) of patients were coinfected by both HIVand
HBV.
Conclusion: These data show a relatively high prevalence of HIV and HBV infections among studied population. Effort should be made therefore to eradicate the
progression of these diseases. A prospective study to investigate the incidence
of HBV on HIV infection be carried out.
Presenting author: charlotte ngansop, pobox 1937, yaounde, Cameroon, Tel.:
[phone]/[phone], Fax: [phone], E-mail: ngansopc @ yahoo.fr

WePeB6015 Anti-Hepatitis B Virus (HBV) activity of Tenofovir
Disoproxil Fumarate (TDF) in Lamivudine (LAM)
experienced HIV/HBV co-infected patients
D. Cooper', A. Cheng2, D.F. Coakley2, J. Sayre2, L. Zhong2, S.S. Chen2,
C. Westland2, M.D. Miller2, C. Brosgart2. INCHECR, University of New South
Wales, 333 lakeside drive, foster city, California, 94404-1147, Australia; 2Gilead
Sciences, Foster City, CA, United States
Background: TDF has potent in vivo and in vitro activity against both wild-type
and LAM resistant HBV. Objective: To evaluate the safety and efficacy of TDF
300mg in the treatment of patients with HIV/HBV co-infection enrolled in Study
907, a double-blind, placebo (PLB)-controlled trial of TDF once daily added to a
stable existing antiretroviral therapy. All patients received TDF from Weeks 24-48.
Methods: Twelve (10 TDF and 2 PLB) HIV/HBV co-infected male patients, with
baseline (BL) serum HBV DNA > 6 log10 copies/mL, who participated in the
full 48 weeks were included in the analysis. BL characteristics: 9/12 Caucasian;
median age 36 years, plasma HIV RNA 3.54 log10 copies/mL, CD4 count 472
cells/mm3, prior ARV 3.9 years, serum HBV DNA 8.69 log10 copies/mL, serum
ALT 81.5 IU/L (ULN, 43 IU/L); 11/12 HBeAg+ (1 missing). All were LAM experienced. Genotypic analysis at BL confirmed that 7 patients harbored LAMresistant HBV (YMDD) and 5 had wild type HBV.
Results: Median change in serum HBV DNA concentration from baseline was
-4.44 and 1.23 log10 copies/mL for TDF and PLB respectively (p = 0.04) at week
24, and -3.94 for TDF recipients at week 48. Serum HBV DNA reduction was similar in patients with wild type or LAM-resistant HBV. By week 48, ALT decreased
from baseline by median 30 IU/L in TDF recipients, with two patients normalizing ALT. HBeAg seroconversion was observed in one TDF patient. Through 24
weeks, plasma HIV RNA concentration declined by median -0.82 and -0.05 log10
copies/mL in TDF and PLB recipients, respectively No new conserved site mutations in the HBV polymerase were detected; YMDD mutations were maintained
in all patients where present at BL. TDF was generally well tolerated with a safety
profile similar to PLB.
Conclusion: These preliminary data indicate that 48 weeks of TDF 300 mg once
daily is well tolerated and has significant activity against both wild-type and LAMresistant HBV in HIV/HBV co-infected patients.
Presenting author: andrew cheng, 333 lakeside drive, foster city, California,
94404-1147, United States, Tel.: [phone], Fax: [phone], Email: [email protected]
WePeB6016 The role of hepatitis B virus in the progression of
HIV and the response to highly active antiretroviral
therapy (HAART)
C.L. Thiol, E.C. Seaberg', L. Kingsley2, J. Phair3, B. Visscher4, A. Muhoz5.
'Johns Hopkins University, Baltimore, Maryland,; 2University of Pittsburgh,
Pittsburgh, Pennsylvania, United States; 3Northwestern University Chicago,
Illinois, United States; 4 University of California, Los Angeles, Los Angeles,
California, United States; 5Johns Hopkins University, Baltimore, Maryland,
United States
Background: Coinfection with human immunodeficiency virus-1 (HIV) and hepatitis B virus (HBV) is common. Recent evidence indicates that the HBV X protein
induces HIV-1 replication. We examined the effect of HBV on (a) HIV disease
progression and (b) the response to HAART
Methods: The exposure of interest was the presence of hepatitis B surface antigen (HBsAg) at enrollment. To characterize the HIV disease progression we studied men enrolled in the Multicenter AIDS Cohort Study (MACS) with HIV seroconversion. To determine the response to HAART we studied men who initiated
HAART. Time-to-event analyses were performed using Kaplan-Meier and personyears methods; comparisons of CD4 and HIV RNA levels were performed using
generalized estimating equations.
Results: Among the 500 HIV seroconverters, 26 (5%) were HBsAg positive. The
HBsAg positive and negative men were similar in time to AIDS (RR=0.7, 95%
CI=0.3-1.4), AIDS-related death (RR=1.2, 95% CI=0.03,7.6), and total mortality (RR=0.9, 95% CI=0.5-1.7). The CD4 and HIV RNA levels were similar with
the HBsAg positive men having, on average, 86 more CD4 cells/mm3 (P=0.16)
and a 0.21 lower log,0 HIV RNA level (P=0.22). Among the 665 HAART initiators, 59 (8.9%) were HBsAg positive. One year following initiation, 48% of the
HBsAg positive men and 45% of the HBsAg negative men had achieved undetectable (<50 copies/ml) HIV RNA levels (P=0.75). The median CD4 cell increase
during the first year was 102 cells (IQR=10, 226) among HBsAg positive men
and 85 cells (IQR=1 1,171) among HBsAg negative men (P=0.46). By four years
following HAART initiation, the cumulative percentage of men who discontinued
HAART was 12% and 19% among HBsAg positive and negative men, respectively (P=0.50).
Conclusions: Although relatively uncommon in the MACS, the presence of HBsAg was not seen to impact the risk of dying, developing or dying from AIDS, or
responding immunologically to HAART.

Presenting author: Chloe Thio, Johns Hopkins University, 424 N. Bond Street,
Baltimore, Maryland, 21231-1001, United States, Tel.: [phone], Fax:
[phone], E-mail: [email protected]