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

XIV International AIDS Conference

Abstracts WePeB6026-WePeB6029 85

500 IU/mi), despite two thirds of the patients having a HCV genotype 1 infection.
Drop-out rate due to adverse events was low with 13.3% after 24 weeks.
Presenting author: J0rgen Rockstroh, University of Bonn, Department of
Medicine I, Sigmund-Freudstr 25, 53105 Bonn, Germany, Tel.: [phone], Fax: [phone], E-mail: rockstroh @uni-bonn.de
WePeB6026 Hepatitis C virus infection among patients
attending sexually transmitted disease clinics with
and without HIV-1 Infection in Pune, India
A.R. Risbud1, M. Pareira1, S.M. Mehendalel, R.R. Gangakhedkar1,
S.N. Joshi1, S.P. Tripathy, R.C. Bollinger2, R.S. Paranjape. 'National AIDS
Research Institute, National AIDS Research Institute, G-73, MIDC, Post Box
1895, Bhosari, Pune 411 026, India, India; 2Johns Hopkins University, Baltimore,
MD, United States
Introduction: Hepatitis C infection is known to increase mortality among HIV
infected individuals leading to development of end-stage liver disease and complications of cirrhosis. A recent study has documented presence of HCV RNA in
semen among eight (38%) of 21 men indicating possibility of sexual transmission
of HCV. We studied the prevalence of anti-HIV and anti-HCV antibodies in our
cohort of STD clinic attendees.
Methods: A total of 9269, stored serum samples collected from consecutive patients during 1994 through 1999 were tested for anti-HIV and anti-HCV antibody
An anti-HCV antibody (ORTHO HCV 3.0, Ortho-clinical Diagnostic, Germany) test
was performed on pools of five sera. All sera from a positive pool were tested individually Positive sera were also tested by HCV RNA PCR using standard primers
(PNAS,1992;89:187-192). Results: Of the 9269 samples tested, 1872 (20.2%)
were positive for HIV-1 antibody and 62 (0.67%) were positive for antibody to
HCV. The prevalence of anti-HCV antibodies was higher in HIV infected than in
HIV uninfected subjects (1.76% vs 0.39%. respectively; p= <0.001). Of the 55
anti-HCV antibody positive sera, 27 were also found to be HCV RNA PCR positive. Univariate analysis revealed that HIV infection, history of tattoo, history of
inguinal swelling and sex with female sex worker were significantly associated
with presence of anti-HCV antibody Multivariate analysis revealed that HIV infection was independently associated with more than 3-fold increased likelihood of
HCV infection in study participants (AOR 3.42; 95% CI 1.87-6.84).
Conclusion: A stable prevalence of anti-HIV and anti-HCV antibody among STD
clinic attendees was observed over last 6 years in an urban STD clinic setting.
Markedly higher HCV sero-prevalence seen in HIV positive STD patients highlights the importance of monitoring HCV status in HIV infected individuals since it
may pose serious challenges in clinical management.
Presenting author: Arun Risbud, National AIDS Research Institute, G-73, MIDC,
Post Box 1895, Bhosari, Pune 411 026, India, India, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeB6027 Necessity of prevention for vertical transmission
of hepatitis C virus among co-infected both HIV
and HCV women
S.Y Zverev, O.V. Novikova, E.A. Zemskova. Regional AIDS Centre, 39
Kuibysheva street, Regional AIDS Centre, 614000, Perm, Russia, Russian
Federation
Background: The total number of HIV-infected persons in Perm region of Russia
on the end of 2001, has reached 3,151. 94% of them (2,964/ 3,151) were injecting drug users (IDUs) consuming artificial drugs and co-infected with HIV-1/HCV.
Among this population 26% (786/ 2,964} were women of fertile age with risk of
vertical transmission both HCV and HIV during pregnancy and delivery The aim
of this study was to evaluate risk of maternal transmission of HCV to babies exposed to both HIV and HCV.
Methods: Plasma samples from children born to IDUs-women co-infected both
HIV-1 and HCV were analysed for HCV and HIV-1 RNA and antibodies to HCV
using PCR and ELISA. The diagnosis of HIV-infection was based on the CDC
criteria, positive result of HCV PCR was the diagnostic criteria for HCV-infected
babies.
Results: Up to 1 January, 2002, 38 children born to women co-infected both HIV1 and HCV were registered in Perm region. All those women were IDUs aged
from 18 to 26 years old. Mode of delivery was by vaginal route for all infants,
none of them were breast-fed. Five (13,2%) babies had HCV RNA in plasma,
but none of them were HIV-infected. 33 non-HCV-infected children had maternal
antibodies to HCV during 9 + 1,5 months. Among HCV-negative 5 babies were
HIV-1 -infected.
Conclusions: Possibility vertical transmission of HCV in children born to coinfected both HIV-1 and HCV women is real. This fact indicates the necessity
of application effective drug prevention vertical transmission for both viruses.
Presenting author: Sergei Zverev, 39 Kuibysheva street, Regional AIDS Centre,

614000, Perm, Russia, Russian Federation, Tel.: [phone], Fax: +7 3422
34 19 07, E-mail: [email protected]

WePeB6028 Efficacy and tolerability of HCV treatment in
HIV-HCV co-infected patients: the potential role of
HCV genotype
I. Poizot-Martin1, C. Marimoutou1, S. Benhaim2, M.P Drogoul-Vey2,
F. Vion-Dury3, C. Tamalet4, J.A. Gastaut5. 'CISIH-Sud hopitalste
Marguerite,InsermU379, Marseille, France; 2CISIH-Sud Hopital Ste Marguerite,
Marseille, France; 3CISIH-Sud,Hopital Ste Marguerite, Marseille, France;
4Virology Laboratory,Hopital La Timone, Marseille, France; 5CISIH-Sud Hopital
Ste Marguerite,Institut Paoli-Calmettes, Marseille, France
Background: Our objective was to evaluate tolerability and efficacy of interferonRibavirin treatment in HIV-HCV co-infectedpatients.
Methods: A systematic screening for HCV infection was performed in regularly
followed patients (qualitative PCR, genotype) in our unit.Liver biopsy was proposed to PCR+ patients and HCV treatment to those with at least Al F2 METAVIR
score. The therapeutic protocol consisted combination of Interferon alpha-2b (peg
or not) + Ribavirin (6 to 12 months).
Results: As of December 2001,297 of the 341 screened patients were PCR+;143
of them have had liver biopsy with METAVIR score and 78 were (A1 F2.66 patients
yet began the therapeutic protocol;94% were under antiretroviral (including 39%
under PI), median CD4 cell count was 494/mm3 (IQR:321-657) and 61% had an
undetectable HIV-RNA level.4 patients left treatment after one or three months
because of severe adverse events,37 received the whole procedure (although,
45% also declared side effects)and 25 are still ongoing therapy.Among the 37
patients that ended the protocol,10 achieved complete clearance of HCV-RNA.In
8 patients serum HCV-RNA concentration was still undetectable up to 9 months
after the end of treatment.Genotype distribution was 75%(n=6) 3a,12.5% (n=1)
type 1 and 12.5%(n=1) type 2 among long term successful patients versus 21%
type 3a, 50% type 1, 8% type 2 and 21% type 4 among those who never achieved
clearance of HCV-RNA.The 2 patients who first achieved clearance but was not
secondary evaluated (n=1) or relapsed (n=1) were both type 3a.Baseline CD4
cell count was higher in successful patients, but HIV RNA level did not differ.
Conclusion: A quarter of patients were considered as durable responders to
HCV treatment in this population of HCV-HIV co-infected patients,most of them
being subtype 3a as observed in non HIV co-infected patients.Although a high
prevalence of secondary effects was declared, they were responsible of treatment withdrawal for only 6% of treated patients.
Presenting author: Isabelle Poizot-Martin, CISIH-Sud h6pital ste marguerite,
270 bd de ste marguerite, 13009 Marseille, France, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
I WePeB6029 No difference in virological and immunological
response to HAART according to HCV genotype
and viral load in a cohort of HIV/HCV co-infected
patients
G. Antonucci', A. Cozzi-Lepri 2, M. Solmone1, A. De Luca3, C. Pastecchia4,
G. Madeddu5, a Piano6, A. Vincenti7, F Carletti'. 'INMI L. Spallanzani, Istituto
Nazionale Malattie Infettive, Via Portuense, 292, 00191 Rome, Italy; 2Royal Free
and University College Medical School, London, United Kingdom; 31stituto di
Malattie Infettive UCSC, Rome, Italy; 41stituto di Malattie Infettive, Universit6 di
Milano, Milano, Italy; 5Clinica di Malattie Infettive, Universita di Cagliari, Cagliari,
Italy; 6Cattedra di Immunologia, Universit& di Cagliari, Cagliari, Italy; 7Divisione
di Malattie Infettive, Ospedale Campo di Marte, Lucca, Italy
Background: HIV/HCV coinfection seems associated with impaired CD4+ recovery after starting HAART The aim of this study is to assess the immunological
response to HAART in coinfected patients according to HCV genotype and viral
load (VL).
Methods: Prospective observational study of 334 HIV+/HCVAb+ patients with
HCV VL and genotype determined from plasma stored within 6 months prior to the
initiation of HAART. According to HCV VL and genotype, patients were grouped
as follows: 73 patients with HCV VL below 5 UI/mlI (A), 128 (38.3%) with genotype 1 (B), 91 (27.2%) with genotype 2/3 (C), and 42 (12.6%) with genotype 4
(D). Time to immunological response was defined as the time to achieve a CD4+
rise 3200 cells/ml. Potential confounders included in a proportional hazard model
were: HIV transmission category, pre-HAART CD4+, most recent change in VL,
use of HG-saquinavir. Mean CD4+ over follow-up according to groups and VL
was also compared using a linear hierarchical model for repeated measurements
with fixed effects and an unstructured matrix of variances and covariances.
Results: The adjusted relative hazards of achieving an immunological response
were: 1.77 (95% Cl: 0.49-6.45) for group B, 1.63 (0.44-6.09) for group C, 1.63
(0.41-6.45) for group D (compared to group A), and 0.96 (0.76-1.21) per log10
UI/mL higher HCV VL. Results from hierarchical model were in agreement with
those of the survival analysis showing no significant differences in the mean CD4+
over follow-up between the groups or according to HCV VL.
Conclusions: In our cohort there is no evidence for a difference in the immunological response to HAART according to either HCV genotype or VL. Our data
carry no evidence for a difference in immune recovery in HCVAb+ patients who

have undetectable HCV VL compared to HCV viremic patients.
Presenting author: Giorgio Antonucci, Istituto Nazionale Malattie Infettive, Via
Portuense, 292, 00191 Rome, Italy, Tel.: [phone], Fax: [phone],
E-mail: [email protected]