AIDS Weekly Plus

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A by >2.45 logio copies/ml with undetectable level for 9/15 pts at W8. Median CD4 cell count increased by
I 68/mm' at W4 and by 103/mmu3 at W8. We concluded that a combination of ritonavir and saquinavir
added to AZT + 3TC is well tolerated and induces a profound viral suppression in immunocompromised
D
pts."
W
E Disease Associations
E "Survival in Human Immunodeficiency Virus Infected Patients with Tuberculosis." S.S. funsiff, P. Alpert, M.N.
K Gourevitch and R.S. Klein. Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New
L York.
Y
According to an abstract submitted by the authors to the 3rd Conference on Retroviruses and
P Opportunistic Infections, held January 28 - February 1, 1997, in Washington, DC, "Objective: To identify
L factors associated with survival in patients with active tuberculosis (TB) and HIV infection. Methods:
u Prospective follow-up of all HIV seropositive (HIV ) TB patients confirmed by culture over 2.5 years at
s two Bronx hospitals. Patients were interviewed and medical charts reviewed at time of TB diagnosis to
obtain demographic and medical data. Patients were followed until death or loss to follow-up. Results:
A 88 patients with TB and HIV infection were identified; 75% were male, 44% injecting drug users (IDUs),
P and 25% had prior AIDS by 1987 CDC criteria. 28% of IDUs and 31% of non-IDUs had TB resistant to
R one or more anti-TB drugs (p=.8). Median baseline CD4 was 9% (range 1-37%, n=67). 11 patients (12%)
I died during initial admission for TB and were excluded from further analysis. 32 died during follow-up.
L Improved survival was associated with directly observed therapy (DOT) for TB treatment, (mean survival
by Kaplan-Meier method 25.2 vs. 18.4 months, p=.018), being non-IDU (24.6 vs. 18.1 months, p=.034),
2 and having TB susceptible to all drugs (24.0 vs. 17.7 months, P=.039). However, the benefit of DOT was
8 greater for those with resistant TB than for patients with fully susceptible TB (mean survival increase of
13.6 months vs. 5.9 months, P=.0005). Sex, race, anatomic site of TB, and Antiretroviral drug use were
1 not associated with survival. Conclusions: DOT for TB treatment was associated with improved survival,
9 particularly in patients with resistant TB. A history of being an IDU was associated with increased
9 mortality, regardless of drug resistance."
7
Epidemiology (HGV)
"Epidemiology of HGV/GBV-C Infection in Rural Zaire." F. Davidson, S. Graham, J. Wokili, W.A.M. Cutting, L.N.
Jarvis and P. Simmonds. Edinburgh and South East Scotland Blood Transfusion Service, Edinburgh; University
of Edinburgh, United Kingdom.
According to an abstract submitted by the authors to the 4th International Meeting on Hepatitis C
Virus and Related Viruses, Molecular Virology and Pathogenesis, held March 6-10, 1997, in Kyoto, Japan,
"The frequency of infection with hepatitis G virus (HGV) or GBV-C, its epidemiology and rate of vertical
transmission to children were investigated in a cohort of antenatal women living in rural bas-Zaire around
Kimpese. Infection with HIV-1 was detected in XX% of this population, comprising subtypes A, B, C, D
and F by sequence analysis of the pl7ga region. For the study, samples from 50 HIV-1 positive and 80
HIV-1 negative women and their children were assayed for HGV/GBV-C sequences using two sets of
conserved primers from the 5'NCR (Jarvis et al., 1996). A high frequency of HGV/GBV-C infection was
found amongst H1V infected individuals, with 28% (14/50) PCR-positive with the 5'NCR primers. This
frequency of infection was significantly higher than observed amongst HTV negative individuals (4/84;
p<O.O0l). There was no association HGV/GB V-C infection with epidemiological factors such as age,
occupation (or husbands occupation) or history of parenteral exposure. In contrast, HCV was found at a
low frequency in this cohort (XX% PCR-positive) and infection was not associated with H1V-1. These
findings suggest a major difference in routes of transmission of HGV/GB V-C and HCV in this
community. Sequence comparisons of HGV/GB V-C sequences amplified from the 5'NCR indicated a
closer similarity to variants previously found in Gambia (described as "genotype 1") than variants obtained
from Europe, USA and Asia. Sequential samples from between 0 and 24 months after birth were collected
from children of each of the HGV/GB V-C infected women. A high frequency of persistent viremia over

the duration of the 2 year study period was observed, and which contrasted with the low rate (<5%) of
infection in those bom of HGV/HBV-C uninfected mothers. These findings tend to exclude other
(possibly environmental) sources of infection in this study group."