European Journal of Medical Research - Deutsche AIDS ...

June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH
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Conclusion: Socio-economic status have an impact on
knowledge about health and as expected integrated (well German
speaking) women are observed to be also integrated into
the health system; they knew more about the illnesses. The
most important challenge for AIDS prevention is to spread intensively
the knowledge about AIDS and for better results in
the mother language of migrants.
A.19 (Poster)
Prevalence of Neurosyphilis (NSI) diagnosed by
Cerebrospinal Fluid (CSF) and clinical
neurological examinations in HIV-positive patients
with primary or secondary infectious Syphilis (SI)
and CSF-repuncture for therapy control after
treatment
Esser S. 1 , Jablonka R. 1 , Körber A. 1 , Ross B. 1 ,
Obermann M. 2 , Hagedorn H.J. 3 , Grabbe S. 1
1 Universitätsklinikum Essen, Dermatologie und Venerologie,
Essen, Germany, 2 Universitätsklinikum Essen, Neurologie,
Essen, Germany, 3 Medizinal-Untersuchungsstelle im
Regierungsbezirk Detmold, Konsiliarlabor Dr. Krone &
Partner, Herford, Germany
Objectives: Since 2000 prevalence of SI increased in Germany.
SI cases showed rapid progression of SI to NSI and
therapy failure in HIV-infected patients. The aim of the study
is to evaluate signs for NSI in CSF in patients with co-infection
of SI and HIV from January 2000 till February 2006.
Methods: This prospective ongoing study included HIV-positive
Patients with serological (TPHA, VDRL, IgM Western
Blot) and clinical diagnosed primary or secondary SI. Neurological
examinations and CSF puncture were performed and
repuncture 12 months after treatment (TPHA, TPHA- ratio,
FTA-ABS-19s-IgM, blood-CSF-barrier).
Results: 94% of the 47 male patients (CDC WHO stage A
17%, B 68%, C 15%; mean age 37 yrs) were described as men
who have sex with men, three were heterosexual. Mean CD4-
cell count was 469/l (range 81-1164) and mean HIV-RNA
48497 copies/ml (range 50–500000). 31 (66%) patients were
treated with antiretroviral therapy. Nine patients (19%)
showed infectious seropositive SI without dermatological
symptoms and 35 (74%) showed makulo-papular exanthema.
All IgM-Western Blots were positive. Mean TPHA was
1:1299885 (range 1:1280-1:41943040), mean VDRL 1:634
(1-1:8192). Mean CSF-TPHA was 1:387 (range 1:2-1:8192),
in repuncture of actual 13 patients 1:32 (range 0-1:128). Nine
(19%) patients had a positive FTA-ABS-19s-IgM in CSF.
Neurological symptoms were verified by a neurologist in
three patients. At least a neurological attendance of SI was diagnosed
in seven cases (15%) followed by intravenous Penicillin
G therapy for 21 days. The others got intramuscularly
treatment with Benzathinpenicillin for 14 days. In repuncture
one year after treatment neither treatment failure nor positive
CSF-FTA-ABS-19s-IgM titer was observed after therapy.
Conclusions: 15 % of the HIV-positive patients with infectious
SI had signs of early NSI. No treatment failure was observed
in repuncture. This survey shows increased risk of NSI
in HIV-Infected patients but obviously no treatment failure
after sufficient therapy.
A.20 (Poster)
Impact of GB virus-C co-infection and quality of
life in a cohort of HIV infected patients in a
private clinic in Germany
Kaiser T. 1 , Kuhlmann B. 2 , Holm S. 2 , Weimann M. 2 ,
Stoll M. 3 , Tillmann H.L. 1
1 Universitätsklinikum Leipzig, Medizinische Klinik &
Poliklinik II, Leipzig, Germany, 2 Internistische
Gemeinschaftspraxis Georgstraße, Hannover, Germany,
3 Medizinische Hochschule Hannover, Klinische Immunologie,
Hannover, Germany
Objective: GB Virus C is a non-pathogenic Flavivirus genetically
closely related to the Hepatitis C Virus, which was
found in relation to a better clinical course of infected HIVpatients
in the pre-HAART era. Aim of this study was to investigate
the effect on HIV viral load, CD4 and CD8 cells and
also the quality of life in a cross sectional patient cohort from
a private clinic in Germany in HAART era.
Methods: 248 patients were analysed for HIV and GBV-C viral
load, CD4 and CD8 cells. In addition, quality of life has
been evaluated in 115 cases by using the SEL questionnaire
and analysed in relation to GBV-C status.
Results: There was a trend though not significant towards
better results for HIV-viral load, CD4 and CD8 cells in the
GBV-C positive patients. Although not reaching the level of
significance in this study, the positive trend was the same in
whatever sub analysis performed.
Likewise, the quality of life was better, though not significantly,
for GBV-C co-infected patients. Limiting the analysis
to patients not yet receiving HAART showed even significant
better QoL for GBV-C viraemic patients (p=0.039).
Discussion: The availability of HAART seems to diminish
but not eliminate GBV-C’s role in slower disease progression
and better quality of life in HIV infected patients.
Key words: GBV-C, HGV, HIV, co-infection, QoL, quality
of life.
A.21 (Vortrag)
KABaSTI-study results: Barebacking among
German men who have sex with men (MSM) - risk
reduction intentions and practice
Marcus U. 1 , Schmidt A.J. 1 , Hamouda O. 1
1 Robert Koch-Institut, Infektionsepidemiologie, Berlin,
Germany
Objectives: During the last decade “barebacking” (intentional
non-use of condoms for anal intercourse with casual partners
in MSM) has become increasingly popular. There has been no
study on sexual risk behaviour and risk management strategies
in MSM with bareback identities in Germany so far.
Methods: Within a larger internet survey on knowledge, attitudes,
and behaviour of German MSM as to sexually transmitted
infections, we analysed reported sexual risk behaviour and
risk management intentions of survey participants recruited
on bareback websites (BBW) compared to participants recruited
on other websites (OW).
Results: BBW (n=564) were significantly older (77% vs.
59% older than 30 years), had been tested for HIV more frequently
(91% vs. 67%), a much higher proportion was HIV
positive (59% vs. 10%), and were living more often in metropolitan
areas (37% vs. 24%) than OW (n=5364). BBW report-