European Journal of Medical Research - Deutsche AIDS ...

June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH
67
increase. However, factors such as tolerance, pill count and
drug-resistance determine the use of AR-drugs. Determination
and specification of (ART)-strategies in HIV treating centres
between 1996 and 2006.
Methods: Analysis of high-grade ART data from 21 ClinSurv
centers. Daily R were generated using documented start and
stop dates for each drug. Ongoing R were censored at the last
known clinical event or the end of the observation period. The
analysis is focused on the main class-regimens (MR) representing
at least 1% of entire R-time.
Results: The assessment of daily ART was based on 15.2 mill.
S-days or 4.6 mill. R-days, respectively. Overall 3,757 patients
have been treated with 30 S in six S-classes. The number of
quarterly used S increased from 11 to 24 over time. 12 MR
from the over-all 87 class-R were representing 83% of R-time.
Mono-class NRTI-R had an over-all share of 9%, whereof 2-
NUC-R held 46% of R-time in 1996 and lost rapidly impact. 3-
NUC-combinations achieved in 2003 9% and decreased to 4%
in 2006. All MR contained at least two NRTI except boosted
double-PI-R having 3% in 2006. In the study period the use of
DDI, DDC and D4T decreased from 43% to 6%, whereas the
use of “new” NRTI as TDF and FTC increased by 23% in the
last five years. The frequency of PI containing R decreased
since 1998 from 60% to 27% in 2003 and currently increased
up to 35%. The frequency of NNRTI containing R increased to
a stable rate of 44% over the last six years. At the end of study
57% of boosted PI-R were based on LPV and 16% on ATV,
whereas in 1999 IDV or SQV were the predominant S.
Conclusions: ART-strategies documented in ClinSurv
changed lasting. With the appearance of TDF and FTC “older”
NUC lost a quarter of impact. Over the years PI-containing
R were replaced by NNRTI-containing R. Since 2004 the
influence of PI-R reincreased. The former were dominated at
the end of the study period by boosted LPV. ClinSurv ART
documentation offers a daily detailed contemporary image of
antiretroviral treatment in Germany.
B.38 (Poster)
Prevalence and characteristics of HIV-2 infection
in Germany
Schwarze-Zander C. 1 , Skoetz N. 2 , Kupfer B. 3 ,
Stellbrink H.J. 4 , Schmidt R.E. 5 , Karwat M. 6 , Jäger H. 7 ,
Brockmeyer N.H. 8 , Rockstroh J.K. 1 , for the Competence
Network for HIV/AIDS
1 University of Bonn, Department of Medicine I, Bonn,
Germany, 2 Coordinating Centre for clinical trials, Cologne,
Germany, 3 University of Bonn, Institute for Medical
Microbiology, Immunology, and Parasitology, Bonn,
Germany, 4 Private Practice, Hamburg, Germany, 5 Hannover
Medical School, Dept. of Clinical Immmunology, Hannover,
Germany, 6 Private Practice, Munich, Germany, 7 MUC
Research, Munich, Germany, 8 Ruhr-University Bochum,
Department of Dermatology, Bochum, Germany
Background: While infection with HIV-2 is predominantly
found in West Africa, HIV-2 infections are rare elsewhere. It
is known that clinical course and clinical picture of HIV-1 and
HIV-2 infection differ. Little is known about HIV-2 infection
in Germany. Therefore we investigated prevalence and clinical
characteristics of HIV-2 infection in Germany.
Methods: Since 2002 13995 HIV positive patients have been
enrolled in the Competence Network for HIV/AIDS. Clinical
data (CD4 cell count, CDC stage) of these patients were collected
every 6 months.
Results: HIV-2 infection was detected in 29/13995 (0.2%) of
HIV infected subjects. In these individuals no co-infection
with HIV-1 was found. Interestingly, only 8/29 (28%) were of
african origin. 85% of HIV-1 infected subjects were men,
while only 65% of HIV-2 infected subjects were male. MSM
was found as risk factor of HIV-2 transmission in 14/29
(48%). No difference in CD4 cell count was found between
HIV-2 and HIV-1 infected patients (489.9 vs 498.9, respectively).
Distribution of the clinical CDC stage in HIV-2 and
HIV-1 was: A = 69% vs. 35%, B = 18% vs. 38%, C = 14% vs.
27%, respectively.
Conclusions: HIV-2 infection is not common in Germany. Interestingly,
risk of HIV-2 infection is not restricted to people
from high prevalence countries. Despite comparable CD4 cell
counts AIDS is less frequent in HIV-2 infection in cohort participants.
B.39 (Poster)
Reasons for hospital admission in HIV patients
5 and 10 years after the introduction of highly
active antiretroviral therapy
Blaas S. 1 , Salzberger B. 1
1 Universitätsklinikum Regensburg, Klinik und Poliklinik für
Innere Medizin I, Regensburg, Germany
Objective: The introduction of HAART in 1996 has greatly
influenced the clinical course and the outcome of patients infected
with HIV. HAART has reduced hospital admissions in
the first years. Whether the admission rate now is further declining
is not clear. Therefore we analysed all hospital admissions
during the years 2001 and 2006 from our in- and outpatient
hospital cohort.
Methods: All inpatient admissions of our department with a
diagnosis including the term “HIV” or “AIDS” during the
years 2001 and 2006 were retrieved through our electronic
database. Baseline characteristics, reasons for hospital admission,
diagnoses and outcome were analysed.
Results: There was an increase from 22 to 39 hospital admissions
of HIV patients from 2001 to 2006. HIV was newly diagnosed
in 3 out of 19 in 2001 and in 9 out of 32 pts. in 2006.
The majority of patients had advanced HIV disease. Only 3
out of 9 (2001) and 7 out of 11 (2006) patients receiving
HAART had a viral load below 50 copies/ml. In only 4 out of
13 (2001) and 3 out of 21 (2006) patients not on HAART, antiretroviral
therapy was not indicated, when restrictive criteria
(CDC stage B/C or CD4 count < 200/l) were applied. Nonadherence
and newly diagnosed HIV-infection were the most
common reasons for not taking HAART. Opportunistic infections
were the most common cause of hospital admission. For
both tuberculosis and pneumocystis jirovecii pneumonia there
was an increase from 1 to 5 cases from 2001 to 2006. There
were 4 cases of non-AIDS-defining malignant disease in 2006
but none in 2001. There were two cases of HAART related diarrhea
and one immune reconstitution syndrome in 2006, but
no hospital admission due to HAART side effects in 2001. In
both years, two patients died in hospital.
Conclusions: Opportunistic and other infections as well as direct
manifestations of HIV are still the most common reasons
for hospital admission 10 years after the introduction of
HAART. Admitted patients had a low rate of virologic suppression
in both periods. Nonadherence and previously unknown
HIV infection were the most common causes for no or
insufficient HAART. Additionally a rise in non-AIDS-defin-