European Journal of Medical Research - Deutsche AIDS ...

June 27, 2007 EUROPEAN JOURNAL OF MEDICAL RESEARCH
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C-) for CD40 (p=0.0018), and 5.37 ± 0.88% (n=7 GBV-C+)
vs. 1.58 ± 0.511% (n=7 GBV-C-) for CD83 (p=0.0041). The
mean fluorescence intensity (MFI) of CD40 and CD86 was
higher in GBV-C coinfected HIV-1 patients after 24hrs. IFNa
production was comparable between the two groups.
Conclusion: HIV-1 patients coinfected with GBV-C have a higher
percentage of pDCs expressing CD40 and CD83. This significant
difference suggests that certain phenotypic characteristics of
pDC are influenced by GBV-C coinfection in HIV-1 infection.
C.13 (Poster)
Hepatitis B virus markers in HIV-infected
pregnant women
Weizsaecker K. 1 , Casteleyn S. 1 , Siedentopf J.-P. 1 ,
Feiterna-Sperling C. 2
1 Charité Universitätsmedizin, Klinik für Geburtsmedizin,
Berlin, Germany, 2 Charité Universitätsmedizin, Klinik für pädiatrische
Pneumologie und Immunologie, Berlin, Germany
Objective: Hepatitis B virus (HBV) coinfection is common in
HIV-infected individuals. According to current German prenatal
care guidelines only HBsAg-status is determined during
the third trimester of pregnancy. Newborns of HBsAg-positive
mothers receive active and passive immunization immediately
after delivery in order to prevent vertical transmission
of HBV. There is little data about the seroprevalence of HBVmarkers
in HIV-infected pregnant women.
Methods: HIV-infected women were cared for at our center during
a total of 245 consecutive pregnancies from January 1998
to February 2006. HBsAg, anti-HBs, anti-HBc (IgG and IgM)
as well as HCV-antibodies and HCV-PCR were determined.
Results: 38.7% of women showed evidence of past or present
HBV-infection; HBsAg was positive in 5.3%. The seroprevalence
of hepatitis B markers in HBsAg-negative women was as
follows: Both anti-HBs and anti-HBc positive 22.4%, only anti-
HBc positive 12.9%, only anti-HBs positive 9.1%, all markers
were negative in 49.6% of women, data were incomplete in
6.0%. Anti-HBc as the only positive marker was found more
frequently among women from high-prevalence regions
(20/119 or 16.8%) and especially among HIV/HCV coinfected
patients (12/45 or 26.7%).
Conclusions: Markers of HBV-infection were detected in a
high proportion of HIV-infected pregnant women at our center.
Especially anti-HBc-only positive women may be potentially
infectious in spite of negative HBsAg-status, and the risk of
vertical transmission of HBV cannot be completely ruled out in
this group. Therefore complete HBV-serology should be part of
routine prenatal care for all HIV-infected women. Furthermore,
only 15.4% of all eligible patients showed serological evidence
of HBV-vaccination, a rate that could be greatly improved.
C.14 (Poster)
Relapse of HCV viremia in two patients with spontaneous
HCV-clearance after restarting HAART
Sauter F. 1 , Wojcik K. 2 , Kupfer B. 3 , Schwarze-Zander C. 2 ,
Bliesener N. 2 , Rockstroh J.K. 2
1 Universität Bonn, Medizinische Klinik 1, Köln, Germany,
2 Universität Bonn, Medizinische Klinik 1, Bonn, Germany,
3 Universität Bonn, Virologie, Bonn, Germany
Overall, in the natural course of HIV/HCV coinfection, higher
HCV-RNA levels are found in HIV seropositive patients as
compared to HIV seronegative patients with hepatitis C. Indeed,
analysis of HCV-RNA levels in haemophiliacs showed
that mean HCV-RNA levels increased by 1 log over the first 2
years after HIV-seroconversion. Which impact HAART has
on HCV kinetics so far is still discussed controversially.
Here we describe 2 rare cases of patients, in which after
having experienced spontaneous HCV-RNA clearance after
developing severe CD4-depletion, reappearance of HCV occurred
when CD4 counts started rising again after initiation or
ongoing HAART. Acute reinfection during the observation
period was ruled out. In one case a new HAART regimen
(TDV,FTC, LPV/r) was started after CD4-counts had fallen
down to 14 cells/l. HIV viral load was then above 500.000
copies/ml. At the same time HCV-RNA became undetectable
after having continuously fallen during the last years. In the
other patient HCV-RNA clearance was documented 6 months
after HAART (LPV/r, ABC,3TC) was initiated but here, due
to compliance problems, HIV-RNA remained detectable. Indeed
HCV clearance was documented at 20.000 HIV-RNA
copies and progredient CD4 count loss with CD4-levels between
14 and 40 cells/l. Subsequently, compliance was improved
and HIV-RNA became undetectable (