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Session 106 Poster Presentations
GBV-C and SENV: Good, Bad, or Indifferent?
Session Day and Time: Wednesday 1:30 - 3:30 pm
Room: Hall B


850
SENV Infection in HIV+ Patients: Prevalence, Subtype Characterization, and Impact on the Clinical Outcome
E. Quiros-Roldan*1, C. Torti1, L. Imberti2, S. Casari2, G. Carosi1, F. Moretti1, S. Pirovano2, F. Castelli1, G. Carosi1
1Univ of Brescia, Italy and 2Spedali Civili, Brescia, Italy

Background: Co-infections with HIV are an emerging problem that could adversely or beneficially affect HIV clinical course. The present study was aimed at characterizing SENV epidemics and exploring whether SENV can impact on survival.

Methods: In our cohort, 165 HIV-infected patients (pts) have been tested by PCR on a portion of ORF-1 gene that is specific for SENV-A, B, D, and H subtypes. Cox regression models (either bi-variate or multi-variate analyses) and Kaplan-Meier estimates were applied for survival analysis. Clinical and laboratory data were collected at least every 4 months (mos) for a mean of 49.1 mos (SD 24.7).

Results: Prevalence of SENV infection was 85/165 (51.5%); among SENV positive pts, 67% were infected by only 1 SENV variant, 24.7% by 2, and 8.2% by 3, with subtype A predominance among SENV mono-infected pts (91.2% SENV-A, 5.2% SENV-D, 1.7% SENV-B, and 1.7% SENV-H). Intravenous drug use (IVDU) as risk factor for HIV acquisition was associated to increased risk of SENV infection (OR: 4.2, 95% CI, 2.1–8.2, p < 0.001), while female gender resulted to be protective (OR: 0.3, 95% CI, 0.1–0.7, p = 0.006). Interestingly, IVDU was also associated to the patients’ risk of being super-infected with more than one SENV variants. Multi-variate stepwise Cox regression model included the following covariates: age, gender, risk factor for HIV acquisition, HCV-Ab, HBs-Ab reactivities, CD4+ and HIV-RNA at the time of testing for SENV, C stage of HIV infection (CDC ’93), exposure to HAART, duration of undetectable HIV-RNA and SENV infection. Among these co-variates, IDVU (HR: 26.3, 95% CI, 2.7–257, p = 0.005) and HAART exposure (HR: 5.3, 95% CI, 1.1–25.8, P=0.035) were associated with increased survival, while C-stage of HIV infection (HR: 0.04, 95% CI, 0.004–0.3, p = 0.002) and, at borderline significance, absent SENV infection (HR: 0.1, 95% CI, 0.02–1.1, p = 0.065) increased the risk of death.

Conclusions: High prevalence, superinfection and broad subtype diversification of SENV infection have been demonstrated in this cohort of HIV+ pts, especially as far as pts who acquired HIV through IVDU are concerned. Infection with SENV does not seem to have any negative impact while, a possible positive relationship with survival needs further investigation.