Summaries from the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy: Part III

conference coverage

Note: The following summaries represent a selection of papers from those presented at the 38th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) held September 24-27, 1998, in San Diego, CA. It is important to recognize that many of these summaries are extracted only from the published abstracts, and it is possible that some of the material may have differed at the time of presentation. Parts I and II, which summarized presentations not related to HIV, were published in the previous two issues of Infectious Disease Alert. —Stan Deresinski, MD, FACP

HIV Infection and Its Complications

Epidemiology

A 20-year-old HIV-infected man in Chautauqua, N. Y., recently achieved notoriety in the national news media for having infected a number of sexual partners. The completed investigation, confirmed by genetic analysis of viral isolates, found that he had, in fact, infected 13 (31%) of 42 female sexuals partners whose ages ranged from 13-21 years. The median number of their sexual contacts with him had been only four, with some infected women having had only a single contact. No secondary cases were identified. (Abstract S-85.) This miniepidemic is consistent with the notion that, similar to observations in HBV infection, certain individuals represent a disproportionate risk in the transmission of HIV-1 infection.

Because of the increased risk of HIV transmission in the presence of other sexually transmitted diseases, one potential approach to HIV control is the aggressive identification and treatment of all STDs. However, in a large randomized study in Uganda, there was no effect on reduction of new HIV infections (despite the successful reduction in the incidence of other STDs) other than bacterial vaginosis. This failure may have been related to the enormous baseline prevalence of HIV infection of 16%. (Abstract S-86.)