HORIZONTAL VERSUS VERTICAL TRANSMISSION OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 (HIV-1) EXPERIENCE FROM SOUTHWESTERN SAUDI-ARABIA

Twenty-five confirmed cases of human immunodeficiency virus type 1 (HI V-1) infection due to blood transfusion have been documented at King F ahad Hospital (KFH) in Al-Baha, southwestern Saudi Arabia since 1986, but complete follow-up was only possible on 19 of these cases and thei r contacts. Seventeen cases were diagnosed as having acquired immunode ficiency syndrome (AIDS) or AIDS-related complex (ARC) after admission to the hospital due to the deterioration of their health status, Two cases were found to be anti-HIV-1 positive on routine screening for bl ood donation, This cluster of HIV-1 infected patients through blood tr ansfusion allowed us to study the efficiency of sexual transmission of HIV-1 infection between spouses, the rate of perinatal transmission o f HIV-1 infection, and to see whether intrafamilial transmission is a possible route of spread of the virus, Firstly, the present results co nfirm our earlier observation that transmission of HIV-1 infection was more efficient from the infected husband to his wife(s) in contrast t o the inefficient transmission of the infection from the infected wife to her husband. Secondly, by the age of 16 months, all nine newborns to HIV-1 infected mothers became HIV-1 infected. This highlights the i mportance df medical adp,ice to those mothers regarding conception and /or breast-feeding, particularly as breast-feeding up to 2 years is no t an uncommon practice among Saudi women, Finally, none of the househo ld contacts of the 19 cases was infected until now, indicating that in trafamilial spread of HIV-1 did not occur among the population studied .