SEROLOGICAL SURVEY OF HIV-1, HIV-2 AND HUMAN T-CELL LEUKEMIA-VIRUS TYPE-1 FOR SUSPECTED AIDS CASES IN GHANA

Objective: To determine seroprevalence among suspected AIDS in Ghana i n relation to clinical manifestations. Materials and methods: Blood sa mples and medical records were collected from 290 Ghanaian patients wi th suspected AIDS in 1990 and 1992. Seroprevalence of HIV-1, HIV-2 and human T-cell leukemia virus (HTLV-1) were investigated by the particl e agglutination method, indirect immunofluorescence assay, the monoepi tope enzyme-linked immunosorbent assay and Western blot. Result: The s pecimens were classified into five serologic categories: 78 were HIV-1 -positive (26.9%), 25 were HIV-positive (8.6%), 17 dual-positive (5.9% ), 16 indeterminate (5.5%) and 154 seronegative (53.1%). No significan t difference was found between the clinical symptoms of patients with HIV-1 and HIV-2 infection. Of the patients, 14 (4.8%) were HTLV-1-sero positive, of whom 11 were also HIV-positive, indicating a significant correlation between the two groups of viral infections (P < 0.001). Ho wever, there was no evidence of an increase in severity of symptoms in cases of dual infection with HTLV-1 and HIV. Conclusions: HIV-1 infec tion is now dominant in Ghana in contrast to our previous survey in 19 86 which showed the dominance of HIV-2. The change in seroprevalence s uggests that an HIV-1 epidemic has been developing in recent years in this country, where HIV-2 was originally endemic. A relatively high pr evalence of dual-reactive specimens implies the existence of highly cr oss-reactive strains of HIV or frequent coinfection of HIV-1 and HIV-2 in the region. The large number of seronegative patients with clinica lly diagnosed AIDS raises the question of the inadequacy of AIDS defin itions based on clinical manifestations only.