Relationship between immunoclinical status and prevalence of viral sexually transmitted diseases among human immunodeficiency virus-1 seropositive patients in Ghana

In view of the strong association between the acquired immunodeficiency syn drome (AIDS) and sexually transmitted diseases (STDs), we screened 182 huma n immunodeficiency virus (HIV)-1 infected patients over a 15-month period f or serological markers to previously encountered or current STDs, most of v iral etiology. The relationship between their immunological and clinical st atus and the prevalence of STDs was assessed and compared with that of 88 H N-seronegative patients. Hepatitis B virus and Treponema pallidum were the most frequently occurring pathogens in both HIV-l-infected and HIV-seronega tive patients. Hepatitis C virus (HCV) infection was also observed in both groups, but no HIV-seronegative patient was infected with human T-lymphotro pic virus type 1 (HTLV-1). The Centers for Disease Control clinical staging of Al through C3, representing asymptomatic to severe AIDS conditions, was observed in HIV-1 patients with or without STDs. A mean CD4 count of 288 c ells per microliter (95% CI of 237-340 cells per microliter) in HIV-1 patie nts was significantly lower (P < 0.05) than that in HIV-seronegative indivi duals with 1019 cells per microliter (95% CI of 924-1115 cells per microlit er), irrespective of whether subjects in either group had previous or curre nt STDs. The mean CD4 count of patients with a single infection from HIV-1 was not significantly different (P = 0.36) from that of HIV-1 patients with multiple infections. HIV-1 infection alone appears to be responsible for t he marked immunodeficiency status of seropositive patients observed in this study.