T-lymphocytopaenia, opportunistic infections and pathological findings in Ghanaian AIDS patients and their sexual partners.

ABSTRACT

PIP: Since HIV infection was first diagnosed in Ghana in 1986, the incidence of HIV infection has increased steadily in the country over the years. Until 1990, most people infected with HIV in Ghana were infected with HIV-2. However, in 1990, most people tested were found to be dually infected with HIV-1 and HIV-2, and recently, most HIV-infected people in Ghana are only HIV-1 positive. Findings are presented from the study of 99 US Centers for Disease Control and Prevention (CDC) clinical stage IV AIDS patients. Polymerase chain reaction assay identified 12 of these patients as HIV-seronegative. HIV-1, HIV-2, and dual infection were identified in 51.5%, 2%, and 22.2% of clinical AIDS patients, respectively, with the remaining patients being indeterminate for HIV antibodies. All but 2 HIV-positive patients were immunocompromised with regard to CD4+ and CD8+ T-lymphocyte counts. 2 healthy spouses and 3 children of patients who died from AIDS were seronegative for HIV antibodies. Herpes simplex virus type 2 and cytomegalovirus antibody titers were higher in HIV-infected than in uninfected blood. Patients with chronic diarrhea, lymphadenopathy, pneumonia, and tuberculosis (TB), either alone or in combination of 2 or more such symptoms, were more likely to be confirmed by serology and immunology as definitive AIDS patients in this study. Pneumonia due to TB was the major cause of death identified through postmortem studies conducted upon 20 patients. Toxoplasmosis, cytomegaloviral esophagitis and enteritis, and cryptococcosis were the major opportunistic infections detected. Programmed cell death was probably not a major mechanism of accelerated culture-induced death of peripheral blood mononuclear cells.