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  • Title: T-lymphocytopaenia, opportunistic infections and pathological findings in Ghanaian AIDS patients and their sexual partners.
    Author: Ayisi NK, Wiredu EK, Sata T, Nyadedzor C, Tsiagbe VK, Newman M, Cofie CN, Taneguchi K.
    Journal: East Afr Med J; 1997 Dec; 74(12):784-91. PubMed ID: 9557423.
    Abstract:
    Ninety-nine patients at Center for Disease Control (CDC) clinical stage IV were studied. Twelve (12.12%) of these patients turned out to be HIV seronegative. Ten out of the 12 HIV negative patients were immunocompetent whereas the other two had proportional decreases in both CD4+ and CD8+ T-lymphocytes. HIV-1, HIV-2, and dual infection, were detected in 51.5%, 2%, and 22.2% respectively of clinical AIDS patients. The other 12.12% of clinical AIDS patients were indeterminate for HIV antibodies. All HIV positive patients with the exception of two, were immunocompromised with respect to CD4+ and CD8+ T-lymphocyte counts. Two healthy spouses and three children of patients who died from the disease were seronegative for HIV antibodies. Herpes simplex virus type 2 (HSV-2) and cytomegalovirus (CMV) antibody titres were higher in HIV infected than uninfected blood. Patients with chronic diarrhoea, lymphadenopathy, pneumonia, and tuberculosis, either alone or in combination of two or more of such symptoms, were found to be more likely to be confirmed by serology and immunology as definitive AIDS patients in Ghana. In postmortem studies on 20 patients, pneumonia due to tuberculosis constituted the major cause of death. Toxoplasmosis, cytomegaloviral eosophagitis and enteritis, and cryptococcosis were the major opportunistic infections detected. Programmed cell death (apoptosis) was found by the DNA gel electrophoresis method to be an unlikely major mechanism of accelerated culture induced death of PBMCs from CDC stage IV AIDS patients. 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.
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