Evidence for heterosexual transmission and clinical manifestations of human immunodeficiency virus infection and related conditions in Lusaka, Zambia
Melbye, M.; Njelesani, E.K.; Bayley, A.; Mukelabai, K.; Manuwele, J.K.; Bowa, F.J.; Clayden, S.A.; Levin, A.; Blattner, W.A.; Weiss, R.A.
Lancet 2(8516): 1113-1115
1986
ISSN/ISBN: 0140-6736 PMID: 2877269 DOI: 10.1016/s0140-6736(86)90527-1Document Number: 345418
In a hospital-based survey conducted in Lusaka, Zambia, 189 (17.5%) of 1078 patients, blood donors, and health workers had antibodies against human immunodeficiency virus (HIV). The prevalence of antibodies (seropositivity) was low in study subjects under age 20 and over age 60. Seropositivity was highest among men age 30-35 (32.9%) and among women age 20-25 (24.4%). There was no significant difference in prevalence by sex, after adjusting for age. Increasing years of education was highly correlated with seropositivity, even after adjustment for age, sex, and marital status. This association presumably reflects the greater opportunities for travel and social interaction--and thus HIV exposure--among the better educated. The antibody against HIV was detected in 18.4% of blood donors and 19.0% of hospital workers. Among clinic patients, antibody prevalence was lowest among pregnant women (8.7%) and orthopedic patients (9.3%) and highest among those attending the dermatology (26.8%) and sexually transmitted disease (29.2%) clinics. Moreover, patients who had attended the sexually transmitted disease clinic more than once were more likely to be seropositive (37.3%) than first-time attendees (22.8%). Finally, patients with infectious conditions had significantly higher seropositivity rates (23.4%) than those with noninfectious problems (11.4%). Herpes zoster, oral thrush, diarrhea, tuberculosis, and weight loss were independently associated with seropositivity. These findings strongly suggest that HIV infection is prevalent in Africa and is transmitted heterosexually. The concentration of seropositivity in the sexually active age groups indicates that the epidemic is newly introduced, at least in this part of Africa.