HIV-1 and hepatitis B transmission in Sudan
McCarthy, M.C.; Hyams, K.C.; el-Tigani el-Hag, A.; el-Dabi, M.A.; el-Sadig el-Tayeb, M.; Khalid, I.O.; George, J.F.; Constantine, N.T.; Woody, J.N.
Aids 3(11): 725-729
1989
ISSN/ISBN: 0269-9370 PMID: 2515878 DOI: 10.1097/00002030-198911000-00006Document Number: 371763
A seroepidemiological survey was conducted in 1987-88 among 773 male soldiers living in 5 urban locations in Sudan (1 in the southern region) to study the prevalence of, and risk factors for, HIV-1 and hepatitis B (HBV) transmission. Twenty eight percent of the study population had been born and raised in southern Sudan, which is adjacent to HIV-1 endemic areas. Twenty five percent of the study population were HBsAg positive and an additional 53% had other HBV markers, with a higher overall prevalence of seropositivity in soldiers from the south (95% versus 72%). Thirteen soldiers (1.7%) were confirmed positive for HIV antibodies (by Western blot), of whom 11 were from the south and the other 2 had been stationed in the south for 5 years. Multivariate analysis indicated an association between living in southern Sudan and both hepatitis B (odds ratio OR, 8.2) and HIV-1 infection (OR, 14); sexual contact with prostitutes (OR, 1.5) and injections for schistosomiasis (OR, 2.72) were additional independent predictors for hepatitis B. Age-specific analysis showed that 94% of southern soldiers already had HBV markers by the age of 20 years compared with 47.5% in the north, rising to >80% at age over 39 years. These findings suggest that sexual promiscuity is a risk factor for hepatitis B transmission in Sudan and suggest a possible route for the spread of HIV north from the endemic areas of central Africa.Richard Gilson.