This proposal is an expansion of an existing DANIDA-financed project which started in 1987. The objectives of the project are to study the epidemiology and natural history of HIV-2 infection in Bissau, there by identifying preventive measures. The inhabitants of 100 houses (1500-2000) are followed clinically and serologically with intervals of 2-3 Years, alternating with case-control studies of risk factors and immunological as well as clinical status.
Some main findings are: Only HIV-2is present. Prevalences: adults 8.9% (1987),10.1%(1989). Age >39 yrs 20% (1987). Incidence 1.0% pr.Year. Vertical transmission very rare. HIV-2 causes a significant immunodepression. We propose to expand the following topics: '
1. The impact of HIV-20n mortality /morbidity of the society and the individual. Paa's child health project contains census records from the area from 1978 onwards; an analysis of existing as well as prospectively collected data can show whether there has been any major change in mortality. The follow-up of the cohort of HIV-2 seropositives will provide information of the potential pathogenicity of HIV-2in the individual. 2. The dynamics of the HIV-2 infection. By expanding the survey in the age group >50 Years, we can study the risk factors of the past and thus the history of HIV-2. When biotechnological advances makes it feasible, an analysis of different HIV-2 strains might provide an explanation to why some People live to old age with HIV-2, while others die of AIDS after few years of infection.
3. The question of vertical transmission of HIV-2 needs to be followed pro spectively in as many women as possible. This is important also in connection with the decision whether or not to advise a pregnant HIV-2 seropositive woman to have an abortion.
4. The connection between Genital Ulcer Disease and HIV-2 still needs to be clarified. The ELISA test for antibodies to H. Ducreyi which causes soft chancre will be used on samples from the main cohort.
5. Anthropological studies of knowledge and attitudes towards AIDS, and of sexual behaviour, are necessary to target and shape public information about AIDS and its prevention, and to evaluate the effect.
Funding SchemeCSC - Cost-sharing contracts
2000 Anvers /Antwerpen