In eight of the 12 countries tested, antibodies to group O viruses were identified. Numbers of HIV-1 group O viruses are low. Their presence is not restricted to Cameroon and neighbouring countries but can also be found in west and south-east Africa.
In Africa the highest HIV infection rate has been reported among female commercial sex workers (CSWs) who are at increasing risk of acquiring and transmitting HIV infection. In October 1995, 176 CSWs were studied in Bamako, the capital city of Mali. The ages of the CSWs ranged from 15 to 50 years old (mean, 28.8 years). Only 20.45% of the 176 CSWs were Malian; the majority were from Nigeria (32.9%) and Ghana (31.8%), and the remaining were from other African countries. Forty-one percent were active for less than 1 year as a commercial sex worker, and the length of prostitution for the remaining women ranged from 1 to 15 years (mean, 2.76). A total of 81 (46.02%) of the 176 CSWs were positive for HIV antibodies; 63 (35.8%) were HIV-1 positive, (3.9%) were HIV-2 positive, 11 (6.2%) had antibodies to HIV-1 and HIV-2, and none of them had antibodies to group O viruses. For all HIV antibody-positive samples, PBMCs were separated and genetic subtypes of HIV-1 were determined using the heteroduplex mobility assay (HMA), with ED5-ED12 as outer and ES7-ES8 as inner primers. Among the 66 HIV-1 strains characterized, 53 (80.3%) were subtype A, 2 (3.1%) belonged to subtype C, 1 (1.5%) belonged to subtype D, and 10 (15.1%) were identified as subtype G. Among the 10 subtype G strains, 8 were obtained from women who were very recent CSWs, with an activity of 1 year or less, assuming that there is a high probability that these infections occurred recently. Genetic subtypes of five HIV-2 viruses were determined by sequencing of the env and/or gag genes followed by phylogenetic analysis, and all of them belonged to subtype A. Comparison of HIV-1 and HIV-2 seroprevalence data from our study with previous data from Mali shows a significant rise in HIV-1 prevalence and a significant decrease in HIV-2 prevalence and confirms similar trends observed in neighboring countries. We have found four different genetic subtypes of HIV-1; however, subtype A is predominant and accounts for 80% of the cases and 15% of the HIV-1 infections were subtype G. It is important to continue the surveillance of subtypes on a systematic basis in order to see to what extent the proportions of the different subtypes will change over time.
The rare occurrence of rubella embryopathy in Mali stimulated us to investigate the rubella immunity of the population. Sera from females from Hamburg (n = 97) between 16 and 42 years old were in 84,5% seropositive (hemolysin-in-gel test) whilst a sample of Malien females (n = 99) were positive in 92,9%. Our investigations showed that the Malien children were significantly (p = less than 0.001) earlier infected by rubella than in Hamburg (Mali: children under 8 years [n = 196] in 46.9%; Hamburg [n = 151] in 20.5%). In Mali 7-8 years old children were already in 87.5% seropositive (Hamburg: only in 46.7%). The early immunity in childhood is due to the bigger African family in comparison with the smaller European family. The height of rubella serum titers was in grown-ups identical, but the relationship was vice versa in both studied newborn populations. Newborns from Mali showed lower rubella antibody titers than their mothers (newborns from Hamburg had a tendency to higher titers). Similar relationships were found already in the amount of neutralizing polioantibodies in newborns from both countries. A rubella immunisation in Mali seems not to be indicated.
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