Increasing number of AIDS cases, mostly caused by HIV-1 infection, in Dakar (Senegal).

Researchers reviewed the medical records of all 266 Western blot confirmed clinical AIDS cases aged 1-76 years (74.4% men and 25.6% women) admitted to Fann Hospital in Dakar Senegal between January 1986 and June 1993 to determine what is the predominant etiologic agent of AIDS in Dakar. The number of ELISA confirmed clinical AIDS cases increased consistently at Fann Hospital since 1986 (6 in 1986; 236 in 1992; 115 during the first 6 months of 1993). 76% of AIDS cases were 20-39 years old. HIV-2 infected persons were older than HIV-1 persons (39 vs. 33; p < 0.05). Most of the AIDS patients were infected with HIV-1 (68.7% HIV-1 alone; 9.4% HIV-1 and HIV-2). Heterosexual transmission was the predominant mode of transmission (73.6%). 71% of the AIDS patients had traveled to another African country during the last five years. HIV-1 infected and dually infected AIDS patients were more likely to have traveled to another African country than HIV-2 AIDS patients (82.5% and 88% respectively vs. 44.8%; p < 0.001). 65% of the AIDS patients had had another sexually transmitted disease (STD) especially urethritis (42.8%). Men were more likely to have had an STD than women (72.2% vs. 44.1%; p < 0.001). These findings show that HIV-1 infection is responsible for most AIDS cases in Dakar even though HIV-2 infection continues to be more common in Senegal than HIV-1 infection. This suggests that HIV-1 is more pathogenic than HIV-2 infection.