Clinical and laboratory characteristics of HIV-1 infection in Zimbabwe.
To define the impact of human immunodeficiency virus (HIV) infection in Africa, clinical and laboratory investigations were conducted on 265 HIV-seropositive outpatients in Zimbabwe. Twenty-four of the study subjects were asymptomatic (ASX), 124 had persistent generalized lymphadenopathy (PGL), and 117 had AIDS-related complex (ARC). HIV infection was assessed by commercial ELISA, Western blots, synthetic peptide ELISA, and measurement of p24 antigen. Serum immunoglobulins, lymphocyte mitogen responses, and CD4+ cell numbers were obtained in 54 sequential patients. Compared to seronegative subjects, mean CD4+ cell numbers were decreased and serum immunoglobulins, particularly IgM and IgG, were increased in all groups of seropositive subjects. Lymphocyte proliferative responses to phytohemagglutinin and concanavalin A decreased progressively in ASX, PGL, and ARC patients and were significantly lower in PGL and ARC patients compared to seronegative controls. Generalized lymphadenopathy was present in 234/265 (88%) of patients. Lymph node biopsies in 100 patients demonstrated follicular hyperplasia in 97 and Mycobacterium tuberculosis in 3. Of 165 patients followed for a median of 6 months, 5 developed the acquired immune deficiency syndrome (AIDS). Symptoms of ARC, low CD4+ cell number, and p24 antigen were predictive of the development of AIDS in Zimbabwe.
Katzenstein
D A
DA
Division of Virology, Food and Drug Administration, Bethesda, Maryland.
Latif
A S
AS
Grace
S A
SA
Basset
M
M
Mashu
A
A
de Villiers
D M
DM
Carrow
E W
EW
Hendry
R M
RM
Marowa
E
E
Emmanuel
J C
JC
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology; D000293:Adolescent; D000328:Adult; D015153:Blotting, Western; D015496:CD4-Positive T-Lymphocytes; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015683:Gene Products, gag / Q000032:analysis; D015483:HIV Antibodies / Q000032:analysis; D015488:HIV Antigens / Q000032:analysis; D016655:HIV Core Protein p24; D015658:HIV Infections / Q000097:blood / Q000276:immunology*; D006679:HIV Seropositivity / Q000276:immunology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007136:Immunoglobulins / Q000096:biosynthesis; D007958:Leukocyte Count; D008137:Longitudinal Studies; D008198:Lymph Nodes / Q000473:pathology; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D014758:Viral Core Proteins / Q000032:analysis; D015030:Zimbabwe
D015683:Gene Products, gag; D015483:HIV Antibodies; D015488:HIV Antigens; D016655:HIV Core Protein p24; D007136:Immunoglobulins; D014758:Viral Core Proteins