Symptomatic human immunodeficiency virus (HIV) infection in Papua New Guinea.
BACKGROUND
Human Immunodeficiency Virus (HIV) infection was first detected in Papua New Guinea (PNG) in 1987. By August 1995 a total of 323 persons had been diagnosed as HIV antibody positive nationwide and seroprevalence rates were climbing. This study was prompted by a lack of data on the clinical syndromes associated with HIV infection in Melanesian adults.


OBJECTIVE
To describe the clinical and epidemiological features of symptomatic HIV infection in adult Melanesians.


METHODS
A largely retrospective study of patients was admitted to the medical wards of the Port Moresby general hospital between January 1990 and September 1995. Clinical records of patients with antibody to HIV were studied and clinical, laboratory and epidemiological data were recorded.


RESULTS
Seventy patients were studied and the majority were young, urban dwelling adults from a variety of social groups. The sex distribution was even. Common clinical syndromes associated with HIV infection were chronic diarrhoea (47.8%), wasting (94.2%) and oropharyngeal candidiasis (68.7%). Tuberculosis was suspected in 68.6% and cryptococcal meningitis was detected in 8.6% including one patient with Cryptococcus. neoformans var. gattii infection. There was a high mortality (53%) in patients admitted to hospital.


CONCLUSIONS
Patients with HIV infection in PNG present to hospital late in their disease course. Clinical syndromes are similar to those observed in Africa and mortality on first admission is high. The major mode of transmission is heterosexual and sexually transmitted diseases and promiscuity are probably important factors in facilitating spread.
Seaton
R A
RA
Department of Clinical Sciences, Medical Faculty, University of Papua New Guinea.
Wembri
J P
JP
Armstrong
P
P
Ombiga
J
J
Naraqi
S
S
Kevau
I
I
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D000293:Adolescent; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D008297:Male; D008875:Middle Aged; D010219:Papua New Guinea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors