FINDINGS IN A HUMAN IMMUNODEFICIENCY VIRUS TYPE 1-SEROPOSITIVE PREGNANT WOMAN AND TWO NEONATES IN RURAL GUINEA-BISSAU

During a 160-household survey conducted in 8 villages in Quitafine a remote rural area in southern Guinea-Bissau blood samples were taken from pregnant women and children to assess the prevalence of human immunodeficiency virus (HIV) infection. 2 (0.7%) of the blood samples obtained from children were positive for antibodies to HIV-2 and human T-cell lymphadenopathy virus type IV (HTLV-IV). Both cases involved healthy breast-fed neonates (ages 1 and 2 months) of healthy mothers (not tested for HIV) in 2 different villages. Of the sera from 27 pregnant women 1 sample was positive for HIV-2 and HTLV-IV. This sample came from a healthy 35-year-old woman in the 23rd week of her 10th pregnancy. She did not belong to any known risk group and resided in a 3rd village. On physical examination this woman appeared malnourished and anemic but showed no signs of lymphadenopathy or hepatosplenomegaly. Serology was positive for hepatitis B markers and malaria but negative for syphilis. At clinical follow-up of these 3 individuals over a 2 1/2-year period the 2 HIV seropositive children have developed normally. Similarly the mother has remained well and delivered a healthy full-term infant. The findings of HTLV-IV/HIV-2 seropositivity in 3 individuals in 1984 living in 3 separate villages and not belonging to any high-risk groups suggest a widespread existence of HTLV-IV/HIV-2 in isolated West African rural populations. Given the causal relationship between HIV-2 infection and acquired immunodeficiency syndrome (AIDS) as well as the long incubation period for AIDS an impending rise in the incidence of AIDS can be expected in Guinea-Bissau.