{"id":{"repo_id":"lund","oai_identifier":"oai:lup.lub.lu.se:4a5e0ad3-c1f0-4f30-b3be-a6b2df6369b6"},"canonical_url":"https://search.dev.ndltd.org/etd/lund/oai:lup.lub.lu.se:4a5e0ad3-c1f0-4f30-b3be-a6b2df6369b6","repository":{"repo_id":"lund","name":"University of Lund","base_url":"https://lup.lub.lu.se/oai"},"display":{"title":"HIV-1, HIV-2 and other Sexually Transmitted Infections in Guinea-Bissau, West Africa","abstract":"HIV-1 is dominating the global HIV pandemic, while HIV-2 is mainly confined to West Africa. The highest HIV-2 prevalence figures have been reported from Guinea-Bissau. While HIV-1 infection almost invariably leads to progressive immune dysfunction and AIDS, HIV-2 infection is characterised by a smaller proportion of individuals with disease progression to AIDS. In order to monitor the long-term epidemiological trends of HIV-1 and HIV-2, we performed sentinel studies among pregnant women and followed a cohort of police officers. During the period 1987 to 2004, HIV-2 prevalence declined from 8.3% to 1.5% in pregnant women and during 1990 to 2007, HIV-2 prevalence declined from 13.4% to 6.2% among police officers. We examined specifically if the civil war 1998 – 1999 had any impact on the HIV epidemic in Guinea-Bissau and found that HIV-1 prevalence among pregnant women increased sharply to 5.2% after the conflict but then stabilised around 5%. Among the police officers the HIV-1 prevalence pattern was the same. Also HIV-1 incidence peaked during and shortly after the conflict, but later stabilised at lower levels. Thus we noticed a short-term effect exerted by the war but we did not see any evidence of long-term effects that could be explained by the conflict. We examined the natural course of HIV-2 infection in seroincident individuals after 20 years of follow-up in the police cohort. As expected, median survival time and disease progression time to AIDS was longer and the CD4+ T cell decline rate was lower compared with HIV-1 infection. There was no significant difference compared with HIV-2 seroprevalent individuals, indicating that earlier studies of HIV-2 seroprevalent individuals were quite representative for HIV-2 infection in general. According to our data, a majority of HIV-2-infected individuals, if followed over longer time, will probably progress to immunodeficiency and clinical disease. Early loss of CD4+ T cells correlated to outcome, just as in HIV-1 infection. We also investigated the difference in disease course in seroincident HIV-1 infection and the influence of contemporaneous HIV-2 infection. The median time of progression to AIDS was 53% longer in dual HIV-1 and HIV-2 infection than in HIV-1 single infection and the difference was more pronounced in the individuals with a recorded HIV-2 infection preceding seroconversion to HIV-1. The epidemiological results correlated to higher CD4+ T cell counts and lower genetic HIV-1 diversity among the dually infected individuals compared with the HIV-1 single-infected. Finally, we investigated the prevalence of other STIs in women with urogenital problems and found high prevalence of several STIs. The most prevalent were Trichomonas vaginalis (20.4%) and Chlamydia trachomatis (12.6%). Infections with Herpes Simplex Virus type 2 and Mycoplasma genitalium were associated with HIV positivity.","abstract_html":"HIV-1 is dominating the global HIV pandemic, while HIV-2 is mainly confined to West Africa. The highest HIV-2 prevalence figures have been reported from Guinea-Bissau. While HIV-1 infection almost invariably leads to progressive immune dysfunction and AIDS, HIV-2 infection is characterised by a smaller proportion of individuals with disease progression to AIDS. In order to monitor the long-term epidemiological trends of HIV-1 and HIV-2, we performed sentinel studies among pregnant women and followed a cohort of police officers. During the period 1987 to 2004, HIV-2 prevalence declined from 8.3% to 1.5% in pregnant women and during 1990 to 2007, HIV-2 prevalence declined from 13.4% to 6.2% among police officers. We examined specifically if the civil war 1998 – 1999 had any impact on the HIV epidemic in Guinea-Bissau and found that HIV-1 prevalence among pregnant women increased sharply to 5.2% after the conflict but then stabilised around 5%. Among the police officers the HIV-1 prevalence pattern was the same. Also HIV-1 incidence peaked during and shortly after the conflict, but later stabilised at lower levels. Thus we noticed a short-term effect exerted by the war but we did not see any evidence of long-term effects that could be explained by the conflict. We examined the natural course of HIV-2 infection in seroincident individuals after 20 years of follow-up in the police cohort. As expected, median survival time and disease progression time to AIDS was longer and the CD4+ T cell decline rate was lower compared with HIV-1 infection. There was no significant difference compared with HIV-2 seroprevalent individuals, indicating that earlier studies of HIV-2 seroprevalent individuals were quite representative for HIV-2 infection in general. According to our data, a majority of HIV-2-infected individuals, if followed over longer time, will probably progress to immunodeficiency and clinical disease. Early loss of CD4+ T cells correlated to outcome, just as in HIV-1 infection. We also investigated the difference in disease course in seroincident HIV-1 infection and the influence of contemporaneous HIV-2 infection. The median time of progression to AIDS was 53% longer in dual HIV-1 and HIV-2 infection than in HIV-1 single infection and the difference was more pronounced in the individuals with a recorded HIV-2 infection preceding seroconversion to HIV-1. The epidemiological results correlated to higher CD4+ T cell counts and lower genetic HIV-1 diversity among the dually infected individuals compared with the HIV-1 single-infected. Finally, we investigated the prevalence of other STIs in women with urogenital problems and found high prevalence of several STIs. The most prevalent were Trichomonas vaginalis (20.4%) and Chlamydia trachomatis (12.6%). Infections with Herpes Simplex Virus type 2 and Mycoplasma genitalium were associated with HIV positivity.","abstract_has_math":false,"creators":["Månsson, Fredrik"],"institution":"Department of Clinical Sciences, Lund University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2012,"date_issued":"2012","date_published":"2012","updated_at":"2026-07-24T02:59:36Z","subjects":["Clinical Medicine","HIV-1 HIV-2 Sexually Transmitted Infections Conflict Guinea-Bissau West Africa"],"languages":["eng"],"rights":["info:eu-repo/semantics/openAccess"],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["urn:isbn:978-91-86871-82-6"],"render_values":[{"text":"urn:isbn:978-91-86871-82-6","href":null,"code":true}]}]},"links":{"outbound_url":"https://lup.lub.lu.se/record/3167642","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Månsson, Fredrik"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2012"]},{"key":"dc:publisher","label":"Institution","values":["Department of Clinical Sciences, Lund University"]},{"key":"dc:type","label":"Dc Type","values":["thesis/doccomp","info:eu-repo/semantics/doctoralThesis","text"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Clinical Medicine","HIV-1 HIV-2 Sexually Transmitted Infections Conflict Guinea-Bissau West Africa"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["eng"]},{"key":"dc:rights","label":"Dc Rights","values":["info:eu-repo/semantics/openAccess"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://lup.lub.lu.se/record/3167642","urn:isbn:978-91-86871-82-6","https://portal.research.lu.se/files/3337737/3167948.pdf"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["HIV-1 is dominating the global HIV pandemic, while HIV-2 is mainly confined to West Africa. The highest HIV-2 prevalence figures have been reported from Guinea-Bissau. While HIV-1 infection almost invariably leads to progressive immune dysfunction and AIDS, HIV-2 infection is characterised by a smaller proportion of individuals with disease progression to AIDS. In order to monitor the long-term epidemiological trends of HIV-1 and HIV-2, we performed sentinel studies among pregnant women and followed a cohort of police officers. During the period 1987 to 2004, HIV-2 prevalence declined from 8.3% to 1.5% in pregnant women and during 1990 to 2007, HIV-2 prevalence declined from 13.4% to 6.2% among police officers. We examined specifically if the civil war 1998 – 1999 had any impact on the HIV epidemic in Guinea-Bissau and found that HIV-1 prevalence among pregnant women increased sharply to 5.2% after the conflict but then stabilised around 5%. Among the police officers the HIV-1 prevalence pattern was the same. Also HIV-1 incidence peaked during and shortly after the conflict, but later stabilised at lower levels. Thus we noticed a short-term effect exerted by the war but we did not see any evidence of long-term effects that could be explained by the conflict. We examined the natural course of HIV-2 infection in seroincident individuals after 20 years of follow-up in the police cohort. As expected, median survival time and disease progression time to AIDS was longer and the CD4+ T cell decline rate was lower compared with HIV-1 infection. There was no significant difference compared with HIV-2 seroprevalent individuals, indicating that earlier studies of HIV-2 seroprevalent individuals were quite representative for HIV-2 infection in general. According to our data, a majority of HIV-2-infected individuals, if followed over longer time, will probably progress to immunodeficiency and clinical disease. Early loss of CD4+ T cells correlated to outcome, just as in HIV-1 infection. We also investigated the difference in disease course in seroincident HIV-1 infection and the influence of contemporaneous HIV-2 infection. The median time of progression to AIDS was 53% longer in dual HIV-1 and HIV-2 infection than in HIV-1 single infection and the difference was more pronounced in the individuals with a recorded HIV-2 infection preceding seroconversion to HIV-1. The epidemiological results correlated to higher CD4+ T cell counts and lower genetic HIV-1 diversity among the dually infected individuals compared with the HIV-1 single-infected. Finally, we investigated the prevalence of other STIs in women with urogenital problems and found high prevalence of several STIs. The most prevalent were Trichomonas vaginalis (20.4%) and Chlamydia trachomatis (12.6%). Infections with Herpes Simplex Virus type 2 and Mycoplasma genitalium were associated with HIV positivity."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:source","label":"Dc Source","values":["Lund University Faculty of Medicine Doctoral Dissertation Series; 2012:20 (2012)","ISSN: 1652-8220"]},{"key":"dc:title","label":"Title","values":["HIV-1, HIV-2 and other Sexually Transmitted Infections in Guinea-Bissau, West Africa"]}]}],"canonical_facts":{"dc:creator":["Månsson, Fredrik"],"dc:date":["2012"],"dc:description":["HIV-1 is dominating the global HIV pandemic, while HIV-2 is mainly confined to West Africa. The highest HIV-2 prevalence figures have been reported from Guinea-Bissau. While HIV-1 infection almost invariably leads to progressive immune dysfunction and AIDS, HIV-2 infection is characterised by a smaller proportion of individuals with disease progression to AIDS. In order to monitor the long-term epidemiological trends of HIV-1 and HIV-2, we performed sentinel studies among pregnant women and followed a cohort of police officers. During the period 1987 to 2004, HIV-2 prevalence declined from 8.3% to 1.5% in pregnant women and during 1990 to 2007, HIV-2 prevalence declined from 13.4% to 6.2% among police officers. We examined specifically if the civil war 1998 – 1999 had any impact on the HIV epidemic in Guinea-Bissau and found that HIV-1 prevalence among pregnant women increased sharply to 5.2% after the conflict but then stabilised around 5%. Among the police officers the HIV-1 prevalence pattern was the same. Also HIV-1 incidence peaked during and shortly after the conflict, but later stabilised at lower levels. Thus we noticed a short-term effect exerted by the war but we did not see any evidence of long-term effects that could be explained by the conflict. We examined the natural course of HIV-2 infection in seroincident individuals after 20 years of follow-up in the police cohort. As expected, median survival time and disease progression time to AIDS was longer and the CD4+ T cell decline rate was lower compared with HIV-1 infection. There was no significant difference compared with HIV-2 seroprevalent individuals, indicating that earlier studies of HIV-2 seroprevalent individuals were quite representative for HIV-2 infection in general. According to our data, a majority of HIV-2-infected individuals, if followed over longer time, will probably progress to immunodeficiency and clinical disease. Early loss of CD4+ T cells correlated to outcome, just as in HIV-1 infection. We also investigated the difference in disease course in seroincident HIV-1 infection and the influence of contemporaneous HIV-2 infection. The median time of progression to AIDS was 53% longer in dual HIV-1 and HIV-2 infection than in HIV-1 single infection and the difference was more pronounced in the individuals with a recorded HIV-2 infection preceding seroconversion to HIV-1. The epidemiological results correlated to higher CD4+ T cell counts and lower genetic HIV-1 diversity among the dually infected individuals compared with the HIV-1 single-infected. Finally, we investigated the prevalence of other STIs in women with urogenital problems and found high prevalence of several STIs. The most prevalent were Trichomonas vaginalis (20.4%) and Chlamydia trachomatis (12.6%). Infections with Herpes Simplex Virus type 2 and Mycoplasma genitalium were associated with HIV positivity."],"dc:format":["application/pdf"],"dc:identifier":["https://lup.lub.lu.se/record/3167642","urn:isbn:978-91-86871-82-6","https://portal.research.lu.se/files/3337737/3167948.pdf"],"dc:language":["eng"],"dc:publisher":["Department of Clinical Sciences, Lund University"],"dc:rights":["info:eu-repo/semantics/openAccess"],"dc:source":["Lund University Faculty of Medicine Doctoral Dissertation Series; 2012:20 (2012)","ISSN: 1652-8220"],"dc:subject":["Clinical Medicine","HIV-1 HIV-2 Sexually Transmitted Infections Conflict Guinea-Bissau West Africa"],"dc:title":["HIV-1, HIV-2 and other Sexually Transmitted Infections in Guinea-Bissau, West Africa"],"dc:type":["thesis/doccomp","info:eu-repo/semantics/doctoralThesis","text"]},"updated_at":"2026-07-24T02:59:36Z"}