Predominance of HIV-1 among patients with AIDS and AIDS-related complex in Ghana.

We determined the prevalence of HIV among AIDS and AIDS-Related Complex (ARC) patients seen within one year in two hospitals in southern Ghana, Subjects were screened by an ELISA procedure for anti-HIV antibodies. Specific identification of the EW type was done with a particle agglutination (PA) kit. All PA-determined dual specimens were then confirmed by Western blotting and Pepti-Lav 1/2 monoepitope kit. Virus isolation was attempted from symptomatic patients by co-culturing patient peripheral blood monocyte cells (PBMCs) and CD4+ cell lines, PBMCs and HIV isolates were characterised by PCR. By ELISA, 43.5% of the subjects (253) had anti-HIV antibodies, Of these, 61 (24%) were HIV-1 positive and 42 (18.6%) were dually reactive by PA. However, only 19% were confirmed as true dually-infected cases by western blotting and Pepti-Lav though all 42 samples were HIV-1 positive on the two tests, No subject was infected with HIV-2 alone, Three viruses were isolated, By PCR two of them had both HIV-1 and HIV-2 proviral sequences while the third virus was HIV-1 only, HIV-1 prevalence now predominates over HIV-2 implying a switch in the HIV infection pattern in Ghana, Furthermore mixed infections exist, The predominance of HIV-1 infection in Ghana may indicate a similar trend in other parts of West Africa.