European Journal of Epidemiology

, Volume 5, Issue 2, pp 158–163 | Cite as

Evaluation of seroepidemiological associations between HIV-infection, hepatitis B and other sexually transmitted diseases in African patients

  • J. Ter Meulen
  • K. M. Wittkowski
  • J. J. Kidenya
  • M. Pöllath
  • R. Dörries
  • K. Fleischer
  • K. Dietz
  • V. Ter Meulen


To assess the possible role of sexually transmitted diseases as cofactors for the spread of AIDS, 248 adult patients were tested for the presence of antibodies against human immunodeficiency virus (HIV), hepatitis B virus (HBV) and syphilis. The survey was conducted in a hospital at Kagondo, Kagera Region, Northwest Tanzania, Africa. Subjects were randomly chosen from the outpatient clinic to include those with and without sexually transmitted diseases, as well as AIDS/pre-AIDS patients. The data were univariately and multivariately analysed by linear logit models, including interactions of demographic parameters. The results obtained reveal a strong association between the presence of antibodies against HIV, syphilis and HBV, respectively. The HBV/HIV-correlation remained stable in the multivariate analysis including interactions of social parameters, in contrast to the syphilis/HIV-correlation. We assume that this reflects the lower virulence of HBV as compared to that of syphilis. The prevalence of anti-HBV antibodies seems to be a more reliable marker for high sexual activity than those against syphilis. The possibility that HBV and HIV act as cofactors for each other's transmission could not be ruled out.

Key words

AIDS Sexually transmitted diseases hepatitis B 


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  1. 1.
    Alter M.J., Ahtone J., Weisfuse al. (1986): Hepatitis B virus transmission between heterosexuals. - JAMA256: 1307–1310.Google Scholar
  2. 2.
    Bishop Y.W.W. (1985): Discrete Multivariate Analysis: Theory and Practice. - Cambridge, Mass: MIT Press.Google Scholar
  3. 3.
    Cameron D., Plummer F.A., Simonsen J.N. et al.: Female to male heterosexual transmission of HIV and its facilitation by genital ulcer disease in Nairobi. (in press).Google Scholar
  4. 4.
    Clumeck N., Sonnet J., Taelman al. (1984): Acquired immune deficiency syndrome in African patients. - N. Engl. J. Med. 310: 492–497.Google Scholar
  5. 5.
    Darrow W.W., Cohen J.B., French J. et al. (1987): Multicenter study of human immunodeficiency virus antibody in U.S. prostitutes. - Proceedings of the III International Conference on AIDS, Washington, DC.Google Scholar
  6. 6.
    Fischl M.A., Dickinson G.M., Scott al. (1987): Evaluation of heterosexual partners, children and household contancts of adults with AIDS. - JAMA 257: 640–644.Google Scholar
  7. 7.
    Hollinger F.B. and Melnick J.L. (1985): Features of viral hepatitis. In Virology (eds. B.N. Fields et al.), Chapter 61, pp. 1417–1494, Raven Press.Google Scholar
  8. 8.
    Marinier E., Barrois V., Laronze B. et al. (1985): Lack of perinatal transmission of hepatitis B virus transmission in Senegal, West Africa. J. Pediat., 843–849.Google Scholar
  9. 9.
    Melbye M. Njelesani EX, Bayley A. et al. (1986): Evidence for heterosexual transmission and clinical manifestation of Human Immunodeficiency Virus Infection and related conditions in Lusaka, Zambia. Lancet, 1113–1115.Google Scholar
  10. 10.
    Pape J.W., Liaulaud B., Thomas al. (1983): Characteristics of the acquired immune deficiency syndrome in Haitians. - N. Engl. J. Med. 309: 945–950.Google Scholar
  11. 11.
    Piot P., Quinn T.C., Taelman al. (1984): Acquired immunodeficiency syndrome in a heterosexual population in Zaire. - Lancet, 2: 65–69.Google Scholar
  12. 12.
    Proceedings of the Symposium on sexually transmitted diseases, Dar es Salaam, September 17, 1985. Medical Association of Tanzania.Google Scholar
  13. 13.
    Quinn T.C., Piot P., McCormick al. (1987): Serologic and immunologic studies in patients with AIDS in North America and Africa. - JAMA 257: 2617–2621.Google Scholar
  14. 14.
    SAS Institute Inc. (1985). SAS User's Guide: Basics, Version 5 Edition, Cary, NC: SAS Institute Inc.Google Scholar
  15. 15.
    Simonsen J.N., Cameron D.W., Gakinya al. (1988): Human immunodeficiency virus among men with sexually transmitted diseases - experience from a center in Africa. - N. Engl. J. Med. 319: 274–278.Google Scholar
  16. 16.
    Sindrup J.H., Weismann K. and Lange-Wantzin G., (1986): Syphilis in HTLV-III infected male homosexuals. - AIDS Research 2: 285–288.Google Scholar
  17. 17.
    Whittle H.C., Bradley A.K., McLauchlan K. et al. (1983): Hepatitis B virus infection in two Gambian villages. - Lancet, 1203–1206.Google Scholar
  18. 18.
    WHO Weekly epidemiological record (1986). 61: 69–76.Google Scholar
  19. 19.
    Van dePerre P., Rouvroy D., Lepage al. (1984): Acquired immunodeficiency syndrome in Rwanda. -Lancet 2: 62–65.Google Scholar
  20. 20.
    Van dePerre P., Clumeck N., Steens al. (1987): Seroepidemiological study on sexually transmitted diseases and hepatitis B in African promiscuous heterosexuals in relation to HTLV-III infection. -Eur. J. Epidemiol. 3, 1: 14–18.Google Scholar

Copyright information

© Kluwer Academic Publishers 1989

Authors and Affiliations

  • J. Ter Meulen
    • 1
  • K. M. Wittkowski
    • 2
  • J. J. Kidenya
    • 3
  • M. Pöllath
    • 4
  • R. Dörries
    • 1
  • K. Fleischer
    • 5
  • K. Dietz
    • 1
  • V. Ter Meulen
    • 1
  1. 1.Institut für Virologie and ImmunbiologieUniversität WürzburgGermany
  2. 2.Institut für Medizinische BiometrieUniversitäat TübingenGermany
  3. 3.RMO, Government HospitalTanzaniaAfrica
  4. 4.St. Joseph HospitalTanzaniaAfrica
  5. 5.Missionsärztliches InstitütWürzburgGermany

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