Abstract
BackgroundA safe effective and affordable HIV vaccine is the most cost effective way to prevent HIV infection worldwide. Current studies of HIV prevalence and incidence are needed to determine potentially suitable cohorts for vaccine studies. The prevalence and incidence of HIV-1 infection among the police in Dar es Salaam in 1996 were 13.8% and 19.6/1000 PYAR respectively. This study aimed at determining the current prevalence and incidence of HIV in a police cohort 10 years after a similar study was conducted.MethodsPolice officers in Dar es Salaam, Tanzania were prospectively enrolled into the study from 2005 and followed-up in an incidence study three years later. HIV infection was determined by two sequential enzyme linked immunosorbent assays (ELISAs) in the prevalence study and discordant results between two ELISAs were resolved by a Western blot assay. Rapid HIV assays (SD Bioline and Determine) were used for the incidence study.ResultsA total of 1,240 police participated in the HIV prevalence study from August 2005 to November 2008. Of these, 1101 joined the study from August 2005-September 2007 and an additional 139 were recruited between October 2007 to November 2008 while conducting the incidence study. A total of 726 (70%) out of the 1043 eligible police participated in the incidence study.The overall HIV-1 prevalence was 65/1240 (5.2%). Females had a non-statistically significant higher prevalence of HIV infection compared to males 19/253, (7.5%) vs. 46/987 (4.7%) respectively (p = 0.07). The overall incidence of HIV-1 was 8.4 per 1000 PYAR (95% CI 4.68-14.03), and by gender was 8.8 and 6.9 per 1000 PYAR, among males and females respectively, (p = 0.82).ConclusionsThe HIV prevalence and incidence among the studied police has declined over the past 10 years, and therefore this cohort is better suited for phase I/II HIV vaccine studies than for efficacy trials.
Highlights
A safe effective and affordable HIV vaccine is the most cost effective way to prevent HIV infection worldwide
The availability of highly active antiretroviral therapy (HAART) has dramatically improved the quality of life and life expectancy of people living with HIV and AIDS, the ultimate control of this pandemic probably depends upon the availability of a safe, effective and affordable HIV vaccine
Setting The study was conducted at all the 32 police stations in Dar es Salaam, Tanzania, which were located in all HIV testing For the HIV prevalence study: HIV serostatus was determined using the Murex antigen/antibody combination (Abbott, UK) enzyme linked immunosorbent assays
Summary
A safe effective and affordable HIV vaccine is the most cost effective way to prevent HIV infection worldwide. Current studies of HIV prevalence and incidence are needed to determine potentially suitable cohorts for vaccine studies. This study aimed at determining the current prevalence and incidence of HIV in a police cohort 10 years after a similar study was conducted. The availability of highly active antiretroviral therapy (HAART) has dramatically improved the quality of life and life expectancy of people living with HIV and AIDS, the ultimate control of this pandemic probably depends upon the availability of a safe, effective and affordable HIV vaccine. Participation of sub-Saharan Africa in HIV vaccine trials is crucial, since this is the region that bears the major brunt of HIV infection and would be a potential region to benefit most from a vaccine [5]. Several vaccine candidates at different phases of trials, including phase III trials have been tested in humans in different continents and have been found to be safe and to elicit immune response, including the recently concluded phase III study conducted in Thailand that revealed a 31% efficacy [4].
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