Abstract
ObjectivesThe objectives of this study were firstly to determine HIV (human immunodeficiency virus) prevalence in the rural Free State, secondly to classify the stages of HIV by utilising CD4 (cluster of differentiation 4) counts, and thirdly to measure differences in haematological abnormalities between HIV-uninfected and HIV-infected participants.MethodBlood specimens were obtained from 552 participants in Springfontein (36.3%), Trompsburg (30.1%) and Philippolis (33.5%). Participants were between 25–64 years of age, of which 28.1% were male (mean age 47.3 years) and 71.9% were female (mean age 46.0 years). The primary screening for HIV status was performed using the Enzygnost® HIV Integral II Ag/ Ab test and confirmed by the Vironostica® HIV Uni-Form II Ag/Ab test. Full blood counts were performed on all participants, but CD4 counts were only performed on HIV-positive serum.ResultsThe overall prevalence of HIV was 17.1%, with the peak prevalence in female participants (41.3%) occurring in the age group of 31–40 years, and in male participants (37.9%) in the age group of 41–50 years. Most HIV-uninfected participants (40.9%) were 51–60 years of age, whilst most HIV-infected participants were 31–40 years (35.6%) of age. The lowest mean CD4 count (276 cells/mm3) was observed in the age group 41–50 years, which was significantly lower than a mean count of 459 cells/mm3 in the age group 31–40 years (p ≤ 0.05). Haemoglobin was significantly reduced in HIV-infected male participants (p < 0.01) and female participants (p < 0.000 1), as ware white blood cell counts (p < 0.001), neutrofil counts (p < 0.005) and lymphocyte counts (p < 0.005). Peak prevalence of HIV in terms of age occurred later (between 31–40 years) than previously described and was reflected by a delayed low CD4 count (41–50 years).ConclusionThe low CD4 counts and anaemia were probably indicative of a generally ill study population. Participants in need of medical care should be identified and referred for management and follow-up.
Highlights
The five countries with the highest HIV prevalence rates in the world are situated in Southern Africa and South Africa.[1]
The Nelson Mandela Trust and Human Science Research Council (HSRC) study of HIV and acquired immune deficiency syndrome (AIDS) (Nelson Mandela Human Sciences Research Council 2002) was the first to describe the prevalence of HIV infection in the total South African population and to provide a detailed picture of the distribution and determinants of this devastating pandemic
The peak prevalence of HIV in female participants was observed in the age group 31–40 years (41.3%), and in male participants in the age group 41–50 years (37.9%)
Summary
The five countries with the highest HIV (human immunodeficiency virus) prevalence rates in the world are situated in Southern Africa and South Africa.[1]. In a recent national community-based survey[3] which included 7249 households and 13 518 individuals, the prevalence of HIV in the general population was 11.4%, with 12.8% prevalence in female participants and 9.5% prevalence in male participants. In formal urban areas, the prevalence in the Black population was 12.9%, 6.2% in the White population, 6.1% in the Coloured population, and 1.6% in the Indian population. Informal settlements in urban areas had a prevalence of 21.6%. The prevalence of HIV in urban formal and informal areas is higher (11.9% and 21.6%, respectively) than in rural formal and informal areas (7.8% and 8.8%, respectively). The peak prevalence occurred in women between ages 20–29 years (24.1%) and in men between 30–39 years (21.3%). The prevalence of HIV infection in the Free State province was reported to be 14.9%.3
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