- Email: [email protected]
REACTIVITIES OF ANTIBODIES TO HIV AND SIV IN HUMAN SERA IN KENYA, GABON, AND GHANA
297
Mean duration of seizures in induction with methohexitone
ten or
patients during ECT after
propofol.
Committee on Safety of Medicines bulletin stated that some reports of associated epileptiform activity had been received.2 We have recorded the duration of seizures in ten patients undergoing a course of ECT. The patients were randomly allocated to receive inductions with methohexitone (1-0 mg/kg) or propofol (1 -5 mg/kg) on different occasions. Seizure duration was measured by observing limb movement, both in the whole body and in an isolated forearm (in practice both gave the same result). The mean (SD) seizure duration was 31.8 s (9-9) with methohexitone, and 17-6 s (9-0) with propofol (p < 0-01, analysis of variance). The figure shows the mean seizure duration with each drug for all ten patients. Simpson et aP demonstrated a similar reduction in seizure duration when propofol was compared with methohexitone. For ECT to have a therapeutic effect, the aggregate duration of seizures must exceed a certain minimum4 and, when using methohexitone, the duration of peripheral motor activity correlates well with the duration of the electroencephalographic seizures.5 Assuming that this relation is also true for propofol, this drug may not be the anaesthetic induction agent of choice for ECT.
Anaesthetics Unit, London Hospital Medical London E1 1BB
College,
A. J. RAMPTON R. M. GRIFFIN J. J. DURCAN C. S. STUART
al. Interaction studies and other investigations of the pharmacology of propofol. Postgrad Med J 1985; 61 (suppl 3) 7-14. 2 Committee on Safety of Medicines Curr Problems No 20, August, 1987. 3. Simpson KH, et al. Seizure duration after methohexitone or propofol for induction of anaesthesia for electroconvulsive therapy Br J Anaesth 1987, 59: 1323P-24P 4. Selvin BL. Electroconvulsive therapy: 1987. Anaesthesiology 1987; 67: 367-85 5 Fink M, Johnson R. Monitoring the duration of electroconvulsive therapy seizures. 1 Glen
JB,
et
10 to 40) against SIV. On the other hand, all 5 Gabonese sera had antibody titres against SIVAGM (10 to 160) as high as those against HIV (10 to 1260). All 12 Ghanaian sera also reacted strongly with SIV AGM (320 to 10 240);in 3 of these sera titres against SIV AGMwere higher than those against HIV. These sera were analysed by western blotting using purified virions of SIV AGBB and HIV as antigens. All the African sera reacted with the gag (p24, pl7) and pol (p66, p55, p31) gene products of HIV, and most of them also reacted with their corresponding proteins of SIV,,,,,,,. Kenyan sera reacted with HIV envelope proteins (gpl20, gp41) but not with envelope (gpl20, gp32) proteins of SIV, like sera of US AIDS patients1 and HIV seropositive Japanese haemophiliacs. Gabonese and Ghanaian sera scarcely reacted with the envelope proteins of HIV, although all of them reacted strongly with SIV AGM gp32 and some of them also reacted with its gpl20. Similar patterns of reactivity have been observed in SIV antibody positive African green monkey seraz and infected persons in Senegal.33 From these serological findings, it is conceivable that the antibody-positive people in Kenya are infected with a virus that is antigenically similar to prototype HIV (HIV-1), while those in Gabon and Ghana are infected with a virus that is closely related to
SIV, such as HTLV-IV or HIV-2. To test this idea, we obtained isolates from these seropositive persons in Kenya and Ghana. Analysis of viral proteins and genomes revealed that the Kenyan isolates were indistinguishable from the prototype HIV-1 group, whereas the Ghanaian isolate belongs to the HIV-2 virus group. In their 1986 letter in The Lancet Neequaye et al’ suggested that Japanese (and Koreans) who had had sexual contact with Ghanaian prostitutes might be responsible for the spread of HIV. However, by June, 1987, only 43 AIDS patients had been notified in Japan, including 5 foreigners and 26 haemophiliac patients, all infected with HIV-1. No Japanese seropositive to HIV-2 has been detected so far, including people returning from Ghana and other African countries. These facts argue against Neequaye and colleagues’ speculation on HIV spread by Japanese. The prostitutes in the Tema district of Ghana who were in contact with Japanese fishermen were all seronegative, except 1;most of the seropositive prostitutes found had returned from Abidjan, Ivory Coast, where their contact with Japanese is not known. Department of Animal Pathology, Institute of Medical Science,
Tokyo University, Tokyo 108, Japan Virus Research Centre, Kenya Medical Research
Institute,
Nairobi, Kenya International Medical Research Franceville, Gabon
Noguchi
T. MASUDA K. ISHIKAWA Y. OHTA M. HAYAMI
H. TSUJIMOTO
Centre,
B. K.
E. M. OCHENG P. M. TUKEI
JOHNSON
E. DELAPORTE
R. W. COOPER
E. FROST
Memorial Institute
for Medical Research, University of Ghana, Accra, Ghana
J. A. A. MINGLE M. OSEI-KWASI
Arch Gen Psychiatry 1982; 39: 1189-91.
REACTIVITIES OF ANTIBODIES TO HIV AND SIV IN HUMAN SERA IN KENYA, GABON, AND GHANA
SiR,—The isolation of simian immunodeficiency virus (SIV) from African non-human primates and two new human retroviruses from people in West Africa (HIV-2 and HTLV-IV) which are antigenically closely related to SIV indicate the importance of viral ecological studies on HIV/SIV, especially in Africa. Here we report on reactivity with the antigens of SIV GM derived from African green monkey and HIV-1of antibodies in 29 anti-HIV-positive human sera from East and West Africa. SIV AGM shares antigenicity with the gag gene products of HIV-1but not with its env gene products. Of the 29 sera, 12 were from patients with AIDS or AIDS-related complex (ARC) in Kenya, 5 from apparently healthy people in Gabon, and 12 from prostitutes manifesting ARC in Ghana. By indirect immunofluorescence assay all 12 Kenyan sera had titres against HIV of between 10 and 5120 but very low titres (below
1. Arya SK, Gallo RC Three novel genes of human T-lymphotropic virus type III: Immune reactivity of their products with sera from acquired immune deficiency syndrome patients. Proc Natl Acad Sci USA 1986; 83: 2209-13. 2 Ohta Y, Masuda T, Tsujimoto H, et al Isolation of simian immunodeficiency virus from Afncan green monkeys and seroepidemiologic survey of the virus in vanous non-human primates Int J Cancer (in press). 3. Barin F, M’Boup S, Denis F, et al. Serological evidence for virus related to simian T-lymphotropic retrovirus III in residents of West Africa. Lancet 1985; ii: 1387-89 4.
Neequaye AR, Neequaye J, Mingle JA, Oforiadjei D. Preponderance of females with AIDS in Ghana Lancet 1986; ii: 978
FALSE POSITIVE ANTI-HIV TESTS ON BLOOD DONATIONS
SIR,-Dr Menitove and colleagues (Nov 21, p 1213) discuss the problem of unconfirmed anti-HIV screen-positive blood donors. 0 5 % of their US blood donors fell into this category and 81 % were negative at their next donation by two independent antibody tests. The remaining 19% were notified of the laboratory findings and
Mean duration of seizures in induction with methohexitone
ten or
patients during ECT after
propofol.
Committee on Safety of Medicines bulletin stated that some reports of associated epileptiform activity had been received.2 We have recorded the duration of seizures in ten patients undergoing a course of ECT. The patients were randomly allocated to receive inductions with methohexitone (1-0 mg/kg) or propofol (1 -5 mg/kg) on different occasions. Seizure duration was measured by observing limb movement, both in the whole body and in an isolated forearm (in practice both gave the same result). The mean (SD) seizure duration was 31.8 s (9-9) with methohexitone, and 17-6 s (9-0) with propofol (p < 0-01, analysis of variance). The figure shows the mean seizure duration with each drug for all ten patients. Simpson et aP demonstrated a similar reduction in seizure duration when propofol was compared with methohexitone. For ECT to have a therapeutic effect, the aggregate duration of seizures must exceed a certain minimum4 and, when using methohexitone, the duration of peripheral motor activity correlates well with the duration of the electroencephalographic seizures.5 Assuming that this relation is also true for propofol, this drug may not be the anaesthetic induction agent of choice for ECT.
Anaesthetics Unit, London Hospital Medical London E1 1BB
College,
A. J. RAMPTON R. M. GRIFFIN J. J. DURCAN C. S. STUART
al. Interaction studies and other investigations of the pharmacology of propofol. Postgrad Med J 1985; 61 (suppl 3) 7-14. 2 Committee on Safety of Medicines Curr Problems No 20, August, 1987. 3. Simpson KH, et al. Seizure duration after methohexitone or propofol for induction of anaesthesia for electroconvulsive therapy Br J Anaesth 1987, 59: 1323P-24P 4. Selvin BL. Electroconvulsive therapy: 1987. Anaesthesiology 1987; 67: 367-85 5 Fink M, Johnson R. Monitoring the duration of electroconvulsive therapy seizures. 1 Glen
JB,
et
10 to 40) against SIV. On the other hand, all 5 Gabonese sera had antibody titres against SIVAGM (10 to 160) as high as those against HIV (10 to 1260). All 12 Ghanaian sera also reacted strongly with SIV AGM (320 to 10 240);in 3 of these sera titres against SIV AGMwere higher than those against HIV. These sera were analysed by western blotting using purified virions of SIV AGBB and HIV as antigens. All the African sera reacted with the gag (p24, pl7) and pol (p66, p55, p31) gene products of HIV, and most of them also reacted with their corresponding proteins of SIV,,,,,,,. Kenyan sera reacted with HIV envelope proteins (gpl20, gp41) but not with envelope (gpl20, gp32) proteins of SIV, like sera of US AIDS patients1 and HIV seropositive Japanese haemophiliacs. Gabonese and Ghanaian sera scarcely reacted with the envelope proteins of HIV, although all of them reacted strongly with SIV AGM gp32 and some of them also reacted with its gpl20. Similar patterns of reactivity have been observed in SIV antibody positive African green monkey seraz and infected persons in Senegal.33 From these serological findings, it is conceivable that the antibody-positive people in Kenya are infected with a virus that is antigenically similar to prototype HIV (HIV-1), while those in Gabon and Ghana are infected with a virus that is closely related to
SIV, such as HTLV-IV or HIV-2. To test this idea, we obtained isolates from these seropositive persons in Kenya and Ghana. Analysis of viral proteins and genomes revealed that the Kenyan isolates were indistinguishable from the prototype HIV-1 group, whereas the Ghanaian isolate belongs to the HIV-2 virus group. In their 1986 letter in The Lancet Neequaye et al’ suggested that Japanese (and Koreans) who had had sexual contact with Ghanaian prostitutes might be responsible for the spread of HIV. However, by June, 1987, only 43 AIDS patients had been notified in Japan, including 5 foreigners and 26 haemophiliac patients, all infected with HIV-1. No Japanese seropositive to HIV-2 has been detected so far, including people returning from Ghana and other African countries. These facts argue against Neequaye and colleagues’ speculation on HIV spread by Japanese. The prostitutes in the Tema district of Ghana who were in contact with Japanese fishermen were all seronegative, except 1;most of the seropositive prostitutes found had returned from Abidjan, Ivory Coast, where their contact with Japanese is not known. Department of Animal Pathology, Institute of Medical Science,
Tokyo University, Tokyo 108, Japan Virus Research Centre, Kenya Medical Research
Institute,
Nairobi, Kenya International Medical Research Franceville, Gabon
Noguchi
T. MASUDA K. ISHIKAWA Y. OHTA M. HAYAMI
H. TSUJIMOTO
Centre,
B. K.
E. M. OCHENG P. M. TUKEI
JOHNSON
E. DELAPORTE
R. W. COOPER
E. FROST
Memorial Institute
for Medical Research, University of Ghana, Accra, Ghana
J. A. A. MINGLE M. OSEI-KWASI
Arch Gen Psychiatry 1982; 39: 1189-91.
REACTIVITIES OF ANTIBODIES TO HIV AND SIV IN HUMAN SERA IN KENYA, GABON, AND GHANA
SiR,—The isolation of simian immunodeficiency virus (SIV) from African non-human primates and two new human retroviruses from people in West Africa (HIV-2 and HTLV-IV) which are antigenically closely related to SIV indicate the importance of viral ecological studies on HIV/SIV, especially in Africa. Here we report on reactivity with the antigens of SIV GM derived from African green monkey and HIV-1of antibodies in 29 anti-HIV-positive human sera from East and West Africa. SIV AGM shares antigenicity with the gag gene products of HIV-1but not with its env gene products. Of the 29 sera, 12 were from patients with AIDS or AIDS-related complex (ARC) in Kenya, 5 from apparently healthy people in Gabon, and 12 from prostitutes manifesting ARC in Ghana. By indirect immunofluorescence assay all 12 Kenyan sera had titres against HIV of between 10 and 5120 but very low titres (below
1. Arya SK, Gallo RC Three novel genes of human T-lymphotropic virus type III: Immune reactivity of their products with sera from acquired immune deficiency syndrome patients. Proc Natl Acad Sci USA 1986; 83: 2209-13. 2 Ohta Y, Masuda T, Tsujimoto H, et al Isolation of simian immunodeficiency virus from Afncan green monkeys and seroepidemiologic survey of the virus in vanous non-human primates Int J Cancer (in press). 3. Barin F, M’Boup S, Denis F, et al. Serological evidence for virus related to simian T-lymphotropic retrovirus III in residents of West Africa. Lancet 1985; ii: 1387-89 4.
Neequaye AR, Neequaye J, Mingle JA, Oforiadjei D. Preponderance of females with AIDS in Ghana Lancet 1986; ii: 978
FALSE POSITIVE ANTI-HIV TESTS ON BLOOD DONATIONS
SIR,-Dr Menitove and colleagues (Nov 21, p 1213) discuss the problem of unconfirmed anti-HIV screen-positive blood donors. 0 5 % of their US blood donors fell into this category and 81 % were negative at their next donation by two independent antibody tests. The remaining 19% were notified of the laboratory findings and