HIV infection in Saudi Arabia: occurrence, pattern of disease and future implications

ABSTRACT

Between 1985 and 1990, 96 people were identified as HIV1 Western blot positive. Of these, 87 were Saudi nationals and 61 attended a clinic dedicated for the management of HIV in Saudi Arabia. The demographic characteristics appear distinct from those previously described and include male predominance [male-female ratio 3 2], bimodal age distribution [childhood peak 6.4 +/- 3.2 years; adult peak 29 +/- 9.2 years] and a predominantly transfusion associated disease [44/71 patients]. However, other well known risk factors are represented. The sexual and maternal-fetal routes could emerge as the predominant mode of transmission in the future. Pneumocystis carinii pneumonia was the index diagnosis of AIDS in 9/17 patients [53%], Kaposi's sarcoma was present in only 2/17 [12%] Oro-pharyngeal candidiasis, CMV, herpes zoster, and cerebral toxoplasmosis were common opportunistic infections, whereas tuberculosis was rare and no case of Leishmania or Brucella was identified. Hepatitis C antibodies were present in 19/31 patients, of which 10 [53%] had raised liver enzymes. All had acquired their HIV via blood transfusion. The point prevalence for AIDS [at mean duration of seropositivity] for blood transfusion associated HIV was 36% [6.1 +/- 2.4 years], promiscuous sexual behaviour/intravenous drug abuse was 58% [3.5 +/- 1.7 years], haemophiliacs 4% [4.9 +/- 0.9 years] and maternal-fetal acquisition 0% [3.6 +/- 1.1 years] The apparent endemicity of HIV in Saudi Arabia and the important gaps in clinical attendees' comprehension of the disease, highlight the need for further epidemiological studies and appropriate health education measures: