HIV infection in Greek intravenous drug users.

In order to investigate the prevalence of HIV infection among Greek intravenous drug users (IVDU), its trend during years recent and possible risk factors, we studied 893 inmates recently admitted to the main prisons of Greece from 1986 to 1989. Screening and counselling was offered to all of them. The acceptance rate was 98%. One thousand one hundred and two IVDUs voluntarily attending the AIDS Reference Centre in Athens for counselling and screening were also included in the study. Anti-HIV were determined by commercially available radioimmunoassays, and positive results were confirmed by Western Blot. Our results showed that the prevalence of HIV infection remained very low in both groups during the study period; it was similar to the prevalence found (2.1%) in stored sera drawn in 1982 from imprisoned IVDU. In the non-prisoner group, the prevalence among those who reported needle/syringe sharing (2.6%) was similar to that among those who denied sharing (2.5%). This lack of difference may be due to the fact that sharing is only an occasional practice and that cleaning of of the injection equipment is common. We conclude that the prevalence of anti-HIV in IVDU in Greece is considerably lower than that in neighbouring countries and that it has remained stable during the last eight years. Further studies are necessary to identify behavioral and other risk factors.

Education in preventing HIV infection in Greek registered prostitutes.

From March 1984 to November 1985, 350 Greek registered prostitutes were screened for anti-HIV. Twelve of them (3.4%) were found to be positive. To monitor and control the further spread of HIV infection, an intensive educational campaign was established and screening every 3 months was implemented. Until October 1986, two new seroconversions were detected out of 270 examined (seroconversion rate of 0.74% per year). Further HIV infections have not been detected among the 282 prostitutes followed to 1988. This should be attributed to avoidance of clients from Central Africa and mainly to almost universal use of condoms as a result of the intensive educational campaign.

Iron-related disturbances of cell-mediated immunity in multitransfused children with thalassemia major.

Immunological abnormalities have been observed in many haemophiliacs receiving clotting factor concentrates. To determine whether similar changes also occur after repeated blood transfusions we estimated T cell subsets and cutaneous delayed hypersensitivity (CDH) in 50 multitransfused children with beta-thalassemia major (beta-TM). All patients were also tested for anti-HTLV-III/LAV antibodies. A diminished percentage of T lymphocytes (E-rosettes, T3+), and T4+ cells and a low T4/T8 ratio was found in patients as compared to age and sex matched controls (P less than 0.001). Negative CDH tests to specific antigens (Multi-test) were also found in a significantly larger proportion of beta-TM children (P less than 0.01). Antibodies against HTLV-III/LAV were negative in all patients. Decreased T4/T8 ratio in beta-TM children was primarily due to a reduction of T4+ cells and was inversely correlated to the patients' age, number of units of transfused blood (P less than 0.05) and especially to ferritin serum levels and annual iron balance (P less than 0.001). These findings indicate that immunological abnormalities in beta-TM patients appear to be acquired, transfusion-associated and related to iron load which depends on the appropriate chelation therapy.

Lack of antibodies to LAV/HTLV-III in hepatitis B vaccine recipients.

There is no evidence up to now that the currently available plasma hepatitis B vaccine transmits the agent of AIDS. To support further the safety of this vaccine we examined 137 vaccinees for the presence of antibodies to LAV/HTLV-III. Three groups had received Merck, Sharp and Dohme hepatitis B vaccine (two groups of 25 Air Force cadets vaccinated with investigational lots and 18 multiply transfused children vaccinated with a commercial lot); another two groups (50 Air Force cadets and 19 multiply transfused) were vaccinated with two commercial lots of Institut Pasteur vaccine. Sera were collected before inoculation, 7 and 24 months later. Enzyme linked immunosorbent assay was used for the detection of antibodies to LAV/HTLV-III. Positive sera were tested again by Western Blot and Radioimmune Precipitation Assay to exclude non-specific binding. Antibodies to LAV/HTLV-III were not detected in any of the sera examined, providing evidence for safety. We believe that these data increase the acceptance of hepatitis B vaccine.