Studies show a spread in HIV among an unexpected Pakistani demographic

AKU, Dow and University of Florida researchers concerned for women and children in Pakistan and Afghanistan.

KARACHI:

Researchers believe that HIV has spread from the usual ‘at-risk’ groups in Pakistan and has leaked into the bloodstreams of women and children.

An international team of researchers, including scientists from Aga Khan University and Dow Medical University and from the University of Florida (UF), crunched the numbers to show that Pakistan’s general population is in danger of contracting the AIDS-causing Human Immunodeficiency Virus (HIV). The team’s epidemiological findings were published in July in the open-access journal, PLoS One.

The researchers are concerned that the transmission of the virus into the general population may serve as an indication that the virus could be spreading into populations within neighbouring Afghanistan also. One way to prove this would be to understand how the virus is spreading and to determine its strain.

“Are the strains in Pakistan and Afghanistan of two different epidemic origins, or are they the same? It’s an important question,” said paper author Marco Salemi of the University of Florida College of Medicine and Emerging Pathogens Institute. “Genetic evidence can be used to test how different populations are intersecting. As you can imagine, behavioural data is difficult to get in some countries and this is why molecular tools are important.”

The team explained that the technique used to understand how this particular virus spreads could also help healthcare professionals understand and intervene in other deadly disease outbreaks wherever they occur.

Salemi analysed the DNA sequences from blood taken from three HIV-positive groups - intravenous drug users, men who have intercourse with men, and women who have become infected by their spouses. Understandably, the spread is exacerbated when two of these groups intersect. Scientists say that, by examining the evolutionary make-up of HIV strains, one of the strongest factors of the disease’s spread is through men who have intercourse with male intravenous drug users.

The study was led by scientists from AKU and DUHS, both in Karachi, and the team is part of a larger worldwide, consortium of researchers. They are documenting the spread of the virus in predominantly Muslim countries and say that they will continue epidemiological work in Afghanistan.

Molecular studies are also essential to complement information derived from in-person interviews that may not necessarily be accurate, or true. “These questions are very sensitive and most of the behaviour we deal with, even in countries outside the Middle East, is illegal,” said Willi McFarland, director of the HIV Epidemiology Section at the San Francisco Department of Public Health.

McFarland is the author of a PLoS One paper that also appeared this summer. That research was led by scientists from the Qatar branch of Weill Cornell Medical College who had conducted smaller studies in Middle East and North Africa by examining men who hid their sexuality out of fear of prosecution.

Despite certain social and legal limitations that may make conducting similar studies in some parts of the world difficult, McFarland believes that the trust and confidentiality established between physicians and their patients has proven crucial in acquiring demographic information needed to conduct international such studies.

“Despite the legal consequences, doctor patient-relationships do seem to be respected,” he said.

Published in The Express Tribune, August 26^th,  2011.