Our research unit has been involved in many projects in Guinea-Bissau, where our employees have been working and researching for several years. Gineau-Bissau is one the poorest countries in the world and it is located in West Africa between Senegal and Guinea Conacry. Until 1974 the country was a Portuguese colony, but since the country became independent, it has been plagued by political tumult and frequent military coups.

Like other countries south from Sahara, Guinea-Bissau has been struck hard by the HIV epidemic. About 10 % of the population is infected with HIV. The most known type is called HIV-1, but there is another type called HIV-2. HIV-2 is less contagious and causes less morbidity and mortality than in those infected with HIV-1. Guinea-Bissau has the highest incidence of HIV-2 in the world. About half of all HIV infected in the country have HIV-2.

The HIV treatment was introduced in Guinea-Bissau in 2005, but the treatment was first widely available in 2007. The same year we established a cohort of HIV patients in cooperation with the Guinean doctors.

The purpose of the Bissau HIV cohort:

The purpose with the cohort was to create a platform for HIV research for the benefit of both African and Danish patients. The cohort was names Bissau HIV Cohort. The patients are recruited from the country’s largest HIV clinic, located in the Nacional Simão Mendes Hospital in the capital Bissau. Data is entered into a database, and excess blood from all patients is sent to Denmark. The samples are stored in a biobank in Department Q and can be used for research projects.

The introduction of treatment for African HIV patients has led to a marked improvement in the survival rate, but still problems with the supply of medicine and equipment is experienced. Frequent periods of drug shortage, lack of reagent for blood samples, bad laboratory equipment, stigmatization and patients who do not attend their appointments because of the lack of knowledge and social instability, are just some of the challenges encountered. When a Danish doctor has experienced how effective the HIV is to Danish patients, you simply wish that African HIV patients will get the same opportunities.

The focus of the research

Today – seven years after the cohort startup – more than 6000 patients have received treatment in the clinic. 2 PhD students and 10 research students from Denmark, Iceland and Spain have spent 1-2 years of research in the clinic. The research projects have focused on HIV treatment, HIV testing, HIV and hepatitis, HIV and tuberculosis, HIV and other infections, how patients can be maintained in treatment, gender differences in HIV and HIV vaccines.

Several research project are being planned in HIV immunology, treatment of HIV2, tracing of transmission, HIV and other sexually transmitted infections, HIV and vaccines and gender differences. Knowledge about why the immune system can control HIV-2 but not HIV-1 can potentially help develop a vaccine against HIV, and in any case research in HIV-2 can give us additional knowledge about immunological mechanisms in HIV-1.