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Norwegian Infectious Disease Specialists Have New Theory On HIV In Africa 118

Posted by samzenpus
from the snail-problem dept.
mdsolar (1045926) writes in about a Norwegian team who believe they have an explanation about the unique distribution of HIV in Africa. "While around the world a vast majority of AIDS victims are men, Africa has long been the glaring exception: Nearly 60 percent are women. And while there are many theories, no one has been able to prove one. In a modest public health clinic behind a gas station here in South Africa's rural KwaZulu/Natal Province, a team of Norwegian infectious disease specialists think they may have found a new explanation. It is far too soon to say whether they are right. But even skeptics say the explanation is biologically plausible. And if it is proved correct, a low-cost solution has the potential to prevent thousands of infections every year. The Norwegian team believes that African women are more vulnerable to H.I.V. because of a chronic, undiagnosed parasitic disease: genital schistosomiasis (pronounced shis-to-so-MY-a-sis), often nicknamed 'schisto.' The disease, also known as bilharzia and snail fever, is caused by parasitic worms picked up in infested river water. It is marked by fragile sores in the far reaches of the vaginal canal that may serve as entry points for H.I.V., the virus that causes AIDS. Dr. Eyrun F. Kjetland, who leads the Otimati team, says that it is more common than syphilis or herpes, which can also open the way for H.I.V."
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Norwegian Infectious Disease Specialists Have New Theory On HIV In Africa

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  • by ColdWetDog (752185) on Sunday May 11, 2014 @01:52PM (#46973697) Homepage

    Problem is that, according to the TFA, there are plenty of OTHER reasons for the high incidence of female AIDS:

    That rape, incest and domestic violence are rife in southern Africa, where the AIDS epidemic is worst. That syphilis and herpes are rampant. That impoverished, fatherless young women are forced to pay with sex for food, clothes, grades and even car rides.

    Still, it sounds like it's reasonable and important to treat the disease schistosmiasis [wikipedia.org] on the grounds that it has other chronic, serious issues. Do the longitudinal study to see if it brings down HIV infections. A potential two in one.

    • by carlhaagen (1021273) on Sunday May 11, 2014 @01:57PM (#46973731)
      A contributing factor is probably their outrageous belief that copulating with virgin girls "dispels" the HIV.
    • by reve_etrange (2377702) on Sunday May 11, 2014 @03:54PM (#46974329)

      These authors aren't the only ones to have identified a link between schistosomiasis and HIV, see this 2011 paper [plosntds.org] in PLoS NTD for example.

      It seems pretty obvious that any source of genital sores is going to increase the risk of HIV transmission, especially considering that this is the entire basis of increased infection rates for individuals engaging in anal sex.

      Still, the link to HIV should only slightly increase our desire to deal with schistosomiasis, because schisto is already the second-most socio-economically devastating illness in the world (after malaria). It causes liver and kidney damage, diarrhea, and vascular disease. It is associated with bladder and colorectal cancers, increases metastasis of other cancer (including breast cancer), impairs mental and physical development in children, and leads to reduced cognitive function and work ability in adults. Further, only one drug is widely used to treat the disease (praziquantel, aka PZQ), and resistance has begun to be observed. 200 million people are believed to require treatment, and more than 600 million are at risk of infection.

      Disclaimer: I develop automated drug screening methods against NTD, including schistosomiasis

      • by reve_etrange (2377702) on Sunday May 11, 2014 @09:34PM (#46976059)

        Thought I would also mention how bizarre the schistosoma (genus) parasites actually are (more details can be found e.g. on wikipedia).

        The eggs are deposited into water by infected humans, and infect certain snails. The snails later release a larval stage which has a tail, but no functional digestive system. These penetrate the skin of a human host, losing their tails in the process. The next larval stage is a few micrometers in size and has a sucker; it can now eat. They typically migrate to the lungs, where they will mature for about 1 week, living off the blood of the host.

        As they mature into adult parasites, which are up to ~10 mM in size and visible to the naked eye, they migrate again, often to the liver or intestine. If possible, they will also find mates. The female parasite lives in a canal formed of by the male flatworm's body rolling up. The breeding pairs are monogamous and individual parasites may live for decades. During this time, the pair will reproduce continually, producing up to thousands of eggs per week (depending on species).

        The eggs are deposited into the infected person's feces, where they find their way back into the water supply, but about half of the eggs become trapped in the body. These eggs mature normally, releasing many antigens which contribute to an active immune response which leads to most of the symptoms of the diseases.

        The parasites are highly evolved to fit their human hosts, to the extent that they depend on human enzymes in order to complete certain essential metabolic pathways. They also have genes which are highly similar to human genes, which may help the parasite evade the immune system (such genes could have evolved or been acquired through horizontal gene transfer).

  • by Anonymous Coward

    Education and literacy are the biggest things you can do to prevent AIDS, and a legion of other diseases. Africa doesn't need cures. It needs a political system that isn't corrupt, and a way to educate women. If the culture doesn't accept those things, then the culture must change - or nothing else will.

    Until that happens ; wait, what's the definition of insanity again?

    • by Mashiki (184564)

      You know, people have tried that. They were called racists and colonialists, right now in society it's a no-win scenario because every time *insert* tries to do something to uplift humanity, that needs a hand. There's some brain dead idiot out there screaming that "they're doing it to *insert insane reason.*" You know, much like the eradication of polio, after all that's just a myth. It's really a clever plot to make people sterile.

      I say to hell with the lot of them, let them enjoy their polio, starvati

    • by Anonymous Coward

      actually, treating diseases like HIV/AIDS solves A LOT of problems

      in fact i cannot imagine how you should study in a country where 50% of your teachers are dying of AIDS, or when you yourself are sick of AIDS, and e.g. as a virgin girl, you might get raped because some guy thinks this cures his HIV.

    • Abstinence, masturbation, internet porn (yeah, fight the spread of AIDS by giving people access to the "internet is for porn"), and monogamous relationships are the biggest things you can do the prevent spreading AIDS, assuming there are still some uninfected individuals. Listening to the preachings of the catholic church, and even entering nun-hood or monk-hood for a few individuals could drastically reduce the spread of AIDS. The key to reducing AIDS is adhering to strict religious practices, pick any rel
      • One way the internet porn can help is that you can see so many mindblowingly hot women on it, that you can get your senses dulled, you can get yourself jaded, to better control yourself with the women in your life around you. There are two sides to everything though, as the women around you will suffer greatly from not getting the attention they feel they deserve, but it's usually a man's duty to control sexual behavior, as a man can rape or force sex with an unwilling and unaroused woman, but it's not impo
        • By the way gorillas have small testicles and are highly monogamous, but chimps are very promiscuous and have large testicles to keep up with production. Of course in absence of a disease like AIDS or other STD's like syphilis, the promiscuous ones may quickly overtake the population compared to the self restrained ones, and drive the self restrained extinct very quickly, so there is always a balance in how non-promiscuous you should get, to adapt to the circumstances. Life adapts. Of course it's possible to
  • by retroworks (652802) on Sunday May 11, 2014 @02:41PM (#46973969) Homepage Journal

    Lived in Africa 2.5 years, mid 80s. It was obvious to us that anyone with a diagnosed anything, any previous disease (such as shisto but also STDs and malaria) has had an injection with an unwashed needle. I've written letters to WHO. Even when we brought our own hypodermic needles to European run hospitals (Norwegian mission in my case), the white doctors would forget and use a used needle.

    Africans typically felt cheated if they went to a doctor and didn't get a shot, and most doctors kept "vitamins" to inject as a placebo. My suspicion has always been that this link to western hypodermic needle / syringe use would be embarrassing to the WHO, same as the dysentery outbreak brought to Haiti by UN helpers. If I'm wrong, I hope someone can at least point to the study showing vaccinations with used needles are NOT the main cause of HIV in Africa, I'd sleep better.

    • http://www.irinnews.org/report/87356/africa-hospital-acquired-hiv-underestimated

      Actually here's an article that they did finally find African medical treatment to be a major cause of HIV, but it wasn't until 2009. Once you identify hospitalization and treatment as a primary cause, any correlation with any record of prior treatment for anything (e.g. shisto) is contaminated by the fact that whoever was diagnosed with the correlated illness probably got a shot.

  • Isn't the incidence of new cases in Africa something like over 5,000 a day?
  • by kbahey (102895) on Sunday May 11, 2014 @05:24PM (#46974863) Homepage

    Evidence elsewhere does not support this theory.

    Egypt for example, has one of the highest Schistosoma infections rates. Even its other name, Bilharzia, is after the guy who discovered it in Egypt in the mid 19th century (Theodor Bilharz).

    My own father died from complications of Schistosoma. This is because in the 40s and 50s, the treatment involved antimony injections, and they used to stand up patients in line, and inject them all with the same glass syringe one after the other. This caused Hepatitis C virus to spread, even before they diagnosed the virus.

    Back to the theory: Egypt has a very low AIDS incidence rate, so that seems to negate the finding.

    However, there are many species of Schistosoma, so there may be variations there. And this vaginal version is something I have never heard about before. So perhaps the species they found over there is the cause.

  • by Beeftopia (1846720) on Sunday May 11, 2014 @05:41PM (#46974969)

    Per the CDC, black hetero females in the US have just about 4 times the new HIV infection rate than white hetero females: http://www.cdc.gov/hiv/statistics/basics/ataglance.html [cdc.gov]

    More CDC statistics here: http://www.cdc.gov/hiv/statistics/basics/ [cdc.gov]

    Certainly this is a worthwhile course of investigation by the Norwegians, but the relatively high black female HIV prevalence in the US could indicate factors specific to race and not merely location.

    • by Anonymous Coward

      Perhaps because the rate of black male HIV is so high.

      Lead a horse to water and all that.

  • Thanks for explaining that it's pronounced exactly as anyone would expect from simply reading the name.

  • How many times does it need to be said?
  • In the US, gay and bisexual men make up the majority of new HIV cases. But, among heterosexuals, women outnumber men in the number of new HIV cases. For whatever reason (perhaps because semen sticks around longer in the vagina than female wetness stays around on the penis after sex), it's known that a woman's chances of contracting HIV from an HIV-positive male is higher than the chances of a man's chances of contracting HIV from an HIV-positive female. If I remember correctly, the chances of an infection
  • As someone who grew up in KZN, I find the correlation interesting. Bilharzia is a significant issue (don't even think about swimming in the rivers unless you're in the Drakensberg mountains -- particularly in northern KZN where one also has the possibility of crocodiles deciding that you'll be a tasty morsel), and KZN is also the province with South Africa's highest HIV infection rate. Obviously, the correlation does not imply causation, but from the information presented in TFA, it's certainly plausible

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