Norwegian Infectious Disease Specialists Have New Theory On HIV In Africa 118
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."
Reasonable, no smoking gun. (Score:5, Insightful)
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.
Re:Reasonable, no smoking gun. (Score:4, Insightful)
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Re:Reasonable, no smoking gun. (Score:5, Funny)
it would be worth exploring whether we could cure female HIV using virgin boys...
You're just searching for a compelling reason to get a woman to sleep with you.
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i'm not sure they believe this in africa but this is most definitely common knowledge in india.
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fact, look it up. and also look up the incidence of infection for various types of sex, by gender.
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The relevant statistic is how many other partners your partners have had. If you have sex with only one very promiscuous person with low health safety standards, you're still very likely to catch something.
Promiscuous people are more likely to catch stds, but they're also more likely to spread them after they've caught them.
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no, there are other relevant statistics. Transmission rate for AIDS from men to women vs. woman to man in vaginal sex is different. Transmission rate by vaginal vs. anal sex is different.
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True, those matter too.
That said, those make the "who is more promiscuous, men or women" measure I was responding to even less significant.
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was alluding to transmission rate of AIDs by vaginal rather than anal sex for example, and of transmission rate of men to women vs. women to men. Those are all quite different
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Only SOME men have multiple partners. Quite a lot Africans (arguably most of them) can never afford a woman or even a prostitute.
And yes, studies have already confirmed that the AIDS rates are higher for high-income African males than poor ones.
Re:Reasonable, no smoking gun. (Score:5, Informative)
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
Re:Reasonable, no smoking gun. (Score:5, Informative)
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).
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Schistosomiasis has been around for hundreds of years, so why would it suddenly be related to HIV
Presumably because HIV wasn't present for it to be related to until recently.
The Norwegians' thesis is that schistosomiasis simply makes transmission easier because it damages intravaginal mucous membranes that would otherwise be more likely to impede viral infection.
They aren't postulating any recent changes in behavior for schistosomiasis, or even any special selectivity for HIV (the compromised membranes would presumably have much the same risk for assorted other sexually transmitted diseases), it'
Re:Schistosomiasis (Score:5, Informative)
When DNA is replicated in most life-forms, there are extensive proofreading mechanisms which identify replication errors, cut them out of the DNA, and then re-copy those sections.
In contrast, HIV does not extensively proofread new DNA during viral replication. That means that copy errors are quite likely, and over time lead to a heterogeneous population of mutant viruses in an infected person.
Like other viruses, HIV has evolved a balance between correct and incorrect DNA replication which keeps the virus deadly while still evading the immune system.
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Most likely because the single virus strain in each case was the one that beat the infected person's immune system long enough to take hold. HIV is really not all that easy to transmit. It's just virulent and deadly once it takes hold.
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If it sounds unlikely, consider that a single bacterium, which only doubles every generation, can rapidly give rise to large colonies. For example, with a reasonable doubling time of 1 hour, 1 bacterium will become ~268 million in 48 hours. In contrast, viruses can create hundreds or thousands of copies with each generation. When actively replicating, they can spread very quickly.
The variety in diversity of viral populations in recent infections is probably caused by a variation in initial viral dose (b/c m
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A mother who had been infected for a long period of time might have multiple strains due to accumulated mutation. About 25% of the time the fetus becomes infected, and in about half of these cases only one of the mother's strains will appear in the infant, which is usually assumed to mean that only a single virus of that strain was able to penetrate the in utero defenses (which are quite good, considering 0 viruses get through ~75% of the time).
To be clear, it's not that all the infections across individual
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Africa doesn't need pills. It needs books. (Score:1)
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?
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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
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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.
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Injections and needles (Score:5, Interesting)
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.
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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.
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You didn't read the TFA but decided to look for an old article somewhere on the web? Look at the nice Wikipedia article. It shows that the disease is endemic to much of Africa and the Caribbean. I don't think the Caribbean borders on the Indian Ocean.
An overlap of HIV incidence (especially male:female infection ratios) and Schistosomiasis infection rates would have been nice, but not at all critical for the argument as it is not described as the sole reason for the unusual ratio.
Thinking about it further
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Refuted here: http://www.ncbi.nlm.nih.gov/pu... [nih.gov]
Prevent "thousands" of infections a year? (Score:2)
Evidence elsewhere does not support it ... (Score:3)
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.
What's the reason in the US then? (Score:4, Interesting)
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.
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Perhaps because the rate of black male HIV is so high.
Lead a horse to water and all that.
Pronounced shis-to-so-MY-a-sis (Score:1)
Thanks for explaining that it's pronounced exactly as anyone would expect from simply reading the name.
correlation != causation (Score:1)
The Numbers (Score:2)
Even if correlation != causation, it's plausible. (Score:2)
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
Re:Overpopulation (Score:5, Insightful)
My understanding is that short of enforced sterlisation or genocide, an improved standard of living and quality of life is the only sure way to curb population growth.
If the world really wants to see Africa bootstrapped out of poverty, we'd be focusing our efforts on the aid groups that are already providing tools, techniques and technologies (too tautological?) that can enable self-sufficiency for African villages wherever possible.
We send altogether too much aid in the form of food and goods which will always be a juicy target for the local factions.
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Agreed, but unfortunately the only way to prevent this aid from falling into the hands of warring factions is through military action. It seems like every time this is tried, accusations of imperialism and colonization are made. Operation Restore Hope may not be the best example, but it's the first that comes to mind.
http://en.wikipedia.org/wiki/U... [wikipedia.org]
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"My understanding is that short of enforced sterlisation or genocide, an improved standard of living and quality of life is the only sure way to curb population growth."
Actually it's the latter.
Every single event of the former (genocide or dieoff caused by disease) has had the population recover and shoot past previous levels within 2 generations. People feel obliged to have more children to fill the obvious gaps left by the dead.
The poor have more children because more children die.
Last year I was startled
Re:Overpopulation (Score:5, Insightful)
The key to reducing birth rates is raising the opportunity cost of children. First world countries have falling birth rates because women have other opportunities and the cost of raising 3+ kids (in terms of hours not worked for pay as much as actual outlays for food, clothes, etc.) is very high.
Letting $insert_disease_here maintain relatively high mortality rates ENCOURAGES birth rates because it increases poverty and so decreases the (opportunity) cost of having children.
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According to Isaac Asimov, lower birth rates are attributed to giving women more power in all aspects of society. When women are empowered in more than just being a good mother, they don't feel the need to have all those children.
See his interview with Bill Moyers from 1988
http://billmoyers.com/content/... [billmoyers.com]
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To be fair, we are going to eventually have to stabilize our growing population. Or find more place for humanity. Letting $insert_disease_here maintain relatively high mortality rates gives the world time to slowly see the issue appear and look for plausible, non-drastic solutions and avoid several consequences of uncontrolled exponential growth instead of having to radically change views to deal with what may turn out to be a potential black period in human history (mass starvation, riots, criminality rates going to an all time high).
...
Except of course the changing of views will never happen. Special interest groups will ensure that their vested interests remain despite the evidence contrary.
Otherwise of course some religions wouldn't be against condoms and Climate change would be universally accepted.
Re:Okay. The West's problem with AIDS is exclusive (Score:5, Informative)
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You have the mindset of the Christian God. Mass genocide...hey, it works.
You atheists are funny. You don't believe in god but then you blame god when people get sick as a consequence of bad behaviour. I have a fool proof way to not get HIV. Ready for it? Are you really ready? Ok here it is.
Don't fuck random strangers. Find a life mate who does not have HIV and marry them. Then remain faithful.
Why is this so damn hard for people to understand? Your choices often have consequences. Make the right choices in life.
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"people get sick as a consequence of bad behaviour" Ah, circular reasoning FTW. In absence of STDs and Christian morality having bareback sex is not bad behavior anymore, you know.
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"people get sick as a consequence of bad behaviour" Ah, circular reasoning FTW. In absence of STDs and Christian morality having bareback sex is not bad behavior anymore, you know.
I think you need to stop using words that you clearly do not understand their meaning. This is not circular reasoning but a matter of your actions having natural consequences. You seem to be engaging in "magical" thinking where because you believe that something is not bad behaviour that somehow the negative consequences of your actions go away. The same consequences exists regardless of what you believe. Your opinion on the matter is irrelevant.
Risky behaviour remains risky no matter how much wishful thi
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Having more people dying will not stop population growth. Even in Africa AIDS treatment works enough that they can just have more children to compensate for the people dying with AIDS. We need children to stay alive so that people will not want more then two children in their family. This has happened in Asia and it can happen in Africa.
And Africa will have 4 billion people. There are already so many kids there that it will happen and nothing - especially AIDS - can stop it.
Look at the presentations of this
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There are already so many kids there that it will happen and nothing - especially AIDS - can stop it.
Well you're right about AIDS, but your fatalism isn't needed. Ultimately you're probably right, the population in Africa (and elsewhere) will probably balloon out of control, but that doesn't mean that nothing can stop it and that we should just give up.
You piss me off a lot less than the people here who adamantly insist that everything is corrupt and voting is worthless and we should all go and live in caves, or go on killing sprees, or whatever. There are an awful lot of nihilists on Slashdot... At leas
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Don't worry. If there was ever a cure for AIDS, it would certainly be sold expensive enough that nobody but the "deserving few" will get it.
We and the Africans can as well go to hell.
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That's not how markets work.
First, yes, it would be hideously expensive, and only those few that could afford it would buy it. As that supply of customers is exhausted, the patent holder or manufacturer(s) would be forced to lower prices and to increase supply in order to maintain profitability through increasing volume with lower overhead. Eventually that tier of
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If you have the cure and I have the disease, there's two things that could happen. I have the cure and you have the money or I have the cure and you have a bullet. It depends on the price you're asking for.
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True, that's not how markets work.
But it's how patent law works.
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