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Norwegian Infectious Disease Specialists Have New Theory On HIV In Africa
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."
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 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.
Faster! Faster! Faster would be better!
It probably always has been. They are just now discovering that it's possible. Same reason with Syphilis is related to Blindness and Deafness. It just wasn't know they were linked for a long time. Medical science my friend.
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 guy for more info:
http://www.ted.com/talks/hans_...
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?
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's just that those two are now coexisting over a large area that they had not historically, since HIV is comparatively new.
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.
Gently reply
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, there are certainly other STDs that do not have a 1:1 male:female infection ratio. Male and female anatomy and physiology is rather different which may lead to different rates of infection or entirely different disease courses. The interesting bit about TFA is that it is certainly reasonable to treat Schistosomiasis in it's own right. If you can decrease HIV infection as well, you get bonus points.
Faster! Faster! Faster would be better!
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.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
Not so. High death rates sustain high birth rates. The only proven way to do this, is by economic development to the extent that they pass the demographic transition -- a key milestone where kids turn from being an asset to a liability. THAT'S how you contain population growth.
How to achieve that by conventional means? No idea; fixing Africa is like the labours of Hercules, and nobody knows how to fix that cesspool of ignorance and corruption.
You've been trolled. Congratulations.
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.
.: Semper Absurda
That information about Bilharzia is wildly inaccurate. Take a look at the actual epidemiological information if you're interested.
.: Semper Absurda
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 customers would be exhausted, and they'd further have to lower prices and expand manufacturing, etc.
I do fully expect that disease treatment in poor countries would still be expensive per-capita, even after the drug companies end up with bottom-barrel pricing over time, and I do expect that the disease wouldn't be totally eradicated in these populations or even pared back to the infection levels of wealthier countries, but I do expect that the epidemic would be reduced to levels that aren't completely destructive to society. I also expect that NGOs and other third-parties would push very hard for as much treatment as possible and for prices to come down or for subsidies.
The hard part will be convincing people to stop having so damn many kids. With an uptick in longevity it will absolutely be necessary for a reduction in new population, lest the already strained continent end up even worse off than they are now.
Do not look into laser with remaining eye.
Refuted here: http://www.ncbi.nlm.nih.gov/pu...
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.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
Isn't the incidence of new cases in Africa something like over 5,000 a day?
sic transit gloria mundi
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.
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 least you're mostly right, it will be very difficult to rein in the population at this point, but giving up is not the right answer when a problem gets difficult. Education can go a long way towards combating that sort of thing, and Africans, especially in the poorer areas, put a high value on education.
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.
..Mullah or Pope, Preacher or Poet, who was it wrote: "Give any one species too much rope and they'll fuck it up"?
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.
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.
2bits.com, Inc: Drupal, WordPress, and LAMP performance tuning.
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
More CDC statistics here: http://www.cdc.gov/hiv/statistics/basics/
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.
True, that's not how markets work.
But it's how patent law works.
Thanks for explaining that it's pronounced exactly as anyone would expect from simply reading the name.
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 more particles make genetic diversity more likely), and also by effects like the two you mentioned. I'm a graduate student in biochemistry, and I've learned never to assume that those types of phenomena are mutually exclusive.
By the way, this popular summary describes a model experiment on the feasibility of very low dose infections and how genetic diversity of the viral population varies probabilistically with the initial dosage.
.: Semper Absurda
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 are about double for women compared to men.
"Women have a much higher risk for getting HIV during vaginal sex without a condom than men do" - http://www.cdc.gov/hiv/risk/ge...
You'll also note that, on the graph shown on this article, if you ignore the gay and bisexual men graphs (listed as "MSM" or "men who have sex with men"), women outnumber men in new infections. For example, in the US, about twice as many heterosexual black women (5300/year) are diagnosed with HIV each year as the number of heterosexual black males (2700/year).
Perhaps what's going on in Africa is that homosexual males are less likely to get HIV - because so many of them are in the closet or keep to a small number of sexual partners for fear of attacks. http://www.theguardian.com/wor...
Or maybe HIV is just so common in Africa that transmissions among heterosexuals has surpassed the homosexual rate (which, given the two risk factors of "gay" and "in Africa" has got to be putting homosexual HIV rates near 100%, but you can't get higher than 100%).
Or maybe there's just a lot more sleeping around in Africa among heterosexuals. Afterall, the reason the homosexual HIV rates are so high is because gay men tend to have a lot of sexual partners.
The important thing to keep in mind here is that, if you ignore the homosexual male population, the rates of HIV infection among heterosexual women is naturally higher than the HIV infection rate among heterosexual men.
no, its heterosexuals spreading it. there have been lots of stories going around africa that to cure yourself of aids you have to have sex with a virgin girl and of course the catholic pope still telling them not to use contraception (now thats a good christian thing to do..).
"The hands that help are better far than lips that pray." - Robert Ingersoll (1833-1899)
yes, and healthier populations would help as the reason for many kids in one family is generally the high mortality rate of those children. birth rate drops when they are educated and healthy.
"The hands that help are better far than lips that pray." - Robert Ingersoll (1833-1899)
can you point to the place in the new testament where jesus et al discredited the old testament and he preached that his old man had it all wrong?
"The hands that help are better far than lips that pray." - Robert Ingersoll (1833-1899)
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 and, in my opinion, worth researching further.
I'm going to back those that have already posted that it's worth treating bilharzia in it's own right. If it contributes to a reduction in the HIV infection rate, so much the better.
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...
If you post as Anonymous Coward, don't expect a reply.
Don't blame a Christian God for AC Troll's notion. It's a product of the progressive left.
Dark Reflection
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/...
"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 to have friends in SE asia, in their late-30s to mid-40s talk about having children now in order to have someone to look after them when they are old.
No welfare system = need kids or you're on the trash heap and need to have enough kids to ensure that a couple of them will live long enough to look after you. The statements were made by _middle class_ people, not at all poor by local standards, although they did state an intention to stop at 2. Poorer people talk about having more kids. Attitudes like this are entrenched all over the world.
"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.
A successful API design takes a mixture of software design and pedagogy.
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.
Wolja Future Tombstone: Shit happened then I died
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 individuals begin with the same strain, it's that each individual infection (frequently) does.
As dreamchaser said, HIV isn't actually all that easy to transmit, so in many cases it is only a single virus which begins the infection. In the other cases (heterogeneous initial infection) there was probably a unusually high viral dose.
.: Semper Absurda
"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 thinking you engage in. Christian morality simply helps people avoid certain risks and ensure that their behaviour does not negatively affect other people around them especially those they care about. You are free to be an amoral a-hole but your actions will have natural consequences down the road and you will have negatively affected other people that you have interacted with.
Jesus was a compassionate social conservative who called individuals to sin no more.