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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."

19 of 118 comments (clear)

  1. Reasonable, no smoking gun. by ColdWetDog · · 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 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!
    1. Re:Reasonable, no smoking gun. by carlhaagen · · Score: 3, Insightful

      A contributing factor is probably their outrageous belief that copulating with virgin girls "dispels" the HIV.

    2. Re:Reasonable, no smoking gun. by reve_etrange · · Score: 5, Informative

      These authors aren't the only ones to have identified a link between schistosomiasis and HIV, see this 2011 paper 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

      --
      .: Semper Absurda :.
    3. Re:Reasonable, no smoking gun. by Ecuador · · Score: 2

      Or, unexpectedly, copulating with a virgin does cure HIV (also Cancer, Herpes and the common cold), and it is the reason only 40% of the AIDS victims are men. In that case it would be worth exploring whether we could cure female HIV using virgin boys...

      --
      Violence is the last refuge of the incompetent. Polar Scope Align for iOS
    4. Re:Reasonable, no smoking gun. by gmhowell · · Score: 4, 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.

      --
      Jesus was all right but his disciples were thick and ordinary. -John Lennon
    5. Re:Reasonable, no smoking gun. by reve_etrange · · 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).

      --
      .: Semper Absurda :.
  2. Re:Overpopulation by pijokela · · Score: 2

    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_...

  3. Injections and needles by retroworks · · 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.

    --
    Gently reply
    1. Re:Injections and needles by retroworks · · Score: 2

      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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      Gently reply
  4. Re:Schistosomiasis by reve_etrange · · 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.

    --
    .: Semper Absurda :.
  5. Re:"The Origin Of Aids" by RDW · · Score: 2
  6. Re:Overpopulation by Opportunist · · Score: 2

    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.
  7. Re:Overpopulation by Sardaukar86 · · 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.

    --
    ..Mullah or Pope, Preacher or Poet, who was it wrote: "Give any one species too much rope and they'll fuck it up"?
  8. Re:Overpopulation by MaskedSlacker · · Score: 4, 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.

  9. Evidence elsewhere does not support it ... by kbahey · · Score: 2

    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.

  10. What's the reason in the US then? by Beeftopia · · Score: 3, 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

    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.

  11. Re:Africa doesn't need pills. It needs books. by sillybilly · · Score: 2

    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 have a lot of kids(that you may not be able to support but somehow, through poverty, they can reach adulthood) through a non-promiscuous monogamous relationship, and overtake the population like that, playing chicken with everybody else as to how far we can drive overpopulation issues before we stop. But promiscuity usually correlates with how many kids you have, especially for the men, that get around, a man can have 100 kids by 100 females within 3 months, while a woman has to wait 9 months before having a 2nd child. So the promiscuity struggle for dominating the population is controlled by the males a whole lot more than the females. A female usually wishes a man to stick around, but sometimes he values a man that lies to her to seduce her, then dumps her to go on to the next female, because the males she'll rear this way will also have a higher chance of survival, higher chance of promiscuous behavior. So a female is guilty for choosing the promiscuous men, too, as ultimately life and death is in the female's hands. She controls abortions, she controls upbringings, she controls what the son is going to be like in sexual behavior, while the father controls, has the most influence on what the daughter is gonna be like in sexual behavior. But regardless how his mother raised him, a man can choose to control his own behavior. There is this concept of personal responsibility.

  12. Re:Okay. The West's problem with AIDS is exclusive by Barsteward · · Score: 4, Informative

    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)
  13. Re:Overpopulation by serialband · · Score: 2

    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/...