Abstract

PIP: The acquired immunodeficiency syndrome (AIDS) is now occurring in many parts of tropical Africa. Knowledge of the genesis of this condition in Africa, its spread between people and between different regions, and the size of the problem has been hampered by lack of data and perhaps misleading preliminary laboratory results. This review summarizes the extent of our knowledge and the relevance of studies of AIDS in Africa to the disease elsewhere. AIDS was 1st diagnosed among African patients referred to Paris and Brussels. Studies of African patients have confirmed the presence of the human T-lymphotropic virus type 3 (HTLV-3) determined to be the causative agent in American patients, but the types of opportunistic infections seen in HTLV-3 immunosuppressed African patients differ from those found in American patients, possibly because of differences in pathogens to which patients are exposed. Karposi's sarcoma (KS) has been common among American AIDS patients, but its linking to AIDS in Africa is more problemmatic, since KS has been endemic to some parts of Africa for decades. Evidence suggests AIDS is as new in Africa as elswhere, and has not existed for decades, although it is possible that it existed in groups poorly served by medical resources. Tests on sera collected in the 1960s, and early 1970s, support a slight possibility of exposure to AIDS. Tracing the evolution of the virus could be very helpful in developing a cure. No animal source has been confirmed. Regarding transmission, heterosexual contact appears to be the most logical agent in Africa, although it may be enhanced by co-factors, possibly venereal disease.