The clinical features of HIV infection in Africa.

In general available information indicates that the course of AIDS is similar in Africa to the disease seen in the developing world. Clinical features of the active disease may differ however given the local environments and pathogens to which Africans are exposed. It takes several years for a person with HIV antibodies to gradually lose their cell-mediated immunity and manifest acute seroconversion syndrome of encephalitis asymptomatic immunodepression (low numbers of T helper cells) generalized lymphadenopathy Kaposis sarcoma cytomegalovirus and the less serious AIDS opportune infections such as oral candidiasis and herpes zoster. One distinction between African and western AIDS disease is less frequent Pneumocystis carinii pneumonia. Conditions seen more often in African AIDS victims include toxoplasmosis and tuberculosis. In contrast malaria helminths and African Burkitts lymphoma do not seem more prevalent among AIDS patients. The pathogenesis of the wasting phenomenon known as "slim disease" in Uganda is unknown. Kaposis sarcoma may be subject to regional variation: it is more common in an area where the condition is endemic that overlaps with the belt of epidemic of AIDS through Zambia and Uganda. Given the high incidence of seropositive young adults in Zaire Zambia Kenya and Rwanda who presumably contracted the virus from heterosexual contact only an effective vaccine will prevent a serious AIDS tragedy in the area.