Letter: HIV is not a death sentence

STEVE CONNOR claims that 'the latest and most comprehensive study of Aids in Africa' contravenes claims that the African epidemic is a myth, and that the Sunday Times has failed to mention this in its recent coverage on Aids in Africa ('HIV is Africa's big killer', 14 November).

The study does no such thing, as I ascertained by questioning Dr Mulder, the scientist directing it, at a press conference in London last June. The study, among 10,000 villages in Uganda, has found that death rates are higher in those who test HIV-positive. However, out of 64 deaths among those testing HIV-positive, only five were diagnosed as Aids.

It is true the study team, having failed to find a link with clinical Aids as currently defined, concluded that 'HIV disease' must be at work in making the villagers more likely to die from other diseases. However, other scientists have questioned the assumption that there is a cause-and-effect link between HIV and Aids.

These workers argue that the HIV test has never been properly validated as a diagnostic tool. They say the test can give positive results in people whose immune systems are jeopardised from a wide variety of reasons other than HIV, including chronic parasitic infections such as are common in Africa.

Researchers in Tanzania have described evidence supporting this point of view. Widespread HIV testing in the Kagera province confirmed the link between HIV positivity and risk of illness; but unlike in Uganda, the Kagera workers treated the HIV positive patients for their various infections, with excellent results. Most recovered and thrived: there were actually fewer deaths in this group than in the rest of the population.

Neville Hodgkinson

The Sunday Times, London E1