Today in History: AIDS in Africa

Jim Burroway

February 4th, 2008

In early 1988, the AIDS hysteria was in full swing. The air was filled with the rhetoric of the innocent “general population” besieged by disease-ridden homosexual men. Just two months earlier, Pat Buchannan wrote an op-ed in the New York Post saying,

There is one, only one, cause of the AIDS crisis — the willful refusal of homosexuals to cease indulging in the immoral, unnatural, unsanitary, unhealthy, and suicidal practice of anal intercourse, which is the primary means by which the AIDS virus is being spread throughout the “gay” community, and, thence, into the needles of IV drug abusers, the transfusions of hemophiliacs, and the bloodstreams of unsuspecting health workers, prostitutes, lovers, wives and children.

The scientific community however wasn’t seeing it that way. For more than five years, several articles had been appearing in medical journals pointing to central Africa as the source for the new disease. Another similar article appeared in the February 4, 1988 edition of the New England Journal of Medicine by lead author Dr. Nzila Nzilambi of Mama Yemo Hospital in Kinshasa, Zaire.

Mama Yemo Hospital saw a large number deaths in the middle 1970’s due to baffling diseases which strongly resembled what would later become known as AIDS. Dr. Nzilambi’s early personal interest in AIDS led him and a group of American and European researchers to investigate the possible origins of AIDS:

The Equateur province of Zaire occupies the northwestern part of the country and has a population of approximately four million people. The river Zaire is an important geographic landmark and provides a major trade route between the cities of Kinshasa and Kisingani.

In 1976, there was an epidemic of Ebola hemorrhagic fever in a remote part of the Equateur province, centered at the mission hospital of Yambuku, near the village of Yandongi. In the course of epidemiologic investigations of this epidemic, many hundreds of serum samples were collected from residents of the surrounding area. This same are was selected for the present study to allow follow-up of persons examined in 1976. There has been no evidence of Ebola virus activity in this region since the 1976 epidemic.

… Five of the 659 serum samples collected in 1976 had antibody to HIV according to both enzyme-linked immunosorbent assay and Western blot analysis. One of the positive samples yielded HIV on culture. At follow-up in 1985, two of the persons who had tested positive for anti-HIV in 1976 were still alive and healthy: Subject 1, a 59-year-old woman, and Subject 2, a 57-year-old-man. Both had remained positive for anti-HIV. The ratio of helper to suppressor T cells was normal in Subject 1 but abnormally low in Subject 2.

A ten years span after infection with the HIV virus and the appearance of AIDS symptoms is quite common. It appears that Subject 1 follows this pattern and may have been very recently infected in 1976. Subject 2 however is beginning to exhibit damage to his immune system ten years after his blood was drawn. The authors continue:

Subject 3, was was 36 years old when blood was collected in 1976, died in 1978 after a prolonged illness characterized by weight loss, fever, cough, and diarrhea. She had lived in Kinshasa from 1972 to 1976, where she was unmarried and was considered a “free woman.” … Subject 4, who was the wife of Subject 2, was 43 years old when sampled for blood in 1976; she died in 1981 after a long illness associated with fever, weight loss, skin rash, and oral lesions. Subject 5, who was 7 years old in 1976, died of pneumonia and weight loss at the age of 16. With the exception of Subject 3, none of these seropositive persons had traveled outside the region of their respective home villages.

The results of our study showed that HIV infection was already present in an isolated area of the Equateur province of Zaire in 1976…

… The clinical descriptions of the modes of death in the three fatal seropositive cases were compatible with a diagnosis of AIDS. These findings illustrate that HIV infection and AIDS could have existed and remained stable in a rural area of Africa for a long period.

Researchers had been writing about AIDS in Africa for several years when this study came out. For example, one study two years earlier found an isolated case of HIV infection from a lone stored blood sample from Leopoldville (Kinshasa’s colonial name) taken in 1959. But none of these studies were able to prove where AIDS came from. That would have to wait until later.

But this one did provide solid evidence that HIV was already present in an isolated region of Zaire in 1976, long before it was noticed in America or Europe. And if the 7-year-old boy was infected from his mother at birth, then that would push the date in this community even further back into the late 1960’s.

Source: Nzilambi, Nzila; De Cock, Kevin M.; Forthal, Donald N.; et al. “The prevalence of infection with human immunodeficiency virus over a 10-year period in rural Zaire.” New England Journal of Medicine 318, no. 5 (February 4, 1988): 276-279. Abstract available here.

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