26,000,000 out of 42,000,000
. . .
FACT: Three-fourths of the the people infected worldwide
with HIV-1 live in Africa, or about 26,000,000

UNAIDS update December 2003

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PRESS RELEASE 26 NOVEMBER 97 FROM THE JOINT UNITED NATIONS PROGRAM ON HIV/AIDS:
"The more we know about the AIDS epidemic, the worse it appears to be," said Dr Peter Piot, Executive Director of UNAIDS. "We are now realizing that rates of HIV transmission have been grossly underestimated - particularly in sub-Saharan Africa, where the bulk of infections have been concentrated to date. South Africa now estimates that one in 10 adults are living with HIV - up by more than a third since 1996. And in Namibia, AIDS now kills nearly twice as many people as malaria, the next most common killer."

2ND HEARD HIV/AIDS DURBAN WORKSHOP 5-16 JULY 1999

In a reported published in the journal Nature by a group from the University of Alabama, the entry of HIV-1 into human populations may have first occurred by the eating of chimp meat in Central Africa. Bill Brewster has written up a very readble report on this exciting new research.

New nucleic acid sequence analysis from a sample of blood taken in Africa in 1959 shows that HIV may have been around in humans for forty years, evolving in Africa, before escaping to the rest of the world. This article published in the 5 FEB 98 issue of the British journal Nature suggests that all subtypes of HIV-1 (see below) do indeed arise from a common primitive precursor strain moving from non-human primates to humans in Africa.

Some links about AIDS and HIV in Africa in general
• This site from the Harvard School of Public Health is up-to-date and very rich in detail
• The Global Program on AIDS of the World Health Organization (WHO), rather slow-loading, but comprehensive (and worth waiting for!)
• A wonderful new site maintained by Family Health International (FHI) about the MAP (Monitoring the AIDS Pandemic) Network
  
• Click the graphic describing the frequency of HIV-1 infection in different areas of the world, showing that HIV-1 infection in sub-Saharan Africa occurs at 7x the rate of HIV-1 infection worldwide
• Ken Davis' article on HIV Losing the Struggle in Africa and Asia from The Green Left Weekly WWW magazine from Australia.
• The U. S. National Academy of Science report from December 1995 declares:

  By the year 2010, it is estimated that AIDS will have lowered the average life expectancy from 66 to 33 years in Zambia, from 70 to 40 years in Zimbabwe, from 68 to 40 years in Kenya, and from 59 to 31 years in Uganda.

• The HIV/AIDS Situation in mid-1996, mirrored on my server from http://gpawww.who.ch/highband/press/Situat96.html
• A WWW page in italiano which mentions subtypes (see also below)
• The AIDSCAP report sponsored by the Harvard School of Public Health about HIV in Africa
• Nelson Mandela on HIV-1:
  

  "Mandela Urges Global Effort to Fight AIDS"
  Reuters (02/03/97)
  Nelson Mandela, president of South Africa, told participants at the World Economic Forum on Monday that a worldwide effort against AIDS was needed. "The AIDS pandemic is getting worse at a rate that makes a collective global effort imperative," he said. More than 6,000 people are infected with HIV around the world each day, Mandela said, noting that the disease is creating economic problems by affecting people in their prime years.

• Although some Caucasians may be GENETICALLY protected against HIV-1 infection by virtue of bearing an allele of the chemokine CCR5 receptor gene called delta32, the frequency of this HIV-protective allele ranges from 20.93% in Ashkenazi Jews and 14.71% in Icelanders to 0.00% in most Africans sampled, including those from Gambia, Central African Republic, Kenya, Ivory Coast, Malawi, Zambia, and Kalahari San:
  

  Martinson JJ, Chapman NH, Rees DC, Liu Y-T, Clegg JB. (1997). Global distribution of the CCR5 gene 32-basepair deletion. Nature Genetics 16, 100-102.

• Michael Dean and Stephen J. O'Brien have also published on the CCR5 genetics story, in the September 1997 issue of Scientific American, from which I borrow a few data, including the CCR5del32 gene frequencies in Sweden and Russia (below):

  

• James Chin's summary of the situation of HIV in Africa and the Middle East from the July 1996 Vancouver conference; the full report from the Vancouver conference on "The Status and Trends of the Global HIV/AIDS Pandemic" can be accessed as a .pdf file at ftp://ftp.aimnet.com/pub/users/jchin/vanrep.pdf.
• The HIV Epidemic in South Africa
• One in 25 South Africans carry HIV (May 1996), or 1,8 million!
• The HIV epidemic may actually control Zimbabwe's population growth:
  

  "Science & Health Bulletin: Zimbabwe-AIDS Zimbabwe" PANA Wire Service (02/19/97) Zimbabwe's population is not expected to increase much beyond its current 11 million in the next 30 years due to the continued spread of HIV, a new study shows. The prevalence of HIV in rural areas appears to be approaching the rate in urban areas, according to the Blair Research Institute and the Welcome Center for Infectious Diseases. Furthermore, survival chances for people aged 20 to 50 are expected to drop from over 80 percent to 20 percent, the Zimbabwe Public Health Association said. The association stressed the importance of targeting HIV prevention campaigns to people in rural communities.

• Tom Moultrie, in the South African insurance industry, talks about HIV in southern Africa (review of subtypes)
• A crude map of HIV-1 subtype around the world
• Projet RETRO-CI -- An HIV/AIDS research project of the U.S. National Centers for Disease Control and the Ivory Coast Ministry of Health.
• A little history by T. J. Moriarity from (World AIDS Day 1995)
• Shall we actually celebrate May 20, 1997, the date of a new nation of sub-Saharan Africa, The Democratic Republic of the Congo, formerly known as Zaire and formerly known as the Belgian Congo? Only time shall tell.
• Women account for about half of HIV-1 infection in sub-Saharan Africa, where heterosexual transmission of HIV-1 seems to be the rule rather than the exception, perhaps linked to viral subtype (below). You can even read about this subject in German
  Recently, the Village Voice [New York City] has expressed doubts about Max Essex's claim for a linkage between HIV-1 subtype E and heterosexual transmission E
• However, here is a 1997 paper from Cape Town (South Africa) suggesting that there are two epidemics, one homosexual (subtype B) and one heterosexual (subtype C)
• A collection of links about Africa in general.
• A link about Project HOPE, an AIDS education project in Malawi
• If you can read italiano, you will enjoy this link.

Some links about HIV-1 infection in African women:
• A headline in the December 7 issue of The Lancet:
  

  World AIDS day aims to combat growing complacence
  HIV is a growing threat to women and children. Nearly 50% of the 2,7 million adults newly infected in 1996 were women. Of the 830000 children currently living with HIV/AIDS, almost half, 400000, contracted HIV in 1996. Each day, 1000 children contract HIV, and nearly 1 million children under the age of 14 have already been orphaned by AIDS in Kenya, Uganda, and Zambia.

• Culture puts HIV+ women at risk by Ndyakira Amooti
• Heterosexual transmission is the predominant mode of transmission worldwide, according to a recent article in The Lancet:
  

  "Sexual transmission is by far the most important, accounting for over 75% of all HIV infections world wide. During the early phases of the epidemic, homosexual transmission was the predominant mode in developed countries. However, during the past 5 years, there has been evidence of increasing trends for heterosexual transmission in industrialised countries. In the Caribbean, heterosexual transmission has now replaced homosexual transmission as the major mode of HIV spread."

• Article in The Lancet (16 Nov 96) about natural immunity and resistance to HIV-1 infection in Kenyan sex workers
• In collaboration with Peter Ebbesen's group at the Danish Cancer Society in Aarhus (Denmark), our group has recently published a study suggestive of a protective role for interferon- in the vertical transmission of HIV-1 from mother to child:
  

  Zachar V, Hager H, Koppelhus U, Zacharova V, Liu X, Bambra CS, Goustin AS, Ebbesen P. (1997). Elevated interferon- in maternal and umbilical cord blood and in the placental trophoblast suggests natural protection against vertical transmission in a Kenyan cohort.
  AIDS [London] 11, 383-385.

Conferences on HIV and AIDS in Africa:
• Conference on Global Strategies for the Prevention of HIV Transmission From Mothers to Infants, Hyatt Regency Crystal City, Washington, D.C., to be held September 3-6, 1997. For more information click here.
• A workshop on <>, was held in Dar Es Salaam, Tanzania, June 25-27, 1997. It was jointly sponsored by the European Commission, DG XII, JNCO DC, Science Research & Development, and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

• The First Pan-African Conference on Biochemistry and Molecular Biology held September 2-6, 1996, in Nairobi, Kenya, featuring a Workshop on the Biomedical Impact of HIV/AIDS in Africa. Contact: Dominic W. Makawiti
• The IX International Conference in Kampala, Uganda, in December 1995
• The XI International AIDS Conference in Vancouver, July 1996

Molecular epidemiology: the HIV-1 subtypes:
• At least nine HIV-1 subtypes (A, B, C, D, E, F, G, H and O) occur on the African continent
• Importance of understanding HIV-1 subtypes and HIV-1 genetic diversity in order to vaccinate throughout Africa
• The wonderful HIV sequence database maintained at Los Alamos National Labs in New Mexico, USA by Gerald Myers and Bette Korber
• The JAMA article on HIV-1 diversity:
  

  Hu DJ, Dondero TJ, Rayfield MA< George JR, Schochetman G, Jaffe HW, Luo C-C, Kalish ML, Weniger BG, Paul C-P, Schable CA, Curran JW. (1996). The emerging genetic diversity of HIV: the importance global surveillance for diagnostics, research, and prevention. J. Amer. Med. Assoc. (Jan 17, 1996)).

• Subtype C, even beginning to creep into the USA. This subtype is present now on five continents and in 21 nations, most recently including Malaysia (Brown et al., AIDS Res. Human Retrov. 12(17), 1655-1657.
  
• Subtype C is the predominant subtype found in India, where upwards to 5,000,000 Indians are infected. You may also read more about AIDS in India
• Subtype E (A/E) is overtaking subtype B in Thailand (Wasi et al., AIDS 9(8), 843-849 (1995).
• Thai subtype E (A/E) is spreading into the Western Hemisphere (Uruguay), Artenstein et al., Lancet 346(8984), 1197-1198 (1995).
• First case of HIV-1 subtype O infection in Germany, published in Infection 23, 369-370 (1995) by Gürtler and collaborators at the Freie Universität Berlin.
• A wonderful site at the Walter Reed Army Institute of Research on HIV Global Molecular Epidemiology set up by Mika Salminen and his co-workers (Andrew Artenstein, Frances McCutchan). This is a must for those interested in the C subtype (found on five continents and twenty nations, including the US) and the A/E subtype (found first in sex workers in rural Thailand). See also:
  

  Chaiyos Kunanusont, Hjordis M. Foy, Joan K. Kreiss, Supachai Rerks-Ngarm, Praphan Phanuphak, Suwanee Raktam, Chou-Pog Pau and Nancy Young, "HIV-1 subtypes and male-to-female transmission in Thailand" The Lancet, Vol. 345 (April 29, 1995), pp. 1078-83.

• A new paper in the journal AIDS [London]:
  

  Delamo J, Petruckevitch A, Phillips AN, Johnson AM, Stephenson JM, Desmond N, Nascheid T, Low N, Newell A, Obasi A, Paine K, Pym A, Pheodore CM, de Cock GM. (1996). Spectrum of disease in Africans with AIDS in London. AIDS [London] pp. 1563-1569.

• Our group is studying subtype-specific differences in the regulation of HIV-1 gene expression:
  

  Zachar V, Thomas RA, Jones T, Goustin AS. (1994). Vertical transmission of HIV: detection of proviral DNA in isolated placental trophoblast cells. AIDS [London] 8(1), 129-130.

  Zachar V, Thomas RA, Zacharova V, Ebbesen P, Goustin AS. (1994). Basal and Tat-transactivated expression from the human immunodeficiency virus-1 long terminal repeat in human placental trophoblast rules out promoter-enhancer activation as the partial block to viral replication, J. Gen. Virology. 75(6),

  Zacharova V, Becker MLB, Zachar V, Ebbesen P, Goustin AS. (1997). DNA sequence analysis of the long terminal repeat of the C subtype of human immunodeficiency virus type 1 from southern Africa reveals a dichotomy between B subtype and African subtypes on the basis of upstream NF-IL6 motif.
  AIDS Research & Human Retroviruses 13(8), 719-724.

  A paper focused on the function of the diverse elements in the C and E subtype viruses appeared recently in J. Virol. from Max Essex' group at the Harvard AIDS Institute:

  Montano MA, Novitsky VA, Blackard JT, Cho NL, Katzenstein DA, Essex M. (1997). Divergent transcriptional regulation among expanding human immunodeficiency type 1 subtypes. J. Virol. 71(11), 8657-8665.

• 
  AIDS information & treatments from Johns Hopkins University AIDS information & treatments from Johns Hopkins University
• All the Virology on the WWW: This up to date index site is maintained by David Sander at Tulane University Medical School in New Orleans, and seeks to link and catalog virology, microbiology and related pages world-wide. Additionally, on-line courses, tutorials, and a catalog of viral images is available. This comprehensive page lists Servers for General Virology, Specific Viruses, Microbiology, AIDS, Emerging Viruses, Electronic Journals, Scientific Societies, Government Sites and much much more. If you're looking for specific virus-related information, or if you're a virology/microbiology professional, this is the place to start.
  
• James Chin's page on trends in infectious disease
• A site for the indexing of sites on the WWW.