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UNSTERILE HYPODERMIC NEEDLES MAY BE LINKED TO ORIGIN AND SPREAD OF AIDS

(Lancet Article Traces AIDS to Massive Penicillin Injections of Africans in 1950s)

Bronx, NY-- December 2001 -- Could a relatively harmless monkey virus called Simian Immunodeficiency Virus (SIV) have mutated into the deadly AIDS virus as a result of the repeated use of unsterilized hypodermic needles among 23 million Africans to whom penicillin was administered during the 1950s? Could the use of unsterilized needles world-wide be the major cause of the current spread of AIDS?

These are the two startling hypotheses of an article titled "The Injection Century," in the December 8, 2001 issue of The Lancet. The principal author of the article is Ernest M. Drucker, Ph.D., of Montefiore Medical Center's Department of Epidemiology and Social Medicine.

"It would be a cruel irony if the introduction of antibiotics into Africa in the last years of the colonial period should be associated with the origins of the HIV pandemic," say Drucker and co-authors P.G. Alcabes, Ph.D., of Hunter College School of Health Sciences and P.A. Marx, Ph.D., of the Aaron Diamond AIDS Research Center at The Rockefeller University.

Penicillin Injections, "Serial Passage" and the Origins of AIDSHow did the monkey virus, usually short-lived in humans, become transformed into AIDS? The authors attribute the species crossover to a process called 'serial passage.' African hunters had, for millennia, become infected with the relatively harmless SIV through bites, cuts, and blood exposure in the course of hunting and butchering monkeys -- but without the appearance of HIV.

What event occurred in Africa in the mid-20th century to cause several SIVs and the emergence of several strains of HIV in a relatively brief period?

That event was the use of unsterile syringes and needles during the massive UN-sponsored campaign to combat Yaws and other diseases, according to the authors, who hypothesize that 'Serial passage' occurred in the following way: Each time an SIV-infected person was injected with penicillin, and the needle was used again, it passed on a slightly mutated version of the SIV virus to the next person injected. The virus kept adapting to each new environment, and after half a dozen mutations it was transformed into AIDS.

Unsterile Injections and the World-wide Spread of AIDS

Drucker and his colleagues also suggest that the current spread of AIDS and Hepatitis C Virus (HCV) is due largely to massive unsterile injections not only of illicit drugs (there are now 10 to 15 million injectors of illicit drugs around the globe), but also of drugs used in medical practice (80,000 to 160,000 new HIV infections per year, and 2.3 to 4.7 million new HCV infections per year) and "self injections" of medications, especially in Africa and developing countries.

While the authors agree that there is a greater awareness of this problem today they note that "...as recently as 1998, the World Health Organization still recommended re-use of syringes up to 200 times in vaccination programs -- relying on sterilization routines the WHO's own studies show are usually not followed."

Montefiore Medical Center is the university hospital and academic medical center for the Albert Einstein College of Medicine.

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CITATIONS

The Lancet, 8-Dec-2001 (8-Dec-2001)