Dagi Kimani
Special Correspondent

Study Says Curing Gonorrhoea Can Delay Onset of Aids

IN A finding that may have far-reaching implications for the management of HIV in sexually active people, Kenyan and British researchers have established that HIV-infected people suffering from gonorrhoea progress more rapidly to full-blown Aids.

The finding, obtained in studies on a group of 16 prostitutes in the Nairobi slum of Pumwani, could mean that treating sexually active HIV-positive people, such as commercial sex workers (CSW) for gonorrhoea could delay the onset of full-blown Aids.

Prevention of Aids onset using such a mechanism would be of particular significance in East Africa, where the vast majority of those infected with the virus do not have access to anti-retrovirals, and gonorrhoea is rampant.

"The finding is particularly significant because gonorrhoea is primarily a genital tract and not a systemic infection," Dr Rupert Kaul, who led the research team which made the finding, told The EastAfrican. "Clinically, our research seems to indicate that if you institute prevention and treatment among HIV-positive people who are at risk of contracting gonorrhoea, then you can delay their progression to full-blown Aids".

Dr Kaul and his colleagues, who included the University of Nairobi's Dr Joshua Kimani and Dr G. Kiama, say that gonorrhoea seems to hasten the progression to full-blown Aids by lowering the function of specialised defence cells called cytotoxic T-lymphocytes, which are a critical component of the body's immune response to HIV.

According to Dr Kaul, the connection between gonorrhoea and a rapid Aids onset may help explain why CSWs at Pumwani generally develop full-blown Aids after only five years of infection, compared with the 10 years observed elsewhere. Many of the CSWs at Pumwani still do not practise safe sex. Previously, the widely known connection that Aids experts had made between HIV and STDs was that the sores and inflammation that the latter cause made sufferers prone to the killer disease by opening a pathway to the blood stream.

The findings by Dr Kaul and his team, which were released to fellow Aids researchers during this year's review meeting of the University of Nairobi STD/Aids Collaborative Group in Nairobi, add to earlier findings by Dr Omu Anzala with another group of HIV-positive Pumwani women that gonorrhoea usually leads to an increase in HIV viral load, as well as to a decrease in the function of T-helper cells, which are essential in the body's fight against HIV.

Dr Kaul's work also adds to a long list of startling findings obtained in studies involving CSWs at Pumwani, where infection rates exceed 80 per cent. The sex workers are best known for their involvement in research, which culminated in the development of a possible Aids vaccine, currently under trial in Kenya and Britain.

Subsequent immunological studies established that the women's immunity was being conferred through a cellular response, using cytotoxic T-lymphocytes.

Researchers subsequently developed the test vaccine, which comprises a HIV DNA construct designed to stimulate the production of the protective T-lymphocytes, with a modified vaccinia virus acting as the carrier.

The vaccine trials are expected to end around 2008.

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