[Clinical aspects of AIDS in Africa].

The clinical manifestations of HIV infection in Africa are similar to those observed in Europe and North America. However, some features related to ecological and diagnostic factors give the disease a certain African peculiarity. In more than 80 p. 100 of the cases AIDS is characterized by deep alteration of the subject's general condition, with chronic diarrhoea, severe asthenia, prolonged fever and massive loss of weight. This "slim disease" is only found at the terminal stage of AIDS in North America. Opportunistic infections are multiple, often associated, and their frequency differs from that found in Europe and the USA. Thus, pulmonary pneumocystosis is rare (12.5 to 21 p. 100 of the cases, as against 50 to 80 p. 100 in Europe). Isosporosis is frequent (4 to 48 p. 100 of the cases instead of 0.2 p. 100 in the USA), and this also applies to cryptosporidiosis (7 to 21 p. 100 of the cases, compared with 3.3 p. 100 in the USA). Gastrointestinal candidiasis occurs in 21 to 49 p. 100 and cryptococcosis in 10 to 30 p. 100 of the patients. Material problems make it impossible to evaluate the prevalence of certain infections, notably toxoplasma and CMV infections. The prevalence of Kaposi's sarcoma is low (15 to 20 p. 100). Dermatological manifestations occur at an early stage and are both common and varied (papular eruption, prurigo, herpes zoster, changes in the hair and skin appearance); they characterize the "African aspect" of AIDS. Tuberculosis is particularly frequent: in Africa, 30 to 40 p. 100 of tuberculous patients are HIV seropositive, as opposed to 10-25 p. 10 in Western countries.(ABSTRACT TRUNCATED AT 250 WORDS)