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HIV and HTLV in Africa

John Kaldor
JAMA. 1991;265(8):975. doi:10.1001/jama.1991.03460080045019.
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To the Editor.—  In a recent letter to The Journal, Tabor et al1 claimed that human immunodeficiency virus type 1 (HIV-1) "had not yet been introduced into two separate populations in Zambia" and that human T-lymphotropic virus type 1 "was absent" from 1976 to 1981. Although the viruses were not present in the individuals for whom stored serum samples were available, the generalizability of the finding even to the local population of Zambia is substantially limited for two reasons.First, there is no indication of the age or sex distribution of the two groups of study subjects. The median age of hepatocellular carcinoma in Africa is about 45 years,2,3 suggesting that the group of 123 subjects with this condition may not have been predominantly in the younger age groups that are most sexually active and presumably at highest risk of retroviral infection in Africa.Second, the 95% confidence

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