Re: The politics of AIDS in South Africa: Did Makgatho Mandela die from ARVs? 13 January 2005
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Nicholas Bennett,
Infectious Disease Postdoc/Clinician
Department of Pediatrics, University Hospital, Syracuse NY

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Re: Re: The politics of AIDS in South Africa: Did Makgatho Mandela die from ARVs?

Without being privy to the confidential health information of Mr Mandela's son, any kind of commentary is pure speculation. But certain things are clear:

Any kind of surgery, especially that in and around the abdomen, is associated with an increased risk of pneumonia (due to many things, including intubation, atelectasis, pain leading to reduced breathing and coughing etc). It's also clear that aside from more exotic diseases like mycomacterium avium complex and cryoptococcus, HIV infection also predisposes to normal pneumonias with more common pathogens such as streptococcus (indeed, frequent community acquired pneumonias are one of the AIDS-defining conditions). I can therefore see a perfectly reasonable explanation as to why someone with an existing immune deficiency might find that contributing to an infectious complication of a routine operation. One would say that a gentleman with lymphoma who died from a post-surgical infection was affected by the lymphoma - so why not with HIV.

I note also than in some reports the gentleman in question underwent a bronchoscopy as part of the hospitalisation, which may also suggest some kind of pulmonary problem.

I do agree that Mr Mandela is making an active effort to promote AIDS -awareness by highlighting the fact that his son had AIDS, and it seems hard to blame him for doing so when he see's a country he fought long and hard for be affected so much due to a lack of action regarding the disease.

Nick Bennett njb35@cantab.net

Competing interests: None declared