Although to some it may seem `curious indeed’ a non-retroviral explanation for the correlation between `seropositivity’ and morbidity mortality and AIDS in Africa is eminently possible. Clinical practitioners are no strangers to tests of significant utility and predictive ability which are nonetheless devoid of specificity. Arguably the test which provides the best example is the erythrocyte sedimentation rate (ESR) because it like the HIV antibody tests is associated with elevations of antibodies and acute phase reactant proteins. Indeed there is evidence that an elevated ESR is a superior predictive marker for the development of clinical AIDS than is a decrease in the CD4 cell count although the latter is said to be the cause of the syndrome. A positive antibody test like the ESR may indicate a propensity to the development of particular diseases without necessarily being linked to HIV infection. (excerpt)