Deaths are on the rise in South Africa, with the latest government mortality figures showing a 3.3 percent increase between 2004 and 2005.
According to a media statement from Statistics SA, the government agency which published the report, the latest figures are consistent with a continuous increase in South Africa's mortality rates since 1997. In that year, 316,000 deaths were recorded, compared to 591,000 in 2005.
The higher figures could partly be attributed to improvements in death registration and population growth, the report said, but they also provided "indirect evidence that HIV may be contributing to the increase in the level of mortality for prime-aged adults, given the increase in the number of deaths due to associated diseases."
The three leading causes of death in 2005 were tuberculosis (TB), influenza and pneumonia, all common opportunistic diseases associated with HIV and AIDS.
"We know that of the people who have got TB, more than half are co-infected with HIV, and that many people who are dying of TB don't even know their HIV status," Prof Glenda Gray, co-director of the Perinatal HIV Research Unit at the University of Witwatersrand in Johannesburg, told IRIN/PlusNews.
HIV is ranked as the nation's tenth biggest killer, but Dr Francois Venter, president of the Southern African HIV Clinicians Society, also attributed most of the pneumonia and TB mortality to HIV, making it "probably number one in reality".
Experts also described demographic trends in the mortality figures as pointing unmistakably to South Africa's heavy HIV/AIDS burden.
The highest numbers of deaths were among children younger than four years, and in the 30 to 34 age group.
"The only thing that could account for this change in child mortality must be HIV/AIDS," said Gray, commenting on the 12 percent rise in infant deaths between 2004 and 2005. "We know that less than 17 percent of women are accessing PMTCT (prevention of mother-to-child transmission services), so this is not surprising."
"Often, when the mother is asked what was wrong, she'll say diarrhea and vomiting," said Gray, explaining why intestinal infectious diseases rather than HIV was listed as the leading cause of death in children aged 1 to 4 years. "Many children die before they get an HIV test," she added.
In the 20 to 34 age group more women than men died and, overall, there was a greater increase in female deaths than male deaths. This is in keeping with 2005 HIV prevalence figures from South Africa's Human Sciences Research Council, indicating that women aged 15 to 24 were four times more likely to be HIV positive than men of the same age.
KwaZulu-Natal, the province with the highest HIV prevalence, also recorded the highest number of deaths in 2005, followed by Gauteng, the nation's economic hub.
"It's a very sad and horrific report, and I hope people are reflecting on it," Gray said.