New Class Of Antiretrovirals
In 1995, the FDA approved saquinavir, the first in a different anti-HIV drug class called protease inhibitors. Like NRTIs, protease inhibitors stop the virus from copying itself, but at a different stage during the infection.
A year later came yet another class of antiretrovirals, called non-nucleoside reverse transcriptase inhibitor , including nevirapine . Similar to AZT, NNRTIs shut down HIV by targeting the enzymes it needs to multiply.
These drugs paved the way to a new era of combination therapy for HIV/AIDS. Doctors began prescribing saquinavir plus AZT or other antiretrovirals. This combination therapy was dubbed highly active antiretroviral therapy . That approach became the new standard of care for HIV in 1996. HAART greatly lengthened the life span of people with AIDS.
Pop Culture Opens Up Conversations About Hiv
Actor Rock Hudson was the first major public figure to acknowledge he had AIDS. After he died in 1985, he left $250,000 to set up an AIDS foundation. Elizabeth Taylor was the national chairperson until her death in 2011. Princess Diana also made international headlines after she shook hands with someone with HIV.
Pop culture icon Freddie Mercury, singer for the band Queen, also passed away from AIDS-related illnesses in 1991. Since then many other celebrities have revealed that theyre HIV-positive. More recently, Charlie Sheen announced his status on national television.
In 1995, the National Association of People with AIDS founded National HIV Testing Day. Organizations, conventions, and communities continue to fight the stigmas attached to this infection.
Origin And Distribution Of Sivgor
HIV-1 origins. The phylogenetic relationships of representative SIVcpz, HIV-1, and SIVgor strains are shown for a region of the viral pol gene . SIVcpz and SIVgor sequences are shown in black and green, respectively. The four groups of HIV-1, each of which represents an independent cross-species transmission, are shown in different colors. Black circles indicate the four branches where cross-species transmission-to-humans has occurred. White circles indicate two possible alternative branches on which chimpanzee-to-gorilla transmission occurred. Brackets at the right denote SIVcpz from P. t. troglodytes and P. t. schweinfurthii , respectively. The phylogenetic tree was estimated using maximum likelihood methods . The scale bar represents 0.05 nucleotide substitutions per site.
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How Many Times Would Siv Need To Be Introduced Into The Human Population In Order To Seed An Epidemic Of The Size That Became Apparent By The Early 1980s
Three groups of HIV-1 exist today – group M, group O and group N. While group M is diverse, groups O and N are not, and remain highly restricted in one location. HIV-2 has one clear group with a separate path of descent, from the form of SIV found in sooty mangabeys in West Africa. This genetic tree suggests four separate transfers to humans, a puzzlingly rare chain of events given the potentially frequent contact with chimps in Central Africa, and the dating of chimp to human virus transfer back to the 18th century or even earlier.
In the opinion of Daniel Law-Beer, an epidemiologist from the University of Oxford, a star-like geography of infection would need to have been established early on in the epidemic, otherwise chance extinction events in one village could have eliminated the new virus from the human population quickly. He estimates that at least 60% of SIV transfers were dead-end infections of this sort which may have flared and died in remote locations.
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Sir Robert May of Oxford University also suggested that it was quite plausible for many viral transfers to have remained confined in locations where local custom did not encourage mixing between populations in different villages.
Activism By Aids Patients And Families
In New York City, Nathan Fain, Larry Kramer, Larry Mass, Paul Popham, Paul Rapoport, and Edmund White officially established the Gay Men’s Health Crisis in 1982.
Also in 1982, Michael Callen and Richard Berkowitz published How to Have Sex in an Epidemic: One Approach. In this short work, they described ways gay men could be sexual and affectionate while dramatically reducing the risk of contracting or spreading HIV. Both authors were themselves gay men living with AIDS. This booklet was one of the first times men were advised to use condoms when having sexual relations with other men.
At the beginning of the AIDS epidemic in the 1980s, there was very little information about the disease. Also, because AIDS affected stigmatized groups, such as LGBTQ and people of low socioeconomic status, there wasn’t much mass media coverage initially when the epidemic started. However, with the rise of activist groups composed of people suffering from AIDS, either directly or through a loved one, more public attention was brought to the epidemic.
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Symptoms Of Hiv Infection
Most people experience a short flu-like illness 2 to 6 weeks after HIV infection, which lasts for a week or 2.
After these symptoms disappear, HIV may not cause any symptoms for many years, although the virus continues to damage your immune system.
This means many people with HIV do not know they’re infected.
Anyone who thinks they could have HIV should get tested.
Some people are advised to have regular tests as they’re at particularly high risk.
The Origin Of The Aids Virus
From time to time, new diseases are discovered. In the past 20 or so years we have seen new diseases like hantavirus, ebola virus, Legionnaires’ disease, lyme disease, chronic fatigue syndrome and toxic shock syndrome. Among these new diseases, AIDS has become the most notorious.
In 1980 and 1981, doctors in the United States discovered that young gay men and IV-drug users, were mysteriously getting diseases most often seen when the immune system is damaged. As the months progressed, more and more people in these groups began to die from diseases associated with a damaged immune system. This trend was also beginning to be seen in Western Europe. As the numbers began to dramatically increase, it became clear that a new disease was upon us. AIDS was identified as a new disease in 1981. Human immunodeficiency virus was co-discovered several years later by Luc Montagnier and Robert Gallo.
AIDS is caused by HIV. HIV is believed to have originated in Africa sometime between the late 1940s and the early 1950s. The earliest known case was in a man from the Belgian Congo in 1959 .
Once HIV entered humans, over time it spread person-to-person primarily through heterosexual contact. In fact, even today, most of the worlds HIV/AIDS cases are spread by heterosexual contact, not by homosexual contact or by needle sharing.
Until next time . . . Work hard, play hard, play safe, stay sober!
Rick Sowadsky, M.S.P.H.
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Where We Are Now: 2000
Since 2000, additional factors have begun contribute to the the global spread of HIV. Heroin addiction in Asia has been on the rise, which brought with it dirty needles and the risk of new infections. India suffered with over 2 million diagnoses alone, in spite of the government’s refusal to admit the epidemic had adversely affected the nation.
The WHO released its comprehensive report examining HIV and AIDS in all of its 25-year history in 2010. This report had good news for developed nations: by 2008, the U.S. domestic HIV infection rate was considered effectively stable, and has remained so to this day. The report also demonstrated that while insistent public awareness campaigns about safe sex and other methods of transmission had slowed the rate of HIV infection in developed countries, there was much to be done elsewhere.
Global Education and Aid Efforts
Under President Bush, the U.S. committed funds to help African countries, but the funds were mismanaged and the spread of HIV continued unabated. Of the 4.1 million cases in sub-Saharan Africa then, only 1% received the available drugs. This led to the WHO’s declaration of the failure to treat the 6 million AIDS patients living in developing nations as a global public health emergency.
HIV Denialism Disrupts Aid
By the time Mbeki was recalled from the presidency in 2008 and one year before the FDA approved its 100th HIV/AIDs drug, an estimated 16.9% of South Africans aged 15-49 were HIV positive.
Are There Other Theories About How The Virus Could Have Gotten Into Humans
There are several competing theories, ranging from implausible conspiracies to arguments grounded in extensive research. The best-known of the latter, the “OPV/AIDS” theory, was exhaustively detailed in the 1999 book The River, by author Edward Hooper. As many as a million Africans were given oral polio vaccines between 1957 and 1960. Hooper says witnesses have told him that a few batches of those vaccines were “grown” in chimp cells at a lab in Kisangani, a city in the Democratic Republic of the Congo — and that the chimp cells, and thus the vaccines, could have contained SIVs that jumped into humans. “There are highly significant correlations between the places where this vaccine was administered and the places where â¦ AIDS first appeared on the planet four to 20 years later,” Hooper says.
The majority of HIV researchers subscribe to the bushmeat theory and raise several arguments against the OPV theory. Hahn’s recent research confirming that HIV-1 M and N arose from Pan troglodytes troglodytes chimps in Cameroon presents one problem: The Kisangani lab is in the Democratic Republic of the Congo, and it’s home to a different subspecies of chimp than the one that was the source of HIV-1 M and N. However, it is possible that the chimps used in the Kisangani experiments were not from the area. In the spring of 2006, Hooper found a paper indicating that at least one of eight chimps at the Kisangani lab was a Pan troglodytes troglodytes.
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Homeless People And Intravenous Drug Users In New York
A volunteer social worker called Betty Williams, a Quaker who worked with the homeless in New York from the seventies and early eighties onwards, has talked about people at that time whose death would be labelled as “junkie flu” or “the dwindles”. In an interview for the Act Up Oral History Project in 2008, she said: “Of course, the horror stories came, mainly concerning women who were injection-drug users … who had PCP pneumonia , and were told that they just had bronchitis.” She continues: “I actually believe that AIDS kind of existed among this group of people first, because if you look back, there was something called junkie pneumonia, there was something called the dwindles that addicts got, and I think this was another early AIDS population way too helpless to ever do anything for themselves on their own behalf.”
Julia Epstein writes in her book Altered Conditions: Disease, Medicine and Storytelling that: “As we uncover more of the early history of HIV infection, it becomes clear that by at least the 1970s the virus was already making major inroads into the immune systems of a number of diverse populations in the United States and had for some time been causing devastation in several countries in Africa.”
New Study Shows Hiv Epidemic Started Spreading In New York In 1970
A new genetic study confirms theories that the global epidemic of HIV and AIDS started in New York around 1970, and it also clears the name of a gay flight attendant long vilified as being “Patient Zero.”
Researchers got hold of frozen samples of blood taken from patients years before the human immunodeficiency virus that causes AIDS was ever recognized, and teased out genetic material from the virus from that blood.
They use it to show that HIV was circulating widely during the 1970s, and certainly before people began noticing a gay plague in New York in the early 1980s.
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Excellent Treatment Is Available But Not Everyone Gets It
While the World Health Organization recommends starting all 36 million people living with HIV worldwide on treatment, many people in developing world still dont have access to adequate treatment.
The situation is much better in the United States, but there are dramatic disparities in HIV infection prevention, diagnosis and treatment. Here, one in eight Americans living with HIV does not know their HIV status. Without a diagnosis, these people will not get necessary treatment and are more likely to develop AIDS and to spread HIV.
African Americans, Latinos, gay and bisexual men, and transgender people are still bearing a disproportionate burden of this disease in the United States. They are more likely to become HIV-infected and less likely to see a doctor regularly, and, thus, to receive treatment. For example, African Americans comprise 12% of the US population but 44% of all new HIV infections. African Americans are also more likely to die from HIV than other racial groups.
Theres a disparity between men and women as well. Women with HIV have the same health concerns as men with HIV, but they often face additional hurdles in managing their disease and other chronic health conditions due to family responsibilities, trauma and violence, poverty, gynecological issues and childbearing.
Pathogenicity Of Siv In Non
In most non-human primate species, natural SIV infection does not cause a fatal disease . Comparison of the gene sequence of SIV with HIV should, therefore, give us information about the factors necessary to cause disease in humans. The factors that determine the virulence of HIV as compared to most SIVs are only now being elucidated. Non-human SIVs contain a nef gene that down-regulates CD3, CD4, and MHC class I expression most non-human SIVs, therefore, do not induce immunodeficiency the HIV-1nef gene, however, has lost its ability to down-regulate CD3, which results in the immune activation and apoptosis that is characteristic of chronic HIV infection.
In addition, a long-term survey of chimpanzees naturally infected with SIVcpz in Gombe, Tanzania found that, contrary to the previous paradigm, chimpanzees with SIVcpz infection do experience an increased mortality, and also suffer from a Human AIDS-like illness. SIV pathogenicity in wild animals could exist in other chimpanzee subspecies and other primate species as well, and stay unrecognized by lack of relevant long term studies.
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Initiation Of Antiretroviral Therapy
Antiretroviral drug treatment guidelines have changed over time. Before 1987, no antiretroviral drugs were available and treatment consisted of treating complications from opportunistic infections and malignancies. After antiretroviral medications were introduced, most clinicians agreed that HIV positive patients with low CD4 counts should be treated, but no consensus formed as to whether to treat patients with high CD4 counts.
In April 1995, Merck and the National Institute of Allergy and Infectious Diseases began recruiting patients for a trial examining the effects of a three drug combination of the protease inhibitor indinavir and two nucleoside analogs. illustrating the substantial benefit of combining 2 NRTIs with a new class of anti-retrovirals, protease inhibitors, namely indinavir. Later that year David Ho became an advocate of this hit hard, hit early approach with aggressive treatment with multiple antiretrovirals early in the course of the infection. Later reviews in the late 90s and early 2000s noted that this approach of hit hard, hit early ran significant risks of increasing side effects and development of multidrug resistance, and this approach was largely abandoned. The only consensus was on treating patients with advanced immunosuppression . Treatment with antiretrovirals was expensive at the time, ranging from $10,000 to $15,000 a year.
Treatment as prevention
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The Aids Epidemic Arises
Though HIV arrived in the United States around 1970, it didnt come to the publics attention until the early 1980s.
In 1981, the Centers for Disease Control and Prevention published a report about five previously healthy homosexual men becoming infected with Pneumocystis pneumonia, which is caused by the normally harmless fungus Pneumocystis jirovecii. This type of pneumonia, the CDC noted, almost never affects people with uncompromised immune systems.
The following year, The New York Times published an alarming article about the new immune system disorder, which, by that time, had affected 335 people, killing 136 of them. Because the disease appeared to affect mostly homosexual men, officials initially called it gay-related immune deficiency, or GRID.
Though the CDC discovered all major routes of the diseases transmissionas well as that female partners of AIDS-positive men could be infectedin 1983, the public considered AIDS a gay disease. It was even called the gay plague for many years after.
In September of 1982, the CDC used the term AIDS to describe the disease for the first time. By the end of the year, AIDS cases were also reported in a number of European countries.
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So Scientists Have Estimated When And Where The Most Deadly Type Of Hiv Started Infecting Humans
Most AIDS researchers believe that the “bushmeat trade” allowed the HIV-1 virus, and separately HIV-2, to enter the human bloodstream several times. Hunters who kill and butcher chimps and monkeys are regularly exposed to animal blood teeming with SIVs. If the hunters have cuts, bites, or scratches — and given the nature of their work they almost always do — they can catch the viruses from their prey. Hunters going after chimps in Cameroon could have caught the first strains of HIV-1. Sooty mangabeys, hunted and kept as pets in West Africa, could have transmitted HIV-2 to humans.
Africans have hunted chimps and monkeys and kept them as pets for centuries they’ve presumably been exposed to SIVs during most of that time. But the conditions needed for HIV to spread widely weren’t in place until after the continent was colonized and urbanized. The first victims would have found it easier to unwittingly spread the virus to sexual partners far and wide as roads and vehicles started connecting previously isolated villages and cities. Hospitals may have played a role, too. Strapped for cash, some of them probably re-used dirty needles, unknowingly infecting patients in the process.