Friday, April 19, 2024

When Did The Hiv Epidemic Start

The Link Between Hiv And Siv

How a Sick Chimp Led to a Global Pandemic: The Rise of HIV

HIV is a type of lentivirus, which means it attacks the immune system. In a similar way, the Simian Immunodeficiency Virus attacks the immune systems of monkeys and apes.1

Research found that HIV is related to SIV and there are many similarities between the two viruses. HIV-1 is closely related to a strain of SIV found in chimpanzees, and HIV-2 is closely related to a strain of SIV found in sooty mangabeys.2

How Did Hiv Cross From Chimps To Humans

The most commonly accepted theory is that of the ‘hunter’. In this scenario, SIVcpz was transferred to humans as a result of chimps being killed and eaten, or their blood getting into cuts or wounds on people in the course of hunting.5 Normally, the hunter’s body would have fought off SIV, but on a few occasions the virus adapted itself within its new human host and became HIV-1.

There are four main groups of HIV strains , each with a slightly different genetic make-up. This supports the hunter theory because every time SIV passed from a chimpanzee to a human, it would have developed in a slightly different way within the human body, and produced a slightly different strain. This explains why there is more than one strain of HIV-1.6

The most studied strain of HIV is HIV-1 Group M, which is the strain that has spread throughout the world and is responsible for the vast majority of HIV infections today.

The Global Distribution Of Deaths From Hiv/aids

In some countries HIV/AIDS is the cause of more than a quarter of all deaths

Globally, 1.7% of deaths were caused by HIV/AIDS in 2017.

This share is high, but masks the wide variations in the toll of HIV/AIDS across the world. In some countries, this share was much higher.In the interactive map we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions the share was low: across Europe, for example, it accounted for less than 0.1% of deaths.

But across some countries focused primarily in Southern Sub-Saharan Africa the share is very high. More than 1-in-4 of deaths in South Africa and Botswana were caused by HIV/AIDS in 2017. The share was also very high across Mozambique Namibia Zambia Kenya and Congo .

Death rates are high across Sub-Saharan Africa

The large health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region.

In the interactive map we see the distribution of death rates across the world. Most countries have a rate of less than 10 deaths per 100,000 often much lower, below 5 per 100,000. Across Europe the death rate is less than one per 100,000.

Across Sub-Saharan Africa the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. In South Africa and Mozambique, it was over 200 per 100,000.

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Drs Gordon And Merrick On Caring For A Generation Of Patients

What will it take to end the epidemic?

Dr. Merrick: NewYork-Presbyterian has a number of grants around the governors Ending the Epidemic initiative, which has a target date of 2020. There are three pillars: We want to get people tested, we want to get people on therapy so their viral loads are undetectable, because undetectable equals untransmittable, and we want to do prevention. A big effort that were working closely together on is getting people on preventive medications known as PrEP and PEP to keep them HIV-free. PrEP is a daily pill for people at high risk of acquiring HIV, and it vastly reduces their chance of getting it. For those who arent on PrEP, PEP is a pill to take after a high-risk exposure, like having sex with someone whose HIV status is positive or unknown. With all of these efforts, Im very optimistic that we may be able to meet the Ending the Epidemic goals in the next few years.

Dr. Gordon: Because of advances in treatment and prevention, it could happen. If we all double down, I think we could end HIV as an epidemic in New York in the next five years. Were so close.

What would you say drove you to do this work all those years ago?

Peter Gordon, M.D. is medical director of the Comprehensive Health Program, the HIV clinics at NewYork-Presbyterian/Columbia University Irving Medical Center. He also is assistant professor of clinical medicine at Columbia University Vagelos College of Physicians and Surgeons.

Origin And Epidemic Emergence


Several of the theories of HIV origin accept the established knowledge of the HIV/SIV phylogenetic relationships, and also accept that bushmeat practice was the most likely cause of the initial transfer to humans. All of them propose that the simultaneous epidemic emergences of four HIV groups in the late 19th-early 20th century, and the lack of previous known emergences, are explained by new factor that appeared in the relevant African regions in that timeframe. These new factor would have acted either to increase human exposures to SIV, to help it to adapt to the human organism by mutation , or to cause an initial burst of transmissions crossing an epidemiological threshold, and therefore increasing the probability of continued spread.

Genetic studies of the virus suggested in 2008 that the most recent common ancestor of the HIV-1 M group dates back to the Belgian Congo city of Léopoldville , circa 1910. Proponents of this dating link the HIV epidemic with the emergence of colonialism and growth of large colonial African cities, leading to social changes, including a higher degree of non-monogamous sexual activity, the spread of prostitution, and the concomitant high frequency of genital ulcer diseases in nascent colonial cities.

Social changes and urbanization

Colonialism in Africa

This theory was later dubbed “Heart of Darkness” by Jim Moore, alluding to the book of the same title written by Joseph Conrad, the main focus of which is colonial abuses in equatorial Africa.

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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.

Is The World Making Progress In Its Fight Against Hiv/aids

The 1990s saw a substantial increase in the number of people infected with HIV and dying of AIDS.

Between 1996 and 2001 more than 3 million people were infected with HIV ever year. Since then the number of new infections began to decline and in 2017 it was reduced to below 2 million. The lowest number of new infections since 1990.

The number of AIDS-related deaths increased throughout the 1990s and reached a peak in 2005, 2006 when in both years close to 2 million people died. Since then the annual number of deaths from AIDS declined as well and was since halved. 2017 was the first year since the peak in which fewer than 1 million people died from AIDS.

The chart also shows the continuing increase in the number of people living with HIV. The rate of increase has slowed down compared to the 1990s, but the absolute number is at the highest ever with more than 36 million people globally living with HIV.

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A Timeline Of Hiv And Aids

The Timeline reflects the history of the domestic HIV/AIDS epidemic from the first reported cases in 1981 to the presentwhere advances in HIV prevention, care, and treatment offer hope for a long, healthy life to people who are living with, or at risk for, HIV and AIDS.

View a timeline of the current Ending the HIV Epidemic initiative. Please visit for a timeline of the global and domestic response to the HIV epidemic.

The Patient Zero Myth

Dr. Stacey Rizza: Forty years of HIV/AIDS: Will the epidemic end?

For decades, a French-Canadian airline employee named Gaetan Dugas, has been known as Patient Zero in the 1980s AIDS epidemic.

Dugas, a man who had sex with men , died in 1984. Since then he has been blamed by some as a primary source for the spread of HIV in North America.

Dugas was one of the primary villains in the 1987 book, And the Band Played On, by San Francisco journalist Randy Shilts.

However, the researchers now say Dugas was falsely accused and unfairly blamed.

Gaetan Dugas is one of the most demonized patients in history, and one of a long line of individuals and groups vilified in the belief that they somehow fueled epidemics with malicious intent, said Richard McKay, D.Phil., a Wellcome Trust Research Fellow in Cambridges Department of History and Philosophy of Science, in a press release.

In fact, McKay says, Dugas actually provided scientists with valuable information before he died.

Dugas told researchers after he contracted HIV that he had 750 sexual partners the previous three years. That wasnt necessarily an unusual number. Researchers said 65 percent of men in a Los Angeles cluster study at the time reported having more than 1,000 sexual partners in their lifetimes.

Much of that sexual connection was with anonymous partners, so many HIV patients couldnt give medical officials any names.

However, McKay says, Dugas provided medical officials with 72 names. That helped scientists track down a wide range of people infected with HIV.

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Federal Recommendations On The Prevention Of Aids

In a March 4, 1983 report, the PHS promulgated its first official recommendations on the prevention of . The recommendations stated that the evidence suggested the disease was a severe disorder of immune regulation caused by a transmissible agent . As evidence, the report indicated that the transmission routes of AIDS paralleled that of hepatitis B and that blood or blood products appeared to be responsible for transmitting AIDS to hemophilia patients. Suspected cases of transfusion-associated AIDS had been reported, but none were yet proven. According to the report, the evidence suggested a latency period of two months to two years between exposure and onset of symptoms. Brandt noted that a significant proportion of individuals in high-risk groups had no symptoms of AIDS, suggesting that the pool of persons potentially capable of transmitting an AIDS agent may be considerably larger than the known number of AIDS cases.

The PHS made the following recommendations for preventing transmission:

Increased Risk Among Individuals With Hemophilia And A Similarity To Hepatitis B

In a December 10, 1982, update on among patients with severe hemophilia A, the CDC reported that all three of the cases reported in the July 16, 1982, MMWR had died and that, in the intervening four months, four additional confirmed cases and one suspected case of AIDS in heterosexual patients had been reported. Two of the patients were children under 10 years of age. In an accompanying editorial note, the CDC stated that the hemophilia patients had all received large amounts of a commercially manufactured anticoagulant known as AHF . None of the patients had any prior opportunistic infections, all had been profoundly lymphopenic, and all had exhibited reversed ratios of : lymphocytes. According to the CDC, these cases provided a new perspective on AIDS by showing that children with hemophilia were at risk for the disease. The report also stated that the number of cases was continuing to increase and that patients with hemophilia might be at significant risk for AIDS. The CDC also reported that a national survey of hemophilia treatment centers had determined that 30 percent or more of all hemophiliacs had abnormal immunological tests. The coincidence of symptoms of AIDS and serologic evidence of hepatitis in the individuals with hemophilia added weight to the theory that AIDS was a disease with a pattern of transmission that mimicked that of hepatitis B .

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Reconsidering The Evidence: Further Attempts To Formulate Policies

In the interval between the decisions of early 1983 and discovery of the virus that causes in early 1984, public health and blood industry officials became more certain that AIDS was a blood-borne disease as the number of reported cases of AIDS among hemophiliacs and transfused patients increased. As their knowledge grew, these officials had to decide about recall of contaminated blood products and possible implementation of a surrogate test for HIV. Major opportunities to reconsider the policies of early 1983 arose at meetings of the FDA’s Product Advisory Committee in July and December 1983.

On May 11, 1983, Hyland Therapeutics recalled a lot of AHF concentrate when it discovered that the product had been manufactured from pools containing plasma from an individual subsequently diagnosed as having . The NHF issued a medical bulletin and a chapter advisory in conjunction with the recall, stating:

It is not the role of the NHF to judge the appropriateness of corporate decisions made by individual pharmaceutical companies. However, we urge that patients and treaters recognize the need for careful evaluation of blood products and note that such a recall action should not cause anxiety or changes in treatment programs. The NHF recommends that patients maintain the use of concentrates or cryoprecipitate as prescribed by their physicians. If you have any questions regarding this matter, they should be directed to your treating physician and/or the NHF .

The Development Of Research Treatment And Prevention

Hiv Epidemic Update 2007

Azidothymidine, also known as zidovudine, was introduced in 1987 as the first treatment for HIV. Scientists also developed treatments to reduce mother to child transmission.

In 1997, highly active antiretroviral therapy became the new treatment standard. It caused a 47 percent decline in death rates.

The Food and Drug Administration approved the first rapid HIV diagnostic test kit in November 2002. The test kit allowed hospitals to provide results with 99.6 percent accuracy in 20 minutes.

Also in 2003, the CDC reported that 40,000 new transmissions occurred each year. More than half of those transmissions came from people who didnt know they had contracted the virus. It was later discovered the number was closer to 56,300 people living with HIV. This number remains roughly the same since the late 1990s.

The World Health Organization set a goal to bring treatment to 3 million people by 2005. By 2010, about 5.25 million people had treatment, and 1.2 million people would start treatment.

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Impact On Young People

  • Teens and young adults continue to be at risk, with those under 35 accounting for 57% of new HIV diagnoses in 2019 .51 Most young people are infected sexually.52
  • Among young people, gay and bisexual men and minorities have been particularly affected.53
  • Perinatal HIV transmission, from an HIV-infected mother to her baby, has declined significantly in the U.S., largely due to increased testing efforts among pregnant women and ART which can prevent mother-to-child transmission.54,55,56
  • A recent survey of young adults found that HIV remains a concern for young people, especially for young people of color.57

Flashback: Radical Aids Activist Group Act Up

We can date the jump into the U.S. in about 1970 and 1971, Michael Worobey, an expert on the evolution of viruses at the University of Arizona, told reporters in a telephone briefing.

HIV had spread to a large number of people many years before AIDS was noticed.

Their findings also suggest HIV moved from New York to San Francisco in about 1976, they report in the journal Nature.

New York City acts as a hub from which the virus moves to the west coast, Worobey said.

HIV had spread to a large number of people many years before AIDS was noticed.

Their findings confirm widespread theories that HIV first leapt from apes to humans in Africa around the beginning of the 20th century and circulated in central Africa before hitting the Caribbean in the 1960s. The genetic evidence supports the theory that the virus came from the Caribbean, perhaps Haiti, to New York in 1970. From there it spread explosively before being exported to Europe, Australia and Asia.

HIV now infects more than 36 million people worldwide. About 35 million have died from AIDS, according to the United Nations AIDS agency. Two million are infected every year and more than 1 million died of it last year.

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When Native Americans Were Slaughtered In The Name Of Civilization

The FDA approves AZT, the first medication for treat AIDS. The treatment does not cure HIV-AIDS, but can be used to slow its progress and prevent transmission in some instances, such as during birth. The FDA also adjusts regulations to expand access to experimental medications.

President Reagan and Prime Minister Jacques Chirac of France agree their countries will .

May 15 The Public Health Service adds HIV to its immigration exclusion list. For the next 23 years, visa applicants are required to take a blood test and may be denied entry to the U.S. if they test positive.

May 31 Reagan gives his first speech about AIDS. On June 24, he creates the first Presidential Commission on AIDS.

A federal judge rules that a Florida school board cannot ban three HIV-positive brothers, Ricky, Robert, and Randy Ray, from attending school. The community of Arcadia, Florida responds with death threats, bomb threats and a school boycott.

The FDA green-lights the first human test of a candidate vaccine against HIV.

After weeks of threats following a ruling that they could not be banned from school for being HIV-positive, the home of brothers Ricky, Robert, and Randy Ray is burned to the ground while the family is staying elsewhere. The Rays later announce that they will leave Arcadia.

The first national AIDS Awareness Month begins, with the CDC launching a massive public education campaign that warns everyone is at risk.

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