Where Did Hiv Come From A Look At The Origins Of The Pandemic Of Our Time
A chimpanzees virus has killed 35 million humans.
That virus, commonly known as HIV, is the defining pandemic of our time. More than 35 million people have been killed by the virus to date. But the virus itself didnt get its start in humans.
HIV/AIDS is, like the vast majority of emerging viruses infecting people, zoonotic in nature. The AIDS crisis, as we generally think of it, began in the 1980s. First as a mysterious illness primarily infecting gay men in urban areas in the United States. But thats not really the beginning. Before the diseases first mention in 1982 in the New York Times, people had been dying of AIDS for at least a decade, though probably not much longer. In Africa, HIVthe virus that causes AIDShad jumped from chimpanzees to humans sometime early in the 20th century.
To date, the earliest known case of HIV-1 infection in human blood is from a sample taken in 1959 from a man whod died in Kinshasa in what was then the Belgian Congo.
Its this fact which keeps me awake at night. Imagine, for a moment, that the HIV virus in that 1959 sample had been studied and identified. If, in the 1950s, the scientific community realized the potential harm this new virus could unleash. What could we have done? What therapies could we have developed before it became one of the deadliest pandemics in human history? Would we have a cure by now?
That work takes several forms, including:
Stigma: Educating A Nation
The first year of the AIDS epidemic seemed isolated to a few individuals in a few cities, so it received little media attention. When cases were reported in infants and people with hemophilia, widespread panic struck Americans. Those with AIDS were often stigmatized. In 1985, Ryan White, a teenage hemophiliac living in Indiana, contracted AIDS from a blood transfusion. Parents in his community feared he would expose their children to AIDS, resulting in Ryan being barred from attending school.
In 1986, U.S. Surgeon General C. Everett Koop issued the Surgeon Generals Report on AIDS. In it, he called for a comprehensive program of sex and AIDS education, urged the widespread use of condoms, and dispelled myths that HIV could be spread by mosquitoes. In 1987, CDC launched an unprecedented national campaign, America Responds to AIDS . The goal of ARTA was to increase awareness and understanding of AIDS, to prevent HIV infection, and to encourage people to seek more information and counseling. CDC also began a program to support HIV prevention efforts with national minority organizations that provided HIV prevention expertise to community-based organizations, developed HIV prevention programs targeting minorities, especially African Americans and Hispanics, and supported groups that used culturally sensitive AIDS prevention programs to address their communities needs.
Where Does Hiv Come From
HIV is thought to have occurred after people ate chimps that were carrying theSimian Immunodeficiency Virus .
HIV is a type of lentivirus, which means it attacks the immune system. SIV attacks the immune systems of monkeys and apes in a very similar way. This suggests HIV and SIV are closely related, and that SIV in monkeys and apes crossed over to humans to become HIV.
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Unresolved Questions About Hiv Origins And Emergence
The discovery of the main HIV/SIV phylogenetic relationships permits explaining broad HIV biogeography: the early centres of the HIV-1 groups were in Central Africa, where the primate reservoirs of the related SIVcpz and SIVgor viruses exist similarly, the HIV-2 groups had their centres in West Africa, where sooty mangabeys, which harbour the related SIVsmm virus, exist. However, these relationships do not explain more detailed patterns of biogeography, such as why epidemic HIV-2 groups only evolved in the Ivory Coast, which is one of only six countries harbouring the sooty mangabey. It is also unclear why the SIVcpz endemic in the chimpanzee subspecies Pan troglodytes schweinfurthii did not spawn an epidemic HIV-1 strain to humans, while the Democratic Republic of Congo was the main centre of HIV-1 group M, a virus descended from SIVcpz strains of a subspecies that does not exist in this country. It is clear that the several HIV-1 and HIV-2 strains descend from SIVcpz, SIVgor, and SIVsmm viruses, and that bushmeat practice provides the most plausible cause of cross-species transfer to humans. However, some loose ends remain.
It is not yet explained why only four HIV groups spread considerably in human populations, despite bushmeat practices being widespread in Central and West Africa, and the resulting human SIV infections being common.
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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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.
Canadian Flight Attendant Theory
A Canadian airline steward named Gaëtan Dugas was referred to as “Case 057” and later “Patient O” with the alphabet letter “O” standing for “outside Southern California”, in an early AIDS study by Dr. William Darrow of the Centers for Disease Control. Because of this, many people had considered Dugas to be responsible for taking HIV to North America. However, HIV reached New York City around 1971 while Dugas did not start work at Air Canada until 1974. In Randy Shilts‘ 1987 book And the Band Played On , Dugas is referred to as AIDS’s Patient Zero instead of “Patient O”, but neither the book nor the movie states that he had been the first to bring the virus to North America. He was incorrectly called “Patient Zero” because at least 40 of the 248 people known to be infected by HIV in 1983 had had sex with him, or with a person who had sexual intercourse with Dugas.
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Why Do Some People Say Hiv Started In The Usa In The 1980s
Because this is when people first became aware of HIV, and it was when HIV was officially recognised as a new health condition. But HIV had actually been around for decades by then.
In 1981, rare diseases, such as Kaposi’s Sarcoma and a lung infection called PCP, were being reported among gay men in New York and California. Scientists began to suspect that an unidentified infectious ‘disease’ was the cause.
At first, the disease was called all sorts of names relating to the word gay’. It wasn’t until mid-1982 that scientists realised it was also spreading among other populations, such as haemophiliacs and people who inject drugs. In September that year, they named it Acquired Immune Deficiency Syndrome .
In 1983, scientists at the Pasteur Institute in France identified the virus linked to AIDS, which they called Lymphadenopathy-Associated Virus . Scientists at the USA National Cancer Institute confirmed this virus was the cause of AIDS and called it HTLV-III. LAV and HTLV-III were later acknowledged to be the same. A few years later, the virus was renamed as HIV.
Who Benefits From Preexposure Prophylaxis
People who may benefit from preexposure prophylaxis include anyone who:
- is in a relationship with an HIV-positive person who has a detectable viral load
- has sex with men and women
- regularly has sexual partners of unknown HIV status, especially if they inject drugs
- has contracted a sexually transmitted infection in the past 6 months
- has injected drugs, been in drug treatment, or shared needles in the past 6 months
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Elisa: The First Hiv Blood Test
In CDCs immunology lab, scientists began working with AIDS specimens as early as July 1981 to understand how the immune systems of young, healthy men were so compromised by the mystery illness. In a photograph from 1983 displayed here, a female CDC research chemist conducts tests on biological fluids from AIDS patients. This work contributed to the theory that an infectious agent, not a genetic defect, was the cause of the disease. CDCs virology labs were among a network of international research centers searching for the virus believed to be the cause of AIDS.
By the next year, the U.S Food and Drug Administration licensed the first commercial blood test, ELISA, to detect HIV. Blood banks begin screening the U.S. blood supply. In a photograph on display, a different CDC lab technician is performing the ELISA test. Using a plastic plate with 96 wells, the lab technician adds the patients blood to different enzymes. Certain reactions between the blood and the enzymes indicated the presence of HIV antibodies.
Global Response To The Hiv Pandemic
In the West the initial response to the appearance of AIDS was by public health authorities, at the local and national level. Very soon gay volunteer organizations started to react after a first defensive denial attitude suspecting just another attack on gay liberation, they organized in self-help groups and activist initiatives to raise awareness amongst authorities and politicians. In the USA, the Federal CDC was engaged from the very beginning, in the early 1980s.
In 1986, WHO started a Special Program on AIDS, later named the Global Program on AIDS and developed a global strategy on AIDS which was adopted by the UN General Assembly in 1987. For the highest UN body to debate a single disease was unique, and indicates the particular political importance of AIDS. The resources and tasks of the GPA grew rapidly, financed by extra-budgetary sources from a handful of donor countries, another remarkable feature. The GPA gained an unusually independent position under the leadership of the charismatic Jonathan Mann, which eventually resulted in a clash with the new WHO Director General, Hiroshi Nakajima and the dramatic decline of Mann. There was also a destructive competition between WHO and the other specialized UN agencies, for instance the large Development Program , Family Program and UNICEF.
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Why Do Scientists Look At Recent Samples Of Hiv To Determine The Virus’ Overall Age Wouldn’t It Be Better To Use Older Samples That Haven’t Had As Much Time To Mutate
It would, but scientists don’t have that luxury. Other than the 1959 sample, there are very few preserved specimens of HIV-infected tissue that predate the early ’80s, when the virus was first recognized by health authorities. Researchers still hope there are forgotten samples in African freezers. “There has to be some serum or plasma somewhere, and given modern technology we could fish out the virus,” says Dr. David Ho, director of the Aaron Diamond AIDS Research Center and one of the world’s leading authorities on HIV.
But even if those samples are found someday, they won’t necessarily yield definite answers about the virus’ age, says Korber: “Often, you can’t get anything out of samples like that.” Most African samples are made of blood serum, and serum samples contain viral RNA, which degrades much faster than the DNA found in tissue samples. In fact, says Ho, the 1959 sample, which was sequenced by his laboratory, was kept in a freezer but still didn’t survive the ravages of time. “It was completely dried up,” he says. “We were only able to get small pieces , and we had to stitch them together.”
Scientists Struggled To Understand Aids
In the early 80s, HIV/AIDS was considered a death sentence.
Scientists and physicians were struggling to understand what caused the disease and how it spread making the process of finding a treatment all the more challenging.
Dr. Anthony Fauci, who became director of the National Institute of Allergy and Infectious Diseases at the height of the AIDS epidemic, refers to that period of his career as the dark years.
I went from a person who was seeing patients with other diseases and developing cures and adequate therapies for them in the early part of my career, to every day taking care of people who inevitably were going to die, usually within a short period of time, he said in a recent interview with CNN.
It was an experience shared by many clinicians who cared for early AIDS patients: Feeling as though there was nothing they could do to stop the suffering.
You were really putting Band-Aids on hemorrhages for a while, Fauci added.
In the absence of viable treatments, Gerald Friedland, who worked on early AIDS cases at Montefiore Medical Center in the Bronx, recalled how he focused on empathy.
The onslaught of death and dying of young men and women was beyond usual professional commitments and terribly hard, he said in a recently published interview with the New England Journal of Medicine. But I learned how to become skilled at providing people with a decent death.
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Hiv/aids In The 1990s And 2000s
In 1991, the red ribbon became an international symbol of AIDS awareness.
In that year, basketball player Magic Johnson announced he had HIV, helping to further bring awareness to the issue and dispel the stereotype of it being a gay disease. Soon after, Freddie Mercurylead singer of the band Queenannounced he had AIDS and died a day later.
In 1994, the FDA approved the first oral HIV test. Two years later, it approved the first home testing kit and the first urine test.
AIDS-related deaths and hospitalizations in developed countries began to decline sharply in 1995 thanks to new medications and the introduction of HAART. Still, by 1999, AIDS was the fourth biggest cause of death in the world and the leading cause of death in Africa.
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 ⦠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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