AIDS (Aquired Immune Deficiency Syndrome) is a disease caused by a retrovirus (a virus that invades a cell and uses that cell to replicate itself) called the HIV (Human Imminodefiency Virus). There is no cure or vaccine for the disease. The incubation period of AIDS is highly variable, anywhere from a few months to a decade or more. Transmitted by the exchange of body fluids and blood primarily through sex, intravenous drug use, blood transfusions and mother to fetus exchanges, it can be averted by staying away from intravenous drugs and potentially-tainted blood supplies, avoiding multiple sexual partners and using a condom when having sex.
As of 2008 about 25 million people had died from AIDS and 33 million people were living with HIV. HIV causes AIDS by killing or damaging cells of the body's immune system and progressively devastating the body's ability to fight infections and certain cancers. Victims die of variety of diseases, including rare skin cancers, tuberculosis and dysentery, as their bodies lose their ability to Effective HIV care that includes antiretroviral drug therapies and regular access to primary health care can help people manage their HIV disease and live longer.
Globally, AIDS is the leading cause of death among women 15 and 44. Unsafe sex, lack to access to contraception and iron deficiency are linked to the problem. According to the World Health Organization (WHO) one in five deaths among women in the age group throughout the world is related to unsafe sex.
The AIDS problem is still terrible but less bad than it once was. It killed 3.1 million people in 2004 alone. In 2000 there were 44 million AIDS cases, with 60 percent of them in Africa; 21 percent in south and southeast Asia; 7 percent in Latin America; and 5 percent in North America, Australia and western Europe. By the late 2000s, HIV/AIDS was stabilizing in sub-Saharan Africa but growing in eastern Europe and Asia.
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Origin of AIDS
It is now widely believed that the AIDS virus originated in chimpanzees or monkeys and made the cross species leap to humans somehow, perhaps through handling bloodied monkey bodies when hunting or eating bush meat. Chimpanzees host viruses similar to the human HIV virus and it is not a farfetched idea for those viruses to mutate into ones that can infect humans.
Scientist believe that AIDS originated in tropical Africa between 50 and 100 years ago where several species of monkey carry a similar virus, now know as SIV (the "S" is for simian). The reason that diseases like AIDS originate in tropical areas is that simply more kinds of life are found there, more microorganism, and more kinds animals and plants to host them. The monkeys have carried the virus for perhaps centuries and somewhere along the way an infected monkey bit a person causing the disease to leap from one species to another. The most recent data suggests that virus originated in chimpanzees. [Source: Peter Jaret, National Geographic, July 1994]
Africa doesn't like being singled out as the place where AIDS originated, but most of the facts seem to point in that direction. Blood samples from West Africa in the 1940s and 50s seem to show the disease existed at that time. As to its origin, some Scientist speculate that AIDS has been around for a long time, hidden away in some far away place, and spread to world as travel and contact increased. But most think the AIDS virus existed in monkeys for centuries and somehow, as recently as 50 years ago, shifted from monkey to man. [Ibid]
First Human Cases of AIDS
The earliest documented case of AIDS is from 1959. That year a British sailor died of a mysterious disease and analysis of a preserved tissue sample in 1986 showed the HIV virus. The frozen blood sample of a Zairean man also taken in 1959 also had the virus. [Source: Peter Jaret, National Geographic, July 1994]
British physician Trevor Stretton still recalls the first AIDS case. In 1959, he told National Geographic, an emaciated 25-year old sailor showed up at his clinic. The man had sores all over his body and seemed to waste away right be fore the doctor, who could do nothing to help fight a disease, the likes of which he had never seen before. When AIDS broke out in the 1980s Stretton suspected there might be link between the sailor and AIDS. No blood from 1959 victim was saved but a small tissue sample was. Using sophisticated bioengineering techniques the sample was analyzed and sure enough the man had AIDS, twenty years before the real AIDS epidemic began. [Source: Peter Garret, National Geographic , January 1991]
According to one theory AIDS may have inadvertently been spread by early testing of a polio vaccine in Africa in the 1950s. Based on evidence first made public in a 1992 Rolling Stone article and described in detail a book by Edward Hooper called The River , the theory is based on the possibility that an experimental polio vaccine was made from chimpanzee contaminated with the ancestor the virus that causes AIDS.
Much of the evidence is circumstantial: primarily that the HIV virus came into existence around the same time in places where the early test of the polio vaccine was tested. Between 1957 and 1960, a vaccine produced in the United States and Belgium, was given to around a million people in what is now the Congo, Rwanda and Burundi. There were no tests for the AIDS virus or similar viruses at that time . Of the 29 cases of AIDS acquired in specified towns in Africa through 1980, 23 were in the same towns where the vaccines was given or within 175 miles of them.
Spread of AIDS
HIV began spreading around the globe in the 1970s and 80s via prostitutes and drivers along truck routes and made the leap to continents via planes and boats. Analysis of blood samples has shown the disease spread slowly through the 1960s and 70s and then dispersed quickly after prostitutes in urban areas caught it and then they passed it on to truck drivers who transported the disease all over Africa. Infected air travelers spread AIDS beyond Africa. The disease first came to the attention of most in the West when ravaged it the homosexual community in the United States and Europe in the 1980s. [Source: "Viruses" by Peter Jaret, National Geographic, July 1994]
Truckers are a fairly well paid group by African standards, while many of the prostitutes who carry the virus are mothers trying to earn money to take care of their children. "In may ways," one health official told the Washington Post, "the epidemic starts in men who have money and women who don't.Ē
AIDS is believed have developed first in the 1970s along the Uganda-Tanzania border in the later Idi Amin era. "AIDS erupted early in Uganda," Peter Jarret wrote in National Geographic in 1994. "Years of civil war and social dislocation helped spread it. In many parts of the country one in five adults is now infected. The sick and dying have overwhelmed already burdened hospitals and rural health centers." [Source: Peter Jaret, National Geographic, July 1994]
In most of Africa, HIV and AIDS spread quickest among the upper classes and the university-educated elite, who traveled more and were more likely to have multiple sexual partners and have money for prostitutes. AIDS also seemed to spread quickly in countries with a strong economy and good infrastructure, which facilitate movement of the disease from place to place. The disease killed people in their prime wage-earning years which had disastrous effects on the economy.
Rich people also spread HIV more because they could afford first rate medical care and lived longer which gave them more time to spread it to other people. The poor tended to die before they could pass the virus on to too many people.
There is no cure or vaccine for HIV/AIDS but there are drugs that suppress the virus and allow people who have the disease to live near normal lives. Without treatment the disease destroys a personís immune system, leaving them vulnerable to infections and cancer.
Most people who live with HIV/AIDS take a cocktail of drugs that includes AZT, a protese inhibitor, which have been available since 1995, taken with other antivirals. The drug regimen is grueling and complex. Some patients have stopped taking the drugs and experienced no return of symptoms.
AZT prevents the HIV virus from multiplying quickly. Protease inhibitors disrupt the ability of proteins on HIV cells to latch onto proteins in healthy cells. In the United States and Europe, AZT and protease inhibitors are taken as part of three drug cocktail that has dramatically reduced the death rate from AIDS.
Patients on the three-drug cocktail take around 15 pills a day according to strict regimen that involves taking the drugs at carefully prescribed times, sometimes alone, sometimes with other drugs, sometimes on a full stomach, sometimes on an empty stomach. Failure to take the drugs according to prescribed regimen allows the HIV-virus to quickly build up a resistance to the drugs. Side effects from the drugs include diarrhea, fatigue, kidney stones, anemia and odd-looking redistribution of body fat from the face, arms and legs ro trunk and back of the neck.
A 2008 study by the British Columbia Center for Excellence in HIV/AIDS reported that HIV/AIDS patients taking the cocktail of HIV/AIDS drugs on average lived 13 years long er than those who took no drugs. It said a person who starts taking the drugs at 20 should expect to live an additional43 years.
The expensive and complex nature of the anti-AIDS drug regimen keeps them out of reach of 9 out of 10 patents that need them in developing nations. The average person in developing countries would have to work 30 years to earn enough to pay for one year of medicine to combat the AIDS virus. One of the current efforts in HIV/AIDS-related aid is making these drugs widely available to people who need them.
In the meantime AIDS patients in African clinic who receive any treatment at all usually get headache medicine for pain, antacid for gastric distress and cough medicine dispensed from a used whiskey bottle. Even iron pills are beyond the reach of most Africans. Most HIV-infected people spend what little money they have on palliatives for the recurrent diarrhea and the latest local herbal AIDS "cure."
HIV/AIDS can tested with a blood or saliva test. One of the earliest symptoms is a high frequency of cold sores. AIDS is not transferred by mosquitos because the AIDS virus is believed to be completely digested and this never enters the salivary glands.
AIDS Vaccines and AIDS Resistance
Most experimental AIDS vaccines are made from proteins found on the virus's coat and delivered via another inactivated virus such as canary pox. These vaccines are safe and activate antibodies but is not clear whether enough of them are activated to destroy the virus. Most fail to trigger T-cells which are most effective in fighting HIV-infected cells.
Developing a HIV/AIDS vaccine is difficult because it is not known exactly what components of the immune system are responsible for combating HIV. In vaccines for other diseases scientists look at the so-called correlates of immunity, which include antibodies that neutralize the virus and other substances that protects against it.
An experimental AIDS vaccine failed in a test in Thailand to prevents AIDS. It was given to 2,500 drugs users, some of whom contacted HIV.
Some people are more resistance to AIDS than others. The resistance rates among some European groups are higher than other groups. There is some evidence the highest resistance rates exist in places devastated by the Great Plague in the Middle Ages. Scientists speculate that people who survived the plague passed down a resistance that was useful battling AIDS.
Scientists are studying prostitutes like Agnes Munyiva in Nairobi who have had condom-less sex with hundreds of clients with the HIV virus for over a dozen years and have not contacted the HIV/AIDS virus themselves even though they have developed syphilis and gonorrhea. Munyiva and a hand full of others are believed to be immune from the virus and the reason why seems to be that their disease fighting antigen cells have the ability to repel, rather than absorb, which is case in AIDS victims, the HIV virus.
Fighting and Preventing HIV/AIDS
According to the United Nations, "AIDS has emerged as the single greatest threat to development in many countries of the world." At one time, worldwide, an estimated 95 percent of all people infected with AIDS virus didnít know they had it. The AIDS epidemic in Africa may turn out to be the worst health crisis in the history the humanity.
The United Nations estimated in 2006 that $15 billion is need for prevention, treatment and care of AIDS. Important factors in controlling AIDS include: 1) the availability of health services: 2) effectively using prevention strategies; 3) availability of effective vaccines.
Bangkok hosted the 15th International AIDS Conference in July, 2004. It was a far cry from the first AIDS meeting in 1985, which was attended by 2,100 scientists and was comprised mainly of dry meetings and paper presentations, The conference in Bangkok was attended by 17,000 delegates and included speeches by celebrities and world leaders, elephants depicting the conference logo, lobbying by drug companies, and meetings among politician to figure out the best way to make available the treatments that are available.
The global priority given to AIDS has taken attention and resources away from equally devastating and deadly diseases such as malaria and tuberculosis. In July 2008 the Bush administration pledged to spend $48 billion over the next five years to help treat and prevent AIDS, tuberculosis and malaria, with $39 billion to be spent on AIDS, $5 billion on tuberculosis and $4 billion on malaria.
AIDS infection rate declining among young people.
Image Sources: 1) 2) 3) 4) 5) 6) 7) 8)
Text Sources: CDC Health Information for International Travel, U.S. Department of Health and Human Services; National Geographic, New York Times, Washington Post, Los Angeles Times, Times of London, The New Yorker, Time, Newsweek, Reuters, AP, Lonely Planet Guides, Comptonís Encyclopedia and various books and other publications.
© 2009 Jeffrey Hays
Last updated March 2011