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AIDS / HIV
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AIDS / HIV
According to the National Institutes of Health (NIH), Acquired Immunodeficiency Syndrome (AIDS) has affected more than 100 million people since it was first identified in 1981, and has killed approximately 70 million men, women and children, making it a key field of medical study.
Facts:
70 million have died worldwide
Currently 40 million Africans live with HIV / AIDS in Sub-Sahara Africa
Fewer than 40,000 of them (0.1%) get treated with anti-retroviral drugs - ARV's
3.4 million newly infected victims in 2001
2.3 million Africans died of AIDS in 2001, equivalent to 6300 a day
Currently 16 million children orphaned by Aids, predicted to climb to 40 million by 2010
Source: UNAIDS
AIDS - Acquired Immuno Deficiency Syndrome, a fatal transmissible disease of the immune system, caused by the Human Immuno-deficiency Virus - HIV.
Acquired Immune Deficiency Syndrome was allegedly first recognized in Zaire, in 1976.
If tested, and it is found that you are HIV-Positive, this means that your blood stream contains HIV antibodies. All active and benign microbes that enter your body will attract attention from your immune system. If the microbes are foreign bodies, the immune system will attempt to destroy them. Whether successful or not, an anti-body will be produced.
How Does Your Body Fight Infection?
Immunity - This is the resistance of the body to infection, especially resistance due to antibodies. Babies have passive immunity from antibodies transferred from the mother’s blood through the placenta. Active immunity involves the formation of antibodies after exposure to an antigen - bacteria that invade the body during an infection are antigens. The two different kinds of immune response produced by antibodies involve: white blood cells called T-lymphocytes - produced by the thymus, which produce cells with antibody properties bound to their surface and are responsible for such reactions as graft rejection; B-lymphocytes, which produce cells that release free antibody into the blood.
T-cells which remember what microbes we have been exposed to, and how best to kill them. T-cells are the key component of the immune system that is missing in AIDS.
Auxiliary T cells infected by the HIV
Leucocyte - lymphocytes - or white blood cell. A colorless cell found in large numbers in the blood. There are several kinds, all involved in the body’s defense mechanisms. Granulocytes and monocytes destroy and feed on bacteria and other microorganisms that cause infection - see also phagocyte. The lymphocytes are involved with the production of antibodies.
Phagocyte - A cell that engulfs and then digests particles from its surroundings: this process is called phagocytosis. In vertebrate animals, phagocytes are a type of white blood cell that protect the body by engulfing bacteria and other foreign particles.
Immunization is the production of immunity by an injection containing antibodies against specific diseases e.g. tetanus and diphtheria, which provides temporary passive immunity, or by vaccination, which produces the longer lasting active immunity.
Antibody - A protein produced by certain white blood cells - lymphocytes that reacts with a particular foreign particle e.g. a bacterium, that has entered the body.
The antibody helps to destroy the foreign particle, known as the antigen. If the same bacteria invade the body in future, many more of the same antibodies are produced, enabling the body to destroy the bacteria very rapidly and so resist infection. This provides the basis of immunity. Antibodies are also responsible for the rejection of foreign tissue or organ transplants. See also monoclonal antibody.
Monoclonal antibody - A type of pure antibody that can be produced artificially in large quantities and used, for example, to distinguish the major blood groups. Mouse lymphocytes producing the required antibody are fused with mouse cancer cells; the resulting hybrid cells multiply rapidly and all produce the same type of antibody as their parent lymphocytes.
Whilst all this bodily protection sounds wonderful, the problem with AIDS, is that there is no defence to it, no answer to its attack.
So being HIV-Positive, is the first stage. AIDS is the penultimate stage, and death is always the final stage of this HIV infection. The Human Immuno-deficiency Virus - HIV slowly attacks and destroys the immune system, the body's main defence against infection, leaving an individual vulnerable to a variety of other infections and certain malignancies that would normally easily be fought off. This eventually can cause death, as the body can no longer cope with the viral and bacterial onslaught that hit us everyday. Simple infections become fatal, and cancers arise, that the body, and drugs can no longer engage.
What type of virus is HIV? - A Lentivirus
A Virus that infect only vertebrates. There are SIX serogroups of Lentivirus, that we have recognized, and they are host-specific, that is the virus only effects the hosts with which they are associated - primates, sheep, goats, horses, cats, and cattle. The primate lentiviruses are distinguished by the use of CD4 protein as a receptor with the absence of DU. Some groups have cross-reactive gag antigens - e.g., the ovine, caprine ( goat ), and feline lentiviruses. Antibodies to gag antigens in lions and other large felids indicate the existence of other viruses related to FIV and the ovine / caprine lentiviruses.
The primate lentiviruses are distinguished by the use of CD4 protein as a receptor with the absence of DU.
HIV is a Lentivirus, slow acting, and like all viruses of this type, it attacks the immune system. Lentiviruses are in turn part of a larger group of viruses known as, Retroviruses.
The name 'Lentivirus', from the French, literally means 'slow virus' because they take such a long time to produce any adverse effects in the body. Moreover, modern drugs slow this process down even more. Whilst in Sub-Saharan Africa, the average life of a man, and to some extent due to AIDS, is only 30 years, soon, in the Western World, having HIV before it becomes full-blown, will be over 30 years.
The Lentivirus has been found in a number of different animals, including cats, sheep, horses and cattle. However, the most interesting Lentivirus in terms of the investigation into the origins of Human HIV is the Simian Immunodeficiency Virus - SIV , that affects monkeys and apes.
There are two types of the Human Immuno-deficiency Virus:
HIV-1 and HIV-2.
Both types are spread by sexual contact, through blood, blood products, like semen and from mother to child, and they appear to cause clinically indistinguishable AIDS. However, it seems that HIV-2 is less easily transmitted, and the period between initial infection, and illness is longer.
Worldwide, the predominant virus is HIV-1, and generally when people refer to HIV without specifying the type of virus they will be referring to HIV-1. The relatively uncommon HIV-2 type is concentrated in West Africa and is rarely found elsewhere.
This adds intrigue as to whether HIV-1 did come from Africa.
The dominant feature of this first period was silence, for the human immunodeficiency virus (HIV) was unknown and transmission was not accompanied by signs or symptoms salient enough to be noticed. While rare, sporadic case reports of AIDS and sero-archaeological studies have documented human infections with HIV prior to 1970, available data suggest that the current pandemic started in the mid- to late 1970s. By 1980, HIV had spread to at least five continents (North America, South America, Europe, Africa and Australia). During this period of silence, spread was unchecked by awareness or any preventive action and approximately 100,000-300,000 persons may have been infected.
It is hard, and maybe impossible, to say how many people have developed this 'Lentivirus', in the past, whether HIV or full-blown AIDS. It is hard to calculate how many got AIDS in the 1970s, or indeed in the decades before and after. In fact it is not really known how long AIDS has had an impact in Africa, where it is believed to have developed. It could have been around for centuries, but without the authorities, or even tribe elders, having any real name or knowledge of what it might be, it was hidden under many other terms.
And because someone could get infected, and become HIV positive, and it might be 20 years before they died, who would connect the two incidents. Also, as there were possibly so few cases around, and the fact that it is actually quite hard to catch this virus off a HIV victim, if you are careful, it was perhaps undeniably very rare.
It did not become pandemic across the Western World, until the eighties, and nobody really cared, until numbers grew out of all expectations. This is further reflected in the fact that the Developed World still does not really care about the millions who have died in Africa.
It is now generally accepted that Human HIV, is a descendant of the host-specific SIV - the Simian Immunodeficiency Virus, that effects our cousins the apes and our distant cousins the monkeys.
Certain strains of SIVs bear a very close resemblance to HIV-1 and HIV-2, the two types of HIV that effect Humankind. Some believe that it was once only a condition that had an effect on monkeys. This was passed onto the apes and then eventually onto humans, during the first half of the twentieth century. Monkey SIV, may have been quite rare and there may have been only one case of it being passed onto an ape.
Conceivably, when a chimpanzee, ate a monkey it had captured, he inadvertently picked up a strain that gave him SIV. This was then passed onto a human, through some erroneous contact that we can only imagine when and where. It may also have been through the human or humans, hunting and eating the ape.
Mad Cow Disease
Cross species contamination is generally quite rare. Take the sheep for example. Sheep have had, Scrapie, a degenerative disease affecting the central nervous system, for about 250 years. Scrapie is caused through an organic mechanical process, the Prion, and is a transmissible spongiform encephalopathy - TSE, that affects sheep and is in the same category of diseases as the so-called Mad Cow Disease - BSE, in cattle.
There is no real evidence linking sheep Scrapie to BSE, but sheep Scrapie never posed any human health risk, until ground sheep remains were fed to cattle. Cattle caught BSE and in turn, some believe, gave humans CJD, the human equivalent. It took the cow, as some catalyst, before humans contracted the human form of Scrapie.
Prions are not alive in the same way a bacteria or virus. They cannot be destroyed through normal sterilization, they have to be burnt and medical instruments have to be disposed of, as they cannot be used again.
So how many of us have Prions inside us, after eating BSE contaminated meat? Are we all now Prion Positive, awaiting yet another incredulous outbreak of CJD, sometime in the future.
It took the UK government 10 years, and twelve billion dollars to eradicate BSE, what about CJD?
As we have said, It is hard, and maybe impossible, to say how many people have developed this slow working virus, in past history, whether HIV or full-blown AIDS. But how did it spread so quickly around the world, after being so constrained for so long. It may well have lied relatively dormant for centuries, but then during the twentieth century the planet grew smaller everyday; and since the fifties world travel is now available to many millions.
Gaetan Dugas; Patient Zero February 1953 – March 1984
But one incident that did not help stop the spread out of Africa, was allegedly due to a French Canadian Air-Steward, Gaetan Dugas; Patient Zero. He apparently caught the disease in West Africa on an overnight stay. It is now infamy that he contracted it quite innocently by having Gay Sex, with a Black man. He had never seen him before, because these were promiscuous times in the late seventies early eighties when most STD's had been supposedly beaten by penicillin, and Gay Sex was rife, and it was not unusual for a Gay man to have several different sexual encounters each week, all unprotected. This Frenchman, the charming and very handsome Gaetan Dugas, was widely known across the Gay community of North America. There were actually a few cases, not attributed to him, that could have been AIDS / HIV, in North America before Gaetan Dugas.
But it was in the summer of 1980 that Dugas began to notice a strange rash and peculiar purple spots on his face and body. The doctors soon realized that he had Kaposi's Sarcoma [ KS ], a type of skin cancer that affected internal organs, and was later associated with AIDS. It followed that Kaposi's Sarcoma was only seen in homosexual men, so it was dubbed the 'gay cancer'. This did not stop the promiscuous Dugas, he continued to travel to San Francisco, Los Angeles, Vancouver, Toronto, and New York, frequenting numerous places, to spread the word; AIDS. This made AIDS become known as the Gay Disease, especially as it is far more prevalent if partners engage in anal-sex.
Kaposi's Sarcoma, was a rare form of relatively benign cancer that tended to occur in older people. But by March 1981 at least eight cases of a more aggressive form of KS had occurred amongst young Gay men in New York. Equally, there was an erroneous increase in both California and New York, in the number of cases of a rare lung infection Pneumocystis Carinii Pneumonia - PCP. It had started, but it was painfully soon realised that this was not The Gay Disease, as Heterosexuals victims soon mounted to overtake Gay numbers.
This part of the epidemic does reflect the many thousands that got HIV / AIDS as drug addicts sharing needles, or the innocents that acquired the virus from blood transfusions, Factor 8 and bone marrow transplants.
In Africa, the most prominent problem in the new millennium, has become an epidemic. Early on, scientists set out to discover more about the occurrence of AIDS in Sub-Saharan Africa. This research resulted in 26 patients with AIDS being identified in Kigali, Rwanda, and 38 patients identified in Kinshasa, Zaire.
The Rwandan study concluded that, - . . . an association of an urban environment, a relatively high income, and heterosexual promiscuity could be a risk factor for AIDS in Africa.
Overtime this spread throughout all classes of those who would make up promiscuous Africa. It now affects the whole structure of their way of life, and is a vicious circle that they will find hard to get off.
Safe-Sex
Today, a recent study has shown that AIDS is killing an African every 10 seconds. This is due to many reasons. Lack of drugs, education, hope but ignorance is perhaps the main reason. AIDS is a sexually transmitted disease and infection can be reduced by 97% if a condom is worn during sex. This is what safe-sex is, wearing a condom. This not only protects the male from catching any virus, but also, and more importantly it protects the female.
An infected man will introduce his sperm into the woman, and leave the AIDS virus inside her, where it has a far greater chance to contaminate her over time. She will then be a time bomb, passing on AIDS to most partners she may have in the future. In African villages where money is scarce, women are sometimes forced to become prostitutes to earn a few pennies, in an area where 50% of all inhabitants have HIV. One prostitute in a large town who knew she was HIV, had up to ten unprotected, customers each day, ironically to earn the money to cure herself. These Johns then went home to their wives and girlfriends and spread the disease even further.
However, the Roman Catholic Church forbids the wearing of condoms for any reason as this is against God's wish. In villages and towns that are rife with AIDS, Catholic Priests preach and brainwash young Africans, that it is blasphemous to protect yourself during sex. Condoms are generally free and easily available, donated by the West. Moreover, young male Africans believe it is not an African thing to wear protection, as they must feel flesh on flesh, when with a woman. Fuelled by cheap alcohol, whilst they know that the odds of catching AIDS or some STD are high, they do not care, grabbing some small moment of pleasure in this sad continent.
Also reported, young men who know that they have HIV, to them a good night out is to get drunk, and find a young girl, and have unprotected sex with her, knowing that there will be a high she also will become HIV positive. Under such a regime it is no wonder that soon 50 million people in Africa will be HIV or be dying of AIDS.
A recent study of gay men in five US cities has found that nearly half – 46% - of Black Gay men were HIV positive.
After three more men were reported last week to be infected with a drug-resistant strain of HIV, there is still no reason to conclude that a new, more treacherous strain of HIV exists, say AIDS activists and doctors.
The biggest story of the 3rd International AIDS Society (IAS) Conference in Rio was a French/South African study which found that up to three-quarters of heterosexual HIV transmission could be stopped by male circumcision.
For the foreseeable future AIDS and HIV will continue to claim a devastating toll in sub-Sahara Africa, with some countries eventually having an HIV infection rate close to 50%, a statistic that can only grow and grow.
For over twenty years most responses to this plague have been to treat it as just a medical issue, or a political issue, sometimes as a social-behavior issue, which are all true. But few efforts have focused on the human aspect; of allowing these developing countries to develop, without the burden of having to have a medical, political or social stigma, that will never go away and allow them to get off the first rung.
The world cannot build enough hospitals to care for all its patients, nor wait for a some miracle. It can be and only will be, Africans themselves; Africans no matter where they were born to put AIDS, and hunger behind them. It cannot always be blamed onto the wicked West.
Most African states were once managed or colonized by European countries, and in the sixties, they all wanted independence, to be free from the shackles of the tyrants that had held them captive. Today they reap the benefits of their self government.
The World Health Organisation - WHO, has announced that by the end of mid-summer 2005 around one million people worldwide – one in six of those who need it - will be on HIV treatment. But this will not reach the WHO’s target of last year by a mile, when it launched the '3 by 5' project. This aimed to have 3 million by end of 2005.
However the initiative has encouraged sharp increases in the number of people on HIV drugs in the countries that need it most. Treatment in Africa has increased 60% and in Asia by 50%, during the '3 by 5' campaign, meaning that one in nine and one in seven people who need it respectively, are on a HIV regime. In Africa, about four in 10 of Ugandans who need help get it, while in neighboring Tanzania it is only one in 40.
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