HIV & AIDS: What We Have Learned in 30 YearsHIV & AIDS: What We Have Learned in 30 Years
It’s been 30 years since the human immunodeficiency virus (HIV) was first identified in patients diagnosed with Kaposi sarcoma, or pneumocystis. The lack of scientific information and treatment options is a leading cause of death in early cases of HIV (Cichocki, 2020). Let’s look at what we have learned about HIV and AIDS in the past 30 years.
In the Beginning:
HIV was first recognized in humans in the late 1800s. Prior to this time, chimpanzees in Central Africa had simian immunodeficiency virus (SIV). The virus was then passed to humans during hunting excursions for chimpanzee meat (Centers for Disease Control and Prevention (CDC), 2020).
HIV is a Virus That Attacks the Body’s Immune System.
- If HIV is not treated, it can lead to acquired immunodeficiency syndrome (AIDS).
- There is currently no effective cure. Once you contract the virus, you have it for life.
- HIV can be controlled, and patients can have long, healthy lives and protect their partners.
(CDC, 2020 & 2021)
Symptoms of HIV are like the flu-. Symptoms include:
- Fever
- Chills
- Rash
- Night sweats
- Muscle aches
- Sore throat
- Fatigue
- Swollen lymph nodes
- Mouth ulcers
(CDC, 2021)
If you have these symptoms and may have been exposed, get tested as it is the only way to know for sure.
Stages of HIV
Stage 1:
Acute HIV Infection: May feel flu-like symptoms or be asymptomatic; have a very high viral load and are very contagious. Antigen/antibody tests or nucleic acid tests can diagnose HIV.
Stage 2:
Chronic HIV Infection: Also known as asymptomatic or clinical latency HIV. The virus is still active, but reproduces at very low levels, and can be transmitted to others. If not treated, this phase may last over a decade. At the end of this phase, the viral load goes up, the person becomes ill and moves into Stage 3. With medication, people may not ever move into stage 3.
Stage 3:
Acquired immunodeficiency syndrome (AIDS): most severe stage, badly damaged immune systems allow opportunistic infections leading to many severe illnesses. Diagnosis: CD4 count less than 200 cells/mm, developing certain opportunistic infections, high viral load, and very infectious. Without medical treatment people usually survive 3 years (CDC, 2020).
HIV has existed in the U.S. since the mid to late 1970s but was officially recognized in early 1980. AIDS was recognized in 1982.
Treatment
1990s:
- Antiretroviral medications such as azidothymidine (AZT) transformed HIV from certain death to a manageable chronic infection. Strict adherence to the regime was essential to success. However, taking up to 20 different pills at various times a day, high drug costs, and severe side effects caused many to stop treatment
- Adding two nucleoside reverse transcriptase drugs (NRTIs) showed that multiple drug therapies were better against HIV than AZT alone. These drugs were easier to manufacture and cost less, leading to more compliance. (National Institute of Allergy and Infectious Diseases (NIH), 2018).
2000s:
- First and second-generation integrase inhibitor drugs were developed. The second generation of these drugs has become first-line drugs against HIV. Dolutegravir, once-a-day dosing, low incidence of side effects, and low cost enhances compliance (NIH, 2018).
Now
- Pre-Exposure Prophylaxis (PrEP): first injectable medication to prevent HIV sexual transmission by 99%! Reduces the risk of getting HIV from injectable drug use by 74%!
- You must be free of HIV before getting drug and tested every three months while on the regime
- Truvada: once-daily dosing, for use by all
- Descovy: once-daily dosing, not for use in females
(NIH, 2018)
On average, 13.1/100,000 people contract HIV every year. Since the advent of PrEP, prescription use has increased from 0.7/100 to 5.8/100 in 2016. This has resulted in a 14.4% reduction in new HIV cases. (CDC, 2020 & 2021)
30 years later, HIV is a manageable disease. Therapies have been developed that slow or stop the progression of HIV to AIDS, and help prevent the spread of HIV. We know we can eliminate HIV/AIDS with education, early diagnosis, and compliance with drug therapies. The most important caveat is GET TESTED!
References:
Centers for Disease Control and Prevention (CDC). (2021). About HIV.
CDC. (2020). HIV and AIDS Timeline
Cichocki, M. (2020). A brief history of HIV. Timeline and History of HIV/AIDS.
National Institute of Allergy and Infectious Diseases (NIH). (2018). Antiretroviral drug discovery and development.
