The History of HIV/AIDS

LA 254- HIV/AIDS IN SOCIETY

Prof. Sol Velazquez, LMSW

History of HIV

• HIV was first reported as a new and distinct clinical disease by the Centers for Disease Control and Prevention (CDC) in June 1981. At the time, the condition did not have a name.

• Doctors in San Francisco, Los Angeles and New York had documented an unusual cluster of diseases in young homosexual men.

• These diseases, Kaposi’s sarcoma and PCP (Pneumocystis carinii pneumonia), were previously unknown to this group.

History of HIV (cont’d)

• All of the subjects were suffering from general immune deficiency.

• Their bodies were vulnerable to rare “opportunistic” infections.

• The subjects were otherwise healthy.

The Earliest Known Cases

• Five young homosexual men in Los Angeles were diagnosed with PCP.

• 26 homosexual men, from both New York and San Francisco, were diagnosed with Kaposi Sarcoma.

• 11 cases of Pneumocystis carinii pneumonia were documented.

The Earliest Known Cases (cont’d)

• Since all of the first cases of this newly identified disease involved homosexual men, researchers initially considered sex among gay men the route of transmission.

• The condition was named GRIDS (Gay-Related Immune Deficiency Syndrome).

• However, HIV cases were soon reported in other populations as well.

The Spread to Other Populations

• IV drug users• Hemophiliacs• Blood transfusion recipients• Adults from Central Africa• Haitians living in the United States• Infants born to IV drug using mothers

Initial Focus

• Researchers then hypothesized that because the virus was primarily affecting homosexual men and IV drug users, the agent causing the disease was probably both blood-borne and sexually transmitted.

Identifying the Virus

• By 1982, research was going on in both the United States and France to identify the virus.

• In the United States, Dr. Robert C. Gallo of the National Cancer Institute called the virus HTLV-III (human T-cell lymphotropic virus type III).

• In France, Dr. Luc Montagnier and his colleagues at the Pasteur Institute in Paris called the virus LAV (Lymphadenopathy-Associated Virus).

AIDS Researchers

Luc Montagnier and Robert Gallo

Identifying the Virus (cont’d)

• Both groups of researchers were working on the same virus.

• In subsequent years, there was a dispute as to who discovered the virus.

• In 1983, the disease was said to be caused by the Human Immunodeficiency Virus (HIV).

• Credit for the discovery was given jointly to the U.S. team and the French group.

AIDS

• The term AIDS stands for Acquired Immune Deficiency Syndrome.

• It is the name given to the condition associated with the HIV virus.

• It replaced the name GRIDS when it became apparent that the disease was not just limited to gay men.

Before the AIDS Era

• A review of the medical literature dating back to the 1950s found 19 cases of what appear to be AIDS cases.

• Meaning? The illnesses fit the CDC criteria for HIV/AIDS with regards to risk factors, symptoms and progression.

Before the AIDS Era (cont’d)

• The mean age of patients was 37 years.• More males than females.• Sixteen patients had opportunistic infections without

Kaposi's sarcoma. • The remainder had Kaposi's sarcoma. • Two patients were reported to be homosexual. • Three others had been living in Africa.• One patient was born in Haiti. • In two instances concurrent or subsequent

opportunistic infection occurred in family members. • All patients died 1 month to 6 years after the initial

manifestation of disease.

The Case of Robert R.

• Frozen tissue and serum samples stored at the University of Arizona were available for one of these possible early AIDS cases.

• The patient was a 15-year-old black male, named Robert R. from St. Louis, Missouri, who was hospitalized in 1968.

• When admitted, the patient had extensive swelling of the genitalia and lower extremities and swelling of the lymph nodes in his neck.

The Case of Robert R. (cont’d)

• Chlamydia was also found in his body, indicating that he was sexually active.

• During the following year, Robert R. deteriorated.• He died on May 16, 1969.• Tests done in the mid 1980s found that he had HIV-

antibodies. • The patient had never received a blood transfusion, nor

had he ever traveled outside of the United States.• Implication: The virus may have been introduced into

the human population long before the first cases were officially reported.

HIV and Primates

• Soon after AIDS was recognized in humans, researchers began to report cases of a similar virus in colonies of monkeys.

• The virus, called Simian Immunodeficiency Virus (SIVsm) was found in African green monkeys, white-collared monkeys and the sooty mangabey monkey, among others.

• Another strain of the virus, named SIVcpz was found in chimpanzees.

HIV and Primates (cont’d)

• The SIV virus was found in more than 30 African primate species (ex. red-capped mangabeys, spot-nosed guenons).

• However, the virus was not causing illness or death to these animals.

• The questions then: – Did this simian virus infect humans?– How is it possible?

Primates

From Species to Species

• It has been known for some time that certain viruses can pass between species, including from animals to humans.

• The transfer of disease from animals to humans is known as zoonosis.

• Other examples of zoonosis:– Anthrax– Bubonic plague– Avian Influenza (Bird flu)– “Mad-cow” disease– SARS

The Contamination of Humans

• It is theorized that the virus at some point crossed species--from primates to humans.

• But how?

Natural Process Theory

This theory proposes that hunters of chimpanzees contracted the virus as early as the 1940s. (This time frame was arrived at based on a study done in 2000 using a computer model to track the evolution of the HIV virus. Margin of error: 15 years).

The hunters cut themselves while preparing infected chimpanzee meat.

The virus then mutated into HIV and was passed along through millions of humans.

Natural Process Theory (cont’d)

• The virus could have also been transferred to humans through the selling and consumption of primate bushmeat sold in African markets, an ongoing practice in parts of Africa.

• Both preparers of the meat and those who ate it could have easily become infected.

Other Theories

• Oral Polio Vaccine theory– Polio vaccine called CHAT was developed in Africa

(Belgian Congo, Rwanda and Urundi) during the 1950s. The theory is that the vaccine was produced using the kidney cells of infected chimps infected with SIV. This then led to the subsequent infection of humans with HIV.

– This theory was disproved when samples of the original polio vaccine were analyzed and no traces of either HIV or SIV were found.

– Other tests showed that the kidney cells were taken from the Asian macaque monkey only, which has been shown to be incapable of being infected with either SIV or HIV.

Other Theories (cont’d)

• Contaminated Needle Theory– Healthcare professionals in Africa during

the 1950s used needles on multiple patients as a way to save money on syringes.

– The virus could have been spread from one person (ex. a chimp hunter) to another with relative ease.

Other Theories (cont’d)

• The Colonialism Theory– People across Africa, under colonial rule, were subjected

to harsh conditions in labor camps, leading to food scarcity, poor sanitation and poor health.

– As a result, SIV could have infiltrated those camps and taken advantage of the weakened immune system of the workers.

– Additionally:• Workers may have been inoculated with contaminated

needles.• Workers may have become contaminated via prostitution

because many of the camps employed prostitutes to keep the workers happy.

– Labor camps were set up around the time that HIV was first believed to have passed into humans—the early 20 th century.

Other Theories (cont’d)

• The Conspiracy Theory

–HIV is a man-made virus and was designed to be part of a government biological warfare program.

–The target? • Blacks and gays.

Prevalence of HIV/AIDS

• HIV/AIDS has spread to virtually every continent on the planet.

• Approximately 33 million people worldwide have the disease.

• Presently, the country with the largest population of people living with HIV/AIDS is South Africa (5.5 million).

• There are about 1.1 million Americans living with HIV/AIDS.– Fifty-five thousand new infections

occur every year.