Dashed hopes

Less than half a century ago, we thought we had eliminated the threat of infectious diseases.

We are about to see “the virtual elimination of the infectious disease as an important factor in social life,” said Nobel Prize Winner, Frank Burnet, in 1962.

And there was great reason to be optimistic.

Conditions that killed and crippled only a generation ago were being defeated, one by one, as we created effective vaccines. The full list of conditions conquered by vaccinations is breathtaking; scourges like measles, mumps, polio suddenly lost their power.  And we had developed antibiotics that could seemingly wipe out any bacterial infection.  Never again would the Black Death or Plague return.

It was an amazing time, which culminated  with the complete eradication of Smallpox in 1979, one of the worst diseases to afflict man ever.  (Smallpox is highly contagious, kills 30% of those infects, and permanently scars those who survive).

Just one year later, things took a dramatic turn for the worse.

Keen eyed researchers noticed that weird diseases were starting to occur, mostly in gay men and intravenous drug users. Kaposi’s Sarcoma, which causes growth of multicolored tumors all over the body, for instance, was happening way too often. And Pneumocystis jiroveci, a rare fungal infection of the lungs, also started to show up much more often than expected.

These diseases, and others, are normally easily stopped by a healthy immune system. Something had clearly destroyed the body’s defense system of those people.

It was the rise of HIV/AIDs.

This monstrous disease has killed more than 25 million people since then. It’s extremely wide spread. In parts of Africa, more than 10% of people currently are infected for the disease. It’s wiped out decades of improvements in life-span for struggling African countries.  The graph of how long you could reasonably hope to live in Uganda, for instance, took a nosedive from which it hasn’t recovered.

Make no mistake – HIV spares no country: more than 50,000 people were infected with it in the USA this year.

An answer is desperately needed, yet none has yet to arise.

What is HIV?

HIV is a retrovirus that spreads through transmission of bodily fluids, whether blood, semen or vaginal. A retrovirus works by infecting a cell then invading the cell’s center and inserting itself into the DNA.  The cell then produces high levels of virus until it dies.

HIV infects the immune system and, over the course of several years, slowly destroys the body’s population of T-cells, which play a key role in regulating immune response as well as directly killing diseases.

HIV specifically cripples the CD4+ line of T cells, which are involved in coordinating and promoting your body’s defense system against diseases.

Normally, you have about 800-1500 of the CD4+ T cells in each cubic millimeter of blood. Over time, with HIV infection, your levels fall to 500, at which point diseases which are normally not dangerous can invade.  Even more serious problems, however, arise when levels reach 200 or lower.

In addition to those mentioned above, infections can include candida albicans, a fungus that forms railroad-like rings in your throat, cyptococcus, toxoplasmosa, histoplasmosa, and others.

Worse. With the rise of a large number of people with weak immune systems, otherwise dormant diseases like Tuberculosis have raised their head. By finding vulnerable hosts, they are much better able to develop resistance to our current treatments, meaning drugs stop working and more virulent forms arise.

Untreated HIV almost always causes death eventually. The weakened body is no longer able to fight off the simplest disease, and so is destroyed. Other complications of infection can include wasting, large loss of weight, and serious diarrhea. In 1/3 of AIDs cases, HIV infects the brain and causes some form of dementia.

Fighting HIV

The greatest minds have turned to fighting this pandemic, and progress has been rapid. Within several years of discovering the presence of HIV, we figured exactly what the structure of the virus is, and created the first drugs to fight it.

It has also been disappointing. While we have developed drug treatments to keep the disease in check, we still have no cure, and no vaccine.

Yet there is hope, and many areas for potential research. We will cover those over the next few posts, including what the recent HIV vaccine news means, and what potential targets of HIV for future treatment are.