It’s been 30 years since the virus causing AIDS was discovered. In this time we
have come a long way to combat the spread of HIV and prevent deaths caused by it.
Coral Williamson looks at our achievements over this period and the next steps
needed to ensure a HIV-negative future.
Introduction
I n the 1980s a new deadly disease began to spread like wildfire. Acquired immunodeficiency syndrome (AIDS) was weakening victims worldwide, who were then claimed by rare opportunistic diseases, and medicine was powerless against this killer. In May 1983, two different medical research teams both submitted their independent discoveries of the virus which they each believed caused AIDS, to the journal Science. Both papers appeared in the same issue, Dr. Luc Montagnier’s team in France naming the offending virus lymphadenopathy-associated virus (LAV); and US-based Robert Gallo and his team calling theirs human T lymphotropic virus type III (HTLV-III). Within a year, it was shown that both teams had identified the same culprit, and in 1986 the name human immunodeficiency virus – HIV – was adopted.
Since the first cases were reported in the early 1980s, it is estimated that more than 25 million people worldwide have died of AIDS. The Health Protection Agency states that by the end of 2011, an estimated 96,000 people were living with HIV in the UK, including 22,600 who were still undiagnosed.
While those numbers seem large, the treatment of HIV has come a long way in the last 30 years, and it is no longer the death sentence it was once. Many early cases of AIDS manifested as rare strains of pneumonia and unusual cases of cancer that originally baffled doctors. Over the years, they were discovered to have been mere symptoms of the underlying lowered immunity of the patients, and a cocktail of carefully developed drugs has since extended the life expectancy of someone with HIV to decades, from the few short months it once was.
HIV-research hit a huge milestone in 2007. The Berlin Patient – also known as Timothy Ray Brown – was the first person to be reportedly functionally cured of HIV, following a blood stem cell transplant. Dr Gero Huetter, a blood cancer expert working at the University of Berlin, was treating Mr Brown’s leukemia, when he saw an opportunity to hit two birds with one stone and sought a donor with a particular genetic mutation which was resistant to HIV.
Although skepticism still remains about whether the patient was truly cured of HIV, his longevity speaks for itself. Such a method isn’t necessarily viable for most people, but its existence paid testament to the fact that treatment for HIV was reaching new heights.
Fast-track to 2013, and we have already seen a baby ‘functionally’ cured of HIV through very early treatment, an approach which was later echoed by French researchers who treated a group of patients known as the Visconti cohort and found that early treatment could control the virus without the need for drugs in between five and 15 percent of cases. This May, Danish researchers began testing a new technique using histone deacetylase (HDAC) Inhibitors to treat HIV.
Social attitudes to HIV have also begun slowly changing; once considered a disease for homosexual men or drug addicts who risked becoming infected through their lifestyle choices, statistics and research have helped people understand and accept that this is not the case. In 1999 in the UK for the first time heterosexual intercourse accounted for a greater proportion of the HIV diagnoses than men having sex with men (MSM), at around 1,500 presented cases. In 2004 the diagnoses from heterosexual intercourse were at an all-time high of just under 5,000, whereas MSM cases were almost half of that, and by the end of 2011 both had dropped to below 3,000.1
Slowly but surely people were realising that HIV is neither as contagious as feared nor something only those with certain interests was susceptible to. Between 2011 and 2012, the Special Immunology Services (SIS) clinic at McMaster University Medical Centre registered 478 new patients, 36 percent of whom were women. That was a six percent rise from the previous year, and compared to 1996, when women accounted for just nine percent, was a big jump.
“We’ve seen a dramatic increase in HIV rates among women,” says Dawn Elston, who was a research co-ordinator at McMaster University for 12 years and worked on a cohort study with the Ontario HIV Treatment Network. “We’ve seen the epidemiology change and women are quickly catching up.”
In the UK, the numbers of men diagnosed with HIV have been higher than those of women since the 90s, and has remained