HIV & AIDS

Not so long ago, people didn’t give much thought to their immune systems. Then AIDS came along. In the early 1980s, reports of the first cases of this intractable disease, caused by the then-unknown human immunodeficiency virus, or HIV, provided the wake-up call. Although there have always been immunodeficiency diseases, in the past most were the result of rare inherited disorders or inadvertent side effects of drug treatments, such as chemotherapy.

Not so with HIV. Spread primarily through sexual contract or infected blood products, HIV turned out to be a relentless insurgent, ravaging the immune systems of most people who came in contact with it. Over time, by destroying the cells that direct the rest of the immune system (the helper T-cells or CD4 cells), HIV makes it harder and harder for an infected body to fight off certain cancers and infections. As the disease progresses, bacteria, viruses and other microbes that would rarely harm a healthy person can explode into severe, sometimes fatal, infections.

Technically, a diagnosis of HIV infection becomes an AIDS diagnosis only after blood tests show that an infected person has fewer than 200 helper T-cells per microlitre of blood. (Healthy adults usually have 1000 or more t-cells per microlitre of blood.) Without treatment, the number of CD4 cells drops over time, the patient becomes more and more immunosuppressed and develops severe infections. Many of the more than 35 million or so people worldwide now infected with HIV are so debilitated they can’t hold down a job or even do household chores. Some of them experience periods of intense, life-threatening illness followed by periods of normal functioning. But a very small number of patients with HIV show no outward evidence of infection at all, even 18 years or so after contracting the virus.

What does the future holds AIDS / HIV patients?

Protease inhibitors, a new class of anti-HIV drugs, have increased life expectancy and reduced illness episodes for many AIDS patients. Scientists are now trying to find out how long-term survivors are different and why they are protected. On other fronts, a flurry of research is focusing on creating the next generation of antiviral drugs, including ‘fusion inhibitors’ that cripple HIV’s ability to attach to and disable white blood cells. Although there are no absolute answers or solutions yet, the fervent desire to stop the rapid spread of HIV has shed much light on the secrets of the immune system – knowledge that is already helping to prolong life and promote health for all, not just those with HIV.

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