HIV/AIDS is an infectious disease. The letters
stand for Human Immunodeficiency Virus, which is the name
of the organism that causes this disease, and Acquired Immune
Deficiency Syndrome, which is the name of the set of symptoms
that characterize this condition.
AIDS was first recognized as a new disease
in 1981, when a number of young gay men in New York and
Los Angeles were diagnosed with symptoms not usually seen
in individuals with healthy immune systems. This information
was reported to the Centers for Disease Control and Prevention
(CDC), the branch of the U.S. government that monitors and
tries to control disease outbreaks.
Many new cases were soon discovered of what
appeared to be a disease associated with the breakdown of
the body's immune or natural defense system.
Normally, the immune system, which consists
of a wide array of cells that can identify and eliminate
invading bacteria, fungus, viruses and other disease-causing
pathogens, is able to protect us from harm. One part of
the immune response involves the creation of antibodies,
which are chemical substances that fight against infectious
agents.
"Opportunistic" Infections
If there is damage to our immune system, however, antibodies
and other bodily defenses may not be produced and we are
subject to many different infectious diseases, including
those called "opportunistic infections" that are
usually only able to strike when the body's defenses are
weakened.
Although the first cases of the disease
that came to be called AIDS were among homosexual men, within
a few months the same strange set of symptoms was being
seen in female patients and hemophiliacs, and before long
injection drug users and their non-drug using sex partners
and children also were being diagnosed with AIDS. It became
clear to the CDC that we were facing a significant new epidemic.
A Worldwide Health Threat
Before long, it was recognized that AIDS should be labeled
a pandemic because it was not limited to a certain region
or country but was truly a worldwide health threat of massive
proportions. Since the beginning of the pandemic, several
million people around the world have died of AIDS.
Since its discovery, scientists immediately
began trying to find the cause of AIDS and to understand
how it so severely damages the human immune system. By 1983,
French and American teams lead by Dr. Luc Montagnier and
Robert Gallo developed a blood test to detect exposure to
HIV.
People who have been exposed to the virus,
which means that it is in their bodies, are said to be HIV
positive, while those who have not been exposed are HIV
negative. This is what the standard HIV blood test (or antibody
test) reveals. The test tells whether or not your body has
begun creating antibodies targeted to fighting HIV. Unfortunately,
while the body mounts a strong defense against HIV, it appears
that in most cases the body alone cannot successfully defeat
the virus.
It is now known that after HIV has entered
a person's body, he/she can live for a number of years without
having any noticeable symptoms. Individuals in this stage
of the disease have HIV infection but not AIDS per se.
AIDS-Related Infections Are Growing
Once an infected individual begins to develop the set of
opportunistic infections associated with immune system damage,
they are defined medically as having AIDS. In recent years,
the number of opportunistic infections known to be associated
with AIDS has grown.
Currently, 26 different clinical conditions
are used in defining whether or not a person has developed
AIDS. Also, as scientists came to recognize how HIV affects
the human body, an additional defining feature of AIDS based
on the health of the person's immune system was added to
a physician's diagnostic guide.
Prior to the discovery of new treatments
for AIDS, most people who were infected with HIV eventually
developed full blown AIDS and most of these individuals
died of this disease. However, there are some strains of
HIV that are not as lethal as others, and scientists are
attempting to understand variation in the virus and the
ability of the immune system to respond to viral infection.
As the name HIV implies, the disease is
known to be caused by a specific virus. Viruses are a curious
type of phenomenon. In a sense, they are only partial organisms
in that they must live inside another organism or host.
Otherwise they are dormant. Moreover, their entire existence
is focused on spreading from one host to another and on
reproducing themselves.
What Happens in the Body
When HIV enters a human body, it tends to seek out and attack
a particular group of white blood cells commonly known as
the T-helper cells. These cells are part of the body's immune
system.
When the body is invaded by a pathogen,
there is a rapid increase in the production of T4 cells,
which is the body's signal that a pathogen is present and
an immune response must be mounted for protection. Unfortunately,
HIV interferes with this process.
When HIV encounters a T4 inside the blood
system, it attaches itself and inserts its genetic code
into the T4. In this way, the T4 is transformed into a biological
factory that begins producing new HIV.
Ultimately, the T4 cell bursts, releasing
new virus into the blood stream, and these, in turn, seek
out other T4 cells to invade. In the process of its own
reproduction, HIV destroys the ability of the body to fight
infection, leading to illness and possible death.
HIV/AIDS has generated a considerable amount
of controversy. Because the disease was first diagnosed
in homosexual patients, some people assumed that it was
somehow a peculiarly homosexual disease, perhaps a consequence
of sexual or other practices common among homosexual men.
This proved to be quite inaccurate. HIV is a blood-borne
disease, meaning that the natural environment of the virus
is human blood. Any behaviors that result in blood and other
body fluids like semen or breast milk passing from one person
to another can transmit the virus between people.
How AIDS Is Transmitted
Most homosexual men with HIV became infected through sexual
contact with other men, but there is nothing specifically
"homosexual" about HIV/AIDS. Many men and women
around the world have been infected with HIV through heterosexual
contact. It appears that some factors, such as having another
sexually transmitted disease like syphilis, or engaging
in sexual practices that tear the skin lining of participants'
sexual organs, may significantly facilitate infection occurring
during sex.
Another common way HIV is transmitted is
through injection drug use, specifically the sharing or
reuse of hypodermic syringes or other injection paraphernalia.
When drug users inject, their blood often enters the syringe.
If they are infected with HIV, and should someone use this
syringe after them, the virus may be transmitted via the
syringe from the first to the second syringe user.
Other equipment used to inject illicit drugs,
such as the "cooker" (usually a bottle cap or
half of a soda can) in which drugs and water are mixed,
may also serve as a route of HIV transmission when people
"shoot up" drugs together.
One method for limiting HIV transmission
is syringe exchange, which involves providing drug users
with sterile syringes in exchange for their used ones. While
there is considerable research data showing that syringe
exchange is effective in limiting the spread of AIDS among
drug users, some people feel very uncomfortable with providing
drug users with syringes.
The public health debate over syringe exchange
is ongoing. Additionally, there has been controversy over
the ability of HIV/AIDS to be transmitted through casual
contact, such as shaking hands.
Casual Contact Not a Culprit
Further, some people have feared that mosquitoes or other
biting insects might transmit HIV. Considerable scientific
research has shown that HIV/AIDS is not transmitted through
casual contact unless blood from one person passes into
the body of the other.
Likewise, hugging, shaking hands with, or
even sharing eating utensils with a person infected with
HIV is not a risk for HIV infection, nor can biting insects
transmit the virus.
Finally, HIV is not and never has been transmitted
by donating blood. Prior to the treatment of the blood supply,
it was possible to become infected through receiving a blood
transfusion, but controls on blood banks in the U.S. have
all but eliminated this risk.
While HIV/AIDS is a significant health risk,
it is possible to protect yourself from becoming infected.
Proper use of latex condoms during oral, anal, or vaginal
sex, is the most effective way to avoid possible infection
for those who are sexually active.
Abstinence from sex is another approach,
although it is not one that many adults choose. When having
sex, it is important to accept that you cannot tell by looking
whether someone is infected with HIV/AIDS. AIDS does not
discriminate. It will infect rich and poor people, people
of all races and nationalities, gay and straight people,
men and women, adults and children.
A Tie That Binds
AIDS binds us all together in a common community of risk,
and demands that we all exercise appropriate health precautions
like condom use. For couples who are attempting to have
a child (and hence desire not to use a condom), HIV testing
can suggest with reasonable certainty whether you and your
partner have been infected.
Couples and individuals can use test results
in making decisions about proceeding or not with forgoing
condom use for the purposes of conceiving a child.
While transmission of HIV from an infected
mother to her unborn child was common earlier in the epidemic,
drugs like AZT have significantly lowered this form of HIV
transmission.
Additionally, a variety of new drugs and
drug combinations have become available in recent years.
Some of these drugs are very effective in treating the opportunistic
infections that are caused by HIV disease.
Others, like the protease inhibitors, are
effective in interfering with reproduction of the virus
and limiting the "viral load" or quantity of virus
in an infected person's body. These new drugs have allowed
many infected individuals to lead longer, healthier, more
active and productive lives.
Currently,
there is no vaccine to prevent HIV infection and there is
no cure.