INTRODUCTION
No other word engenders as much fear, revulsion, despair and utter
helplessness as AIDS. It is, in fact, rewriting medical history as
humankind`s deadliest scourge. With 40 million deaths forecast in this
millennium, statistics tell their own sordid tale.
The first recorded sample of HIV was discovered in 1959 in a blood
specimen obtained at Leopoldville (now Kinshasa) in the Belgian Congo.
This was the first known
death
chalked up by AIDS. The virus is thought to have originally affected
chimpanzees. The crossover from animals to humans may have occurred in
the 1950s through an accident or a bite.
Intermittently, other theories of its origins have been advanced. One
theory, put forward by Bette Korber, traces the disease to a single
viral ancestor that could have emerged between 1910 and 1950. Through an
analysis done at the Los Alamos National Lab in New Mexico, Korber
contends that the pandemic may have come from one or more infected
humans around 1930.
Another highly controversial—but plausible—theory is that of American
philosopher, Louis Pascal, first spelt out in 1987. All the early
AIDS
cases originated in the Central African states of Congo, Rwanda or
Burundi. This belt was subjected to trials of a live polio vaccine on
300,000 men, women and children..
Pascal argued that the vaccine, which was grown in cultures obtained
from chopped up chimpanzee kidneys, may have carried this virus. Polio
researcher Dr Albert Sabin had reported that such a batch was
contaminated by an unknown virus. In fact, monkeys harbor SIV or simian
immunodeficiency virus (SV-40 to be more specific), which is thought to
be the ancestor of HIV..
The first cases of
AIDS
were reported in the United States in 1981, amongst male homosexuals in
Los Angeles and New York. Within two decades, up to 50 million may have
been infected globally, approximately 22 million have succumbed and
nearly 15,000 new infections are said to occur daily..
What Is Aids & HIV
HIV has two major categories: HIV-1 and HIV-2. HIV-1, which currently
has about 10 subtypes, is most common worldwide and the only form found
in the US. HIV-2 is less virulent and though currently confined to West
Africa—it`s spreading.
The Human Immunodeficiency Virus (HIV) basically provokes an infection, which destroys the body`s immune system. And
AIDS
or Acquired Immune Deficiency Syndrome is the advanced stage of this
disease, when the immune system becomes irreparably damaged, engendering
multiple infections and cancers. A person is considered HIV positive
when s/he tests positive for any of the 26 diseases (Kaposi`s sarcoma,
lymphoma, pulmonary tuberculosis, recurrent pneumonia within a 12-month
period, wasting syndrome and other indicators) that can easily invade
the body during our immune system`s nonfunctionality.
On invading the body, the virus specifically attacks T-cells. A core
part of the human defence system, they mobilize other cells to seek and
destroy contagious foreign elements besides leading the immune system`s
fight against infections. T-cells are targeted because the
AIDS virus parasitizes the CD4 molecules on their surface.
With a protective outer shell of proteins and glyco-proteins, the
AIDS
virus contains genetic information on the inside. Although
substantially smaller than the host T-cells—the virus reproduces by
sponging off the host`s cellular resources! Our body fights back by
producing up to two billion new T-cells to replace the infected ones,
stabilizing the T-cell count temporarily. Yet from day one, the T-cells
fight a losing battle.
The genetic information of the
AIDS
virus, which is encoded as RNA (ribonucleic acid), needs to be reverse
transcripted—which the intruder accomplishes with the help of the host
cell itself! The now legible DNA is thereafter randomly transferred into
the nucleus. All this is accomplished barely a dozen hours following
the infection. By this time, the aggressor begins to substantially
weaken the host cell, which eventually dies, eroding the immune system
and making the body vulnerable to diseases.
Although HIV targets T-cells and other cells in the body, it thrives
mainly in the lymph nodes—another important part of the immune system.
Each lymph node has a netlike structure inside it that acts as a
protective filter by trapping virus and infected T-cells. But as healthy
T-cells move through contaminated lymph nodes, they are infected by
HIV. Particularly during the early stage of the disease, lymph nodes
contain more infected cells than the blood.
Symptoms
In the early stages, a mild flu and swollen glands are typical. But the symptoms are often unmistakeable when full-blown
AIDS
develops. Loss of appetite, weight loss, constant fever, prolonged
fatigue, diarrhea, constipation, changing bowel patterns, swollen
glands, chills coupled with excessive sweating, especially at nights,
lesions in the mouth, sore throat, persistent cough, shortness of
breath, tumours, skin rashes, headaches,
memory lapses, swelling in the joints,
pain in various parts of the body, vision problems and a regular feeling of lethargy and ill
health make up the litany of symptoms.
With immune systems out of kilter, HIV-positive persons are susceptible
to several types of cancer, particularly Kaposi`s sarcoma (KS), an
uncommon form that occurs under the skin and in the mucus membranes of
the eyes, nose and mouth. Affected persons have lesions that appear as
dark-coloured raised blotches. Though the lesions are painless, once KS
spreads to the lungs, lymph nodes and digestive tract, the victim
experiences difficulty in breathing, gastrointestinal bleeding and
painful swelling around the lymph nodes, especially in the legs.
Modes Of Transmission
HIV is transmitted primarily by sex (anal, vaginal or oral sex with an
infected partner), by injections (sharing contaminated needles for drug
use or accidental piercing with a contaminated needle), or from infected
mother to child through pregnancy or breast-feeding.
Infected semen and vaginal fluids, infected blood and blood products
lead to the transmission of HIV. Drug abuse with unsterilized needles is
another high-risk activity. Unprotected sex with multiple partners is
the primary cause of infection. During unprotected sex, the infected
fluid could enter the bloodstream through a tiny cut or a sore. Anal
penetration has a higher risk of transmission, which is why a high
percentage of homosexuals develop the disease. Bleeding during sex also
raises the chances of infection. Therefore unprotected sex during
menstrual periods and anal intercourse are best avoided.
An infected mother can also transmit the virus to her baby before or
during birth or through breast milk. Although traces of HIV have been
detected in body fluids (saliva, urine, faeces and tears) there is no
evidence that HIV spreads through these fluids. Nor is it water-borne,
air-borne or transmitted through mosquitoes and other insects.
Some HIV-infected patients progress to
AIDS
quickly while others can remain healthy for 10 years or more. Between
initial infection and full-blown disease, a middle phase called
symptomatic HIV infection, or AIDS-related complex (ARC), occurs,
prompting symptoms such as weight loss, diarrhea, and swollen lymph
glands.
Scientists have recently discovered clues to why some patients develop
AIDS
quickly. In a study published last March in the journal Science,
National Cancer Institute researchers found that inherited genes may set
the clock for
AIDS
progression. Certain gene patterns tend to stave off AIDS, while others
promote it. The researchers say the study may help lead to an
AIDS-preventive vaccine or improved therapies against the virus.
Gender Differences in the Risk of HIV Infection
HIV risk factors among injection drug users (IDUs) differ markedly by
gender, according to a 10-year study funded by the National Institute on
Drug Abuse (NIDA). A recent study by researchers at the Johns Hopkins
University reported that while drug-related risk behaviors and
homosexual activity are the most important predictors of HIV
seroconversion among males, factors consistent with high-risk
heterosexual activities are the main predictors among females. The
findings, reported in the May 28 (2001) issue of the Archives of
Internal Medicine, provide insight into the
relationship between gender and high-risk sexual behaviors in the development of HIV infection.
"Early studies of injection drug users suggested that most HIV infections were due primarily to
sharing
needles," said NIDA Director Alan I. Leshner, Ph.D. "This study adds to
the body of evidence that supports the need for gender-specific
interventions in the treatment of that group of drug users."
Between 1988 and 1998, a team of researchers, led by Dr. Steffanie
Strathdee at the Johns Hopkins University Bloomberg School of Public
Health, examined both drug related and sexual risk factors for HIV
transmission in a study of more than 1,800 injecting drug users in
Baltimore, Maryland. Study participants were aged 18 or older, did not
have an
AIDS
defining illness at enrollment, and reported a history of illicit
injection drug use within the previous 10 years. Through semiannual
interviews, researchers collected data on drug use history,
sociodemographics, and drug use and sexual behavior within the last 6
months. Blood samples were also obtained at each study visit.
Researchers used commercial HIV and antibody ELISA to identify those
participants who had become HIV positive since their last visit.
Dr. Strathdee and her colleagues found that the greatest predictor for
HIV seroconversion among both male and female IDUs was high-risk sexual
behavior. Study findings revealed that male injection drug users who
reported recent homosexual activity were four times more likely to
become infected with HIV.
Among females, indicators of high-risk heterosexual activity outweighed
needle-sharing behaviors as independent predictors of HIV
seroconversion. HIV incidence was more than two times higher among women
who reported recently having sex with another injection drug user.
Another common predictor of HIV seroconversion observed by researchers
among both male and female IDUs was younger age. Investigators found
that IDUs who were aged 30 or younger at enrollment were more than twice
as likely to seroconvert than those aged 40 or older.
"This is consistent with several reports which indicate that younger IDUs are more likely to engage in needle
sharing and other behaviors that place them at higher risk of acquiring HIV and hepatitis B or C viruses," stated Dr. Strathdee.
Prevention
While
AIDS
is a high-risk disease it can be prevented if proper precautions are
taken and greater awareness meted out to those who are ignorant of the
virus and its repercussions on the human body. Here we have listed a few
measures which can be adopted by everyone inorder to stave off the
insidious entry of HIV.
• Prevention is still the best bet. Promiscuous sexual behavior can
leave a person highly susceptible to contracting the virus. Where
abstinence is not possible, always use latex condoms. The female condom
can also help protect both partners. Use only water-based lubricants.
Oil lubricants (such as Vaseline) might even tear latex condoms. Use
spermicidal (birth control) foams and jellies in addition to condoms. By
themselves, spermicides may not be effective in preventing HIV.
• Avoid alcohol or drugs during sex, you might lose control of your
senses and engage in unsafe sex. Stick to safer sex practices at all
times and avoid having multiple partners. Practice monogamy. If this is a
tall order, serial relationships are a lesser evil than multiple ones
• High-risk sexual behavior should be avoided at all costs. These
include: oral genital sex involving contact with semen or vaginal
fluids, oral anal sex, vaginal sex without a condom, anal sex sans a
condom (active or passive), fisting or manual anal intercourse, the
sharing
of sex toys, using saliva for lubrication and blood contact of any kind
during performance. If unable to resist oral sex, use a dental dam. If a
woman is infected, avoid sex during the menses as menstrual blood is
infectious
• For transfusions, use disposable syringes and needles. Ensure you get
blood that is screened and certified as HIV-free. Better still, get
blood from close family members rather than professional donors whose
medical antecedents are nebulous
• The presence of sexually transmitted diseases (STDs) increases the
risk of contracting HIV from an infected partner. STDs could cause
breaks in the skin of the vagina, penis or anus permitting the virus to
enter your bloodstream. If you ever contract an STD of any kind, ensure
you get prompt treatment.
• The CDC recommends that an HIV-positive woman should not breast-feed
her baby. The infant should be given AZT for the first several weeks to
substantially reduce the risk of infection.
Myths & Facts
Say `AIDS` and dime-a-dozen misconceptions abound. The chart topper is that
AIDS
is supposedly a disease of gay men and intravenous drug users. The
facts are otherwise. No doubt in the early years many HIV-positive cases
were reported amongst the Western gay community. In recent years,
however, prevalence rates among gays have leveled off. Instead,
heterosexual transmission has been forging ahead of all other modes of
transmission.
The
AIDS virus is NOT contracted through touching, hugging, kissing, massage,
sharing
toilet seats, drinking or eating from utensils used by an infected
person or any other mode of casual contact. Nor does working,
socialising and living with infected people cause the disease.
Repeated sexual contact without proper precautions with an infected
person, using an infected syringe, exposure to infected blood or sexual
fluids are ways through which the disease can be transmitted.
Donating blood also does not run the risk of disease contraction since
needles used for such purposes are always sterile. Since the
AIDS
virus is unable to survive outside the human body beyond a short
duration, dried blood is not infectious For this reason, mosquitoes are
incapable of transmitting HIV as the virus cannot replicate itself in
the intestine of insects.
Although medical personnel are potentially at risk from infection, this
is minimal if protective gear such as gloves, masks and goggles are
always used when handling potentially infected material.
The Elusive Cure
The large-scale infections and deaths have spurred a spate of worldwide efforts for a cure. In the US, however,
AIDS cases are said to be dropping and new infections leveling off. Mortality from
AIDS is also dropping.
In the developing countries, though, the cases continue to rise
alarmingly. Globally, three million died in the year 2000, with 5.3
million newly infected people, 95 percent of whom might die.
Many scientists, doctors and researchers contend that
AIDS
is not a new disease, having been around much longer than people
believe. Dr. Robert Willner—author of Deadly Deception: The Proof That
Sex and HIV Absolutely Do Not Cause AIDS—asserts that HIV is not the
cause of AIDS. He claims that nearly 500 hundred top scientists of the
world have challenged the hypothesis of Robert Gallo—who patented the
HIV test the day after the
AIDS virus was discovered—that HIV is the precursor of AIDS.
Besides other telling facts, the dissenters want to know how one can explain HIV-free
AIDS cases, of which there are said to be nearly 5,000 on record.
Dr. Frank Shallenberger, a licensed medical and homeopathic
practitioner, says that statistics are only a correlation—not a
result—that HIV is one cause of AIDS, citing the fact that some
AIDS victims do not have HIV antibodies. Dr. Shallenberger considers
AIDS a multifactorial disease that strikes when the immune system is down.
The search for a cure, also brings to light other interesting facets.
African chimpanzees have been harboring the simian equivalent of the
AIDS
virus for centuries, according to detailed studies conducted by
researches at the University of Alabama in Birmingham. Why don`t the
chimps succumb to the virus?
Says Dr. Anthony Fauci from the National Institutes of Health: "There
must be something about the chimp`s immune system or some host defense
system that is doing a very good job of containing the virus. If we find
that out we may be able to extrapolate to humans."
Chimpanzees being the closest living relatives of humans, their DNA
differs from human DNA by less than two percent. Adds Dr. Fauci: "It`s
entirely conceivable that the very small genetic differences between the
chimp and the human will explain why the chimpanzee does not get sick
and the human does."
