The Big Question: What Do We Really Know About Aids?

World AIDS Day, observed December 1 each year, is dedicated to raising awareness of the global AIDS pandemic caused by the spread of HIV infection.

Here are some facts taken from The Independent, UK, 01.12.06
By Ben Chu

Remind me, what exactly is Aids?
Aids stands for Acquired Immune Deficiency Syndrome. This is a broad description of a variety of symptoms displayed by someone who has been infected by the Human Immunodeficiency Virus (HIV). It usually takes about a decade for someone who is "HIV positive" to develop full-blown Aids. Once they are infected, they are infected for life.

What does it do to the body?
The virus itself does not kill. HIV attacks a person's immune system, our natural defence system, fatally weakening it over time. To be more precise, HIV sabotages a specific immune cell, known as CD4 lymphocyte. This makes Aids sufferers especially vulnerable to infections. People with Aids often succumb to illnesses such as pneumonia that a healthy person would normally be expected to fight off. Without treatment, the average survival time after developing Aids is 10 months, but in individual cases it can range from two weeks up to 20 years.

Where did it come from?
Wild chimpanzees is the most likely theory. Cases of human infection were recorded in Kinshasa, the capital of the Democratic Republic of Congo, in the 1930s. It is believed that people hunting chimpanzees in neighbouring Cameroon may have contracted a mutation of the Simian Immunodeficiency Virus (SIVcpz) that managed to jump the species barrier.

Earlier this year, a team of scientists from the universities of Nottingham, Montpellier and Alabama identified a natural reservoir of SIVcpz in chimpanzees in southern Cameroon. According to Paul Sharp, professor of genetics at the University of Nottingham: "When you consider that HIV probably originated more than 75 years ago, it is most unlikely that there are any viruses out there that will prove to be more closely related to this human virus."

Why did it take so long for us become aware of it?
The relative rarity of cases and the fact that symptoms differ significantly between individuals meant the virus was not identified for another half a century. The condition first came to public attention when gay men in the United States began dying of routine illnesses in unusually large numbers. On 5 June 1981, the US Centers for Disease Control and Prevention recorded a cluster of pneumonia in five homosexual men in Los Angeles. So strong was the apparent link with homosexuals that it was at first labelled "Gay Related Immune Deficiency". But when it became clear that half of those affected were not gay, the term Aids was coined. The scientific breakthrough came in 1983 when HIV was isolated by Luc Montagnier of the Pasteur Institute in Paris, and then a year later it was confirmed by Robert Gallo of the US National Cancer Institute.

How prevalent is it?
Aids is a pandemic. According to the World Health Organisation and Unaids, the Joint United Nations Programme on HIV/Aids, some 40 million people are living with HIV around the world. And more than 25 million people are estimated to have died since 1981 as a result of Aids-related diseases. In 2005, around 2.8 million people died of Aids-related illnesses, 570,000 of them children. Meanwhile, approximately 4.1 million people were newly infected.

Sub-Saharan Africa is easily the worst affected region, with between 21 million and 28 million people suffering, 64 per cent of the world's total. But numbers in eastern Europe and Asia continue to rise. Ukraine and Russia are particularly badly hit. And India has overtaken South Africa as the country with the highest number of sufferers within its borders. In the UK, US and western Europe levels of infection have stabilised, but are showing disturbing signs of a resurgence in the gay community.

How is it transmitted?
The virus is passed through blood, semen, vaginal fluids and breast milk. Unprotected sexual intercourse with an infected person is the most common method of transmission. It can also be spread by contact with infected blood. HIV can cross from mother to child during pregnancy, childbirth or breastfeeding. Another common route is the sharing of needles. A person cannot catch HIV from toilet seats, or by touching, hugging or shaking hands with an affected person.

Is there a cure?
No. Scientists are working to find a vaccine, though 25 years of research has yet to yield any significant breakthrough. But HIV need not be an imminent death sentence anymore. There have been major advances in HIV treatment development. In 1996, highly active antiretroviral therapy (Haart), a daily cocktail of drugs, was introduced. This stabilises a patient's symptoms.

The result is that many people, although by no means all, can now live with HIV for decades.

Despite unpleasant side-effects such as nausea and diarrhoea, many of those taking these drugs have experienced a vast improvement in their general health and quality of life.

How can it be prevented?
Using a clean needle for the injection of drugs and using condoms in sexual intercourse.

Resistance, or ignorance, with regard to the second has been the most significant contributor to the rapid spread of HIV around the world. The Catholic Church has come in for a good deal of criticism for its opposition to the use of condoms on religious grounds.

How have public attitudes to the illness changed over the years?
Fundraising and lobbying by the gay community forced the media to take notice. In 1987, the National Aids Trust was set up by the Department of Health, and the Government launched its famous "Don't die of ignorance" campaign. The photographing of Princess Diana embracing an HIV sufferer in the same year did an enormous amount to lift the stigma from the condition.

The deaths of high-profile Aids victims such as Rock Hudson in 1985 and Freddie Mercury in 1991 also heightened awareness. The first international World Aids Day was held in 1988. The annual event has successfully projected Aids as a global problem, requiring a global solution.

Are there any grounds for hope?
Some. A survey by Unaids of 126 countries this year found the rate at which people are infected with HIV may have peaked in the late 1990s. The incidence of new HIV infections in some countries seems to have stabilised for the first time in 25 years. Six out of 11 African countries reported declines of at least 25 per cent in HIV prevalence among 15- to 24-year-olds in capital cities.

And this year Bill Gates, below, the world's richest man, pledged $287m (£155m) to try to speed up the development of a vaccine for the HIV/Aids virus. The money is being split into 16 grants for science teams across the world - with the aim that they work more collaboratively on new approaches. All the recipients have had to agree to share their findings - even if they had been working on competing projects. There are also signs that the Catholic Church is preparing to liberalise its views on condoms, which could have a significant impact on reducing the rates of infection among Africa's Catholic communities.

So have we reached a turning point?
Far from it. Many millions continue to die needlessly because antiretroviral drugs are extremely expensive and not widely available in many poor countries, despite the fact that it is in poor countries where Aids is most widespread. And drug companies are still resistant to the widespread production of cheaper generic versions of their patented antiretroviral drugs.

A UN target of getting antiretroviral therapy to three million people by 2005 was missed. Only one in five people around the world gets the drugs they need. Vast numbers will continue to be infected through ignorance too. The UN's Declaration of Commitment on HIV/Aids wanted 90 per cent of young people around the world to know about the disease by 2005. But surveys show that fewer than half have comprehensive knowledge of the nature of Aids and how to avoid it.

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It is amazing that we spend so much on space expeditions and military expenditure and other rubbish that no vaccine has been found for Aids and other various other threats to mankind.

The origins of Aids is fiercely debated. Here’s some useful reading:

Website: www.Advert.org
Article: The origin of HIV & the First Cases

Website: www.Aidsorigins.com
Google Video: Origins Of Aids (2003)