Living With Aids–20 Years Later Part I
Living With Aids–20 Years Later Part I
One of the most devastating epidemics in human history began with little fanfare in 1981 when the U.S. Centers for Disease Control and Prevention quietly released a nine-paragraph report detailing five cases of an unusual disease in gay men.The disease in the report, which came to be known as AIDS, soon would grab headlines nationwide. In the years since, its never let go. Shortly after the reports release, doctors and scientists worldwide rapidly realized they were up against a new and little-understood viral foe with an almost sinister ability to outwit that most powerful of disease fighters–the human immune system. In turn, public fears mounted as news reports detailed the lack of medical weapons with which to assault this new, frightening disease and its potential to spread to those previously not thought to be at risk.
In the past two decades, many of these fears have been realized. AIDS has indeed become a 21st century plague. Fifty-eight million people worldwide have been infected with HIV, the virus that causes AIDS, according to the Joint United Nations Program on HIV/AIDS. Twenty-two million have died after the virus rendered their immune system nearly defenseless, leaving them open to some types of cancer, nerve degeneration and opportunistic infections such as tuberculosis and pneumonia that physicians once thought were under control.Over the past 20 years, AIDS has become a part of life everywhere on the planet. Few people have been unaffected by its tragic toll, and it remains one of the most feared of all infections. Thats not likely to change as the third decade of AIDS begins. Despite medical advances, a cure is elusive. AIDS is a serious, difficult-to-treat and ultimately fatal disease, though the outlook for those living with it has steadily improved in the United States as new drugs have gained approval from the Food and Drug Administration.Twenty years of public discussion about AIDS has also yielded slow progress in the ongoing debate about how to fight the disease and care for those who have it. Today, the financial, political and social issues that stem from AIDS are discussed as much as its symptoms, and those issues grow more complex each year.Simply put, “AIDS remains a challenge for us all,” says Keith Henry, M.D., an internationally known researcher and clinician at the University of Minnesota and Hennepin County Medical Center in Minneapolis.
Understanding the VirusAlthough AIDS was first recognized in 1981, HIV, the human immunodeficiency virus that causes AIDS, was not identified until 1983. Since then, researchers have been studying how the virus attacks and replicates itself inside cells of the immune system.HIV is a virus–essentially a submicroscopic parasite consisting of a core of RNA wrapped in a protein coat–that cannot replicate without invading living cells. At its most basic, a virus takes over the cells mission control center to make the cell do HIVs bidding instead of functioning normally. Viruses responsible for influenza and the common cold operate similarly. However, while cold and flu viruses can make people miserable for a time, in healthy people they are usually defeated handily by the immune system.HIV is different. It directly attacks the cells of the immune system, the bodys defense system. Specifically, HIV goes after a type of immune cell called the CD4 lymphocyte. CD4 cells play a crucial role in the immune system because they coordinate the attack by white blood cells and antibodies on viruses and other body invaders.HIV has a stealthy ability to escape detection as an enemy by CD4 cells. It then attaches to these cells and enters them. Once inside, the viruss genetic material takes command of the CD4 cell and forces it to make copies of the virus.New copies of the virus burst forth from the cell, which then dies, and go in search of other cells to invade. The cycle continues again and again, with up to10 billion new HIV virus particles produced every day by the commandeered cells. About 2 billion new CD4 cells are needed each day if this process is to be kept in check.But the body cant keep up. In fact, the number of CD4 cells drops off sharply as HIVs foothold in the body strengthens. The body becomes unable to protect itself not only from HIV, but also from other viruses, bacteria, fungi and parasites. This is when someone infected with HIV develops Acquired Immune Deficiency Syndrome, o…
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