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HIV – It’s Still Not Under Control…

By Claudia M. Huether-Franken Découvrir les sciences de la vie

December 1st – It’s World AIDS Day. HIV is no marginal issue. AIDS concerns all of us - let’s consider the status quo, the future prospects and new medical developments.

Most people won’t even be aware of their time of infection. The first symptoms, which occur shortly afterwards, are inconspicuous. Chills, fever and muscle aches, sometimes accompanied by swollen lymph nodes or a rash – an early HIV infection feels more or less like flu. Following this initial illness, infected persons may remain symptom free for many years. During this time, they will be unaware that they are contagious – an explosive combination for spreading the disease.

Disseminated worldwide

HIV, the human immunodeficiency virus which causes acquired immune deficiency syndrome, or AIDS, is a global challenge. UNAIDS, the Joint United Nations Program on HIV/AIDS, annually analyzes the worldwide status of the fight against the HIV virus. According to their latest statistics, nearly 40 million people are living with HIV globally, only 17 million of whom have access antiretroviral therapy. Furthermore, it has not yet been possible to significantly reduce the number of new infections. Over the last 5 years, about 2 million people have been annually infected with the virus, the vast majority living in sub-Saharan Africa. In reality, HIV infection rates are actually increasing for girls and young woman in Africa as well as generally in Eastern Europe.Since the HIV epidemic started in the early 1980’s, around 80 million humans have been infected. More than 35 million people have already died from AIDS- related illnesses. This year at the World AIDS Conference, experts have made it their mission to stop AIDS by 2030.

Protection is the best weapon

In the first years of the epidemic, AIDS was clearly linked to homosexual men. A few years later, however, many HIV infections occurred through the use of contaminated blood during transfusions. Nowadays, blood products are tested regularly in most of the world’s countries. The HI virus is now primarily spread through unprotected sex, from mother to child during pregnancy, birth and breast-feeding or through the sharing of needles by drug users.The conscientious use of condoms is the most powerful protection against sexual transmission of HIV. The infection rate can be minimized in all other risk groups as well. The mother-child transmission rate, for example, is less than 1 % when the mother is in antiretroviral therapy andforegoes breast-feeding. Public facilities for the distribution of free needles will also help to reduce the chances of hard drug addicts being infected with HIV.

Diverse progression

A typical HIV infection follows no set course. It differs from one patient to another and is often characterized by several distinct phases. Long periods without symptoms may occur between individual bouts of illness. This reflects the interaction of the virus with the human immune system. The HI virus destroys the immune system by entering and knocking out CD4 T helper cells. These cells are very important for defending immunity as they provide a control mechanism for other cells within the system, thus providing resistance against pathogens. As long as patients have enough working CD4 cells, they remain symptom free. In the end, however, the complete immune system breaks down when most of the helper cells become infected. At this time the patient will simultaneously develop multiple bacterial, viral and fungal infections and associated tumor diseases.

Research provides hope

Up until now there has been no cure or vaccination available for HIV. However, British researchers have found a method of targeted intervention to combat the disease. This novel approach allows the virus in all parts of the body to be located and then specifically destroyed. It is currently being tested on an HIV infected volunteer. Even though further studies are required and will take many years, the current findings are promising in the search for a cure to AIDS.