Spotlight in the Field: The AIDS Epidemic

In 1981 Dr. Michael Gottlieb, a doctor at the UCLA medical center, identified five patients suffering from Pneumocystis carinii pneumonia. The patients exhibited strikingly similar symptoms, they were active homosexuals, aged between 29 and 36, and had almost zero T cells. By December of 1981 270 similar cases were identified and most were in young male homosexuals leading officials to name the disease Gay Related Immunodeficiency Disease (GRID). However, as epidemiological studies progressed and the disease spread, experts discovered that GRID did not occur in just homosexuals. In fact, by the end of 1982 42% of the 788 cases could not be attributed to homosexual activity, drug use, or blood transfusions.

Despite the increasing spread of AIDS, experts remained unsure of the causative virus that resulted in AIDS. Dr. Luc Montagnier, from England showed convincing evidence that the causative agent was lympadenopathy-associated virus (LAV), however, Dr. Gallo, of the National Cancer Institute, claimed the virus was most closely related to Human T Lymphotrophic Virus-1 (HTLV-1). The debate continued to rage until Dr. Gallo and the Secretary of the Health and Human Services announced that HTLV-III, a strain closely related strain HTLV-I, was the cause of AIDS in North America. Dr. Montagnier and the Pasteur Institute continued to claim that LAV caused AIDS and by 1985 research showed that LAV and HTLV-III were genetically identical. Later, the Center for Disease Control (CDC) would show that 90% of all AIDS patients had antibodies for LAV. Also, in 1985 Dr. Jay Levy demonstrated that a distinct retrovirus, called AIDS-Associated Retrovirus (ARV), caused AIDS in a significant population of gay men. Officials renamed HTLV-III, LAV, and ARV to Human Immunodeficiency Virus (HIV).

In 1986 Zidovudine (AZT) was demonstrated to have antiretroviral capabilities specifically targeted at the HIV virus and by 1987 the Food and Drug Administration (FDA) approved the use of AZT in the United States. Still the number of AIDS cases rose; 62,811 cases were reported in over 127 different countries. Numerous countries began coordinated education campaigns in the 80's to prevent the spread of AIDS. The United States, however, was the last Western industrialized country to make such an effort. President Reagan made the first public address on the AIDS epidemic, at which point 20,000 Americans were already claimed by the virus. In 1987 the Surgeon General issued a pamphlet which was distributed throughout the United States describing the methods of transmission and precautions. Still employers and institutions continued to discriminate against individuals with AIDS claiming they were a liability.

In 1990 Ryan White, a hemophiliac and AIDS patient was not allowed to attend public schools died. His death inspired congress to pass the CARE Act, which was aimed to provide quality health care to AIDS patients without adequate insurance. By the end of 1990 there were 9 million projected HIV patients world wide and 1 million AIDS patients. Among the most famous cases were Ervine (Magic) Johnson and Arthur Ashe who declared they had AIDS in 1992 and 1993 respectively. AIDS became the leading cause of death in 1994 with more than 250,000 deaths and 440,000 AIDS cases. At the same time scientists produced increasing drugs against HIV, including the discovery that three different types of drugs, which act at different sites of the virus, were more effective than one drug. Despite the new drug therapies and increasing optimism the number of AIDS cases continued to climb. By 1997 it was estimated that nearly 2.7 million people died of AIDS and 30 million people had contracted the disease.

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