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. 2008:133–142. doi: 10.1007/978-0-387-75722-3_8

HIV/AIDS: Lessons from a New Disease Pandemic

M Essex 3, Yichen Lu 3
Editors: Yichen Lu1, M Essex1, Bryan Roberts2
PMCID: PMC7121503

Abstract

The acquired immunodeficiency syndrome (AIDS) was first recognized about 25 years ago (Gottlieb et al., 1981; Masur et al., 1981; Siegal et al., 1981). The best available evidence suggests that HIV newly infected the human species about 50–100 years ago (Korber et al., 2000). It did not originate in Asia. It apparently moved to people from sub-human primates in Africa (Keele et al., 2006; Kanki, 1997). Because of different clinical presentations in different populations of people, and a long incubation period, it was more difficult to diagnose than SARS or avian influenza.

As a new epidemic that originated in the era of modern medicine, it taught us many lessons about the difficulties that a new infectious disease can present. Already claiming at least 60–80 million victims, AIDS seems destined to continue as a pandemic for the foreseeable future. Drugs that control HIV replication and reverse disease progression have been developed, but none eliminate the virus from the body. Sexual transmission can be prevented by abstinence or condoms, but such measures, which prevent procreation, provide only limited value.

Approaches for making a vaccine using conventional techniques have failed. Most experts believe that an effective vaccine will be made eventually, but not for at least 10–20 years. We need to learn more about the immunobiology of acute HIV infection, and about potentially protective immunoepitopes, such as conformational intermediates of the virus envelope. Until a vaccine is available, there is little or no chance that HIV can be eliminated, or even drastically reduced in prevalence. AIDS has presented scientists, political leaders, and health policy experts with unprecedented challenges.

Keywords: Human Immunodeficiency Virus Type, Avian Influenza, Acquire Immune Deficiency Syndrome, Acquire Immune Deficiency Syndrome Patient, Disease Pandemic

Contributor Information

Yichen Lu, Email: yichenlu@hsph.harvard.edu.

M. Essex, Email: messex@hsph.harvard.edu

Bryan Roberts, Email: bryanr1@comcast.net.

M. Essex, Email: messex@hsph.harvard.edu

Yichen Lu, Email: yichenlu@hsph.harvard.edu.

References

  1. Barre-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, Dauguet C, Axler-Blin C, Vezinet-Brun F, Rouzioux C, Rozenbaum W, Montagnier L. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS) Science. 1983;220(4599):868–871. doi: 10.1126/science.6189183. [DOI] [PubMed] [Google Scholar]
  2. Brenner BG, Oliveira M, Doualla-Bell F, Moisi DD, Ntemgwa M, Frankel F, Essex M, Wainberg MA. HIV-1 subtype C viruses rapidly develop K65R resistance to tenofovir in cell culture. AIDS. 2006;20(9):F9–13. doi: 10.1097/01.aids.0000232228.88511.0b. [DOI] [PubMed] [Google Scholar]
  3. Clumeck N, Mascart-Lemone F, de Maubeuge J, Brenez D, Marcelis L. Acquired immune deficiency syndrome in Black Africans. Lancet. 1983;1:8325–642. doi: 10.1016/s0140-6736(83)91808-1. [DOI] [PubMed] [Google Scholar]
  4. Curran JW, Lawrence DN, Jaffe H, Kaplan JE, Zyla LD, Chamberland M, Weinstein R, Lui KJ, Schonberger LB, Spira TJ. Acquired immunodeficiency syndrome (AIDS) associated with transfusions. The New England Journal of Medicine. 1984;310(2):69–75. doi: 10.1056/NEJM198401123100201. [DOI] [PubMed] [Google Scholar]
  5. Daniel MD, Letvin NL, King NW, Kannagi M, Sehgal PK, Hunt RD, Kanki PJ, Essex M, Desrosiers RC. Isolation of T-cell tropic HTLV-III-like retrovirus from macaques. Science. 1985;228(4704):1201–1204. doi: 10.1126/science.3159089. [DOI] [PubMed] [Google Scholar]
  6. Doualla-Bell F, Avalos A, Gaolathe T, Mine M, Gaseitsiwe S, Ndwapi N, Novitsky V, Brenner B, Oliveira M, Moisi D, Moffat H, Thior I, Essex M, Wainberg MA. Impact of human immunodeficiency virus type 1 subtype C on drug resistance mutations in patients from Botswana failing a nelfinavir-containing regimen. Antimicrobial Agents and Chemotherapy. 2006;50(6):2210–2213. doi: 10.1128/AAC.01447-05. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Duesberg P. HIV is not the cause of AIDS. Science. 1988;241(4865):514. doi: 10.1126/science.3399880. [DOI] [PubMed] [Google Scholar]
  8. Eshleman SH, Hoover DR, Chen S, Hudelson SE, Guay LA, Mwatha A, Fiscus SA, Mmiro F, Musoke P, Jackson JB, Kumwenda N, Taha T. Nevirapine (NVP) resistance in women with HIV-1 subtype C, compared with subtypes A and D, after the administration of single-dose NVP. The Journal of Infectious Diseases. 2005;192(1):30–36. doi: 10.1086/430764. [DOI] [PubMed] [Google Scholar]
  9. Essex M, Mboup S. Regional variations in the epidemic. In: Essex M, Mboup S, Kanki P, Marlink R, Tlou S, editors. AIDS in Africa. 2. New York: Kluwer Academic/Plenum; 2002. pp. 629–638. [Google Scholar]
  10. Essex M, Hardy WD, Jr., Cotter SM, Jakowski RM, Sliski A. Naturally occurring persistent feline oncornavirus infections in the absence of disease. Infection and Immunology. 1975;11(3):470–475. doi: 10.1128/iai.11.3.470-475.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Essex M, McLane MF, Lee TH, Falk L, Howe CW, Mullins JI, Cabradilla C, Francis DP. Antibodies to cell membrane antigens associated with human T-cell leukemia virus in patients with AIDS. Science. 1983;220(4599):859–862. doi: 10.1126/science.6342136. [DOI] [PubMed] [Google Scholar]
  12. Essex M, McLane MF, Lee TH, Tachibana N, Mullins JI, Kreiss J, Kasper CK, Poon M-C, Landay A, Stein SF, Francis DP, Cabradilla C, Lawrence DN, Evatt BL. Antibodies to human T-cell leukemia virus membrane antigens (HTLV-MA) in hemophiliacs. Science. 1983;221(4615):1061–1064. doi: 10.1126/science.6603659. [DOI] [PubMed] [Google Scholar]
  13. Essex ME, McLane MF, Tachibana N, Francis DP, Lee TH. Seroepidemiology of human T-cell leukemia virus in relation to immunosuppression and the acquired immunodeficiency syndrome. In: Gallo RC, Essex M, Gross L, editors. Human T-Cell Leukemia/Lymphoma Viruses. Cold Spring Harbor: Cold Spring Harbor Laboratory; 1984. pp. 355–362. [Google Scholar]
  14. Francis DP, Curran JW, Essex M. Epidemic acquired immune deficiency syndrome: epidemiologic evidence for a transmissible agent. Journal of the National Cancer Institute. 1983;71(1):1–4. [PubMed] [Google Scholar]
  15. Gallo RC, Sarin PS, Gelmann EP, Robert-Guroff M, Richardson E, Kalyanaraman VS, Mann D, Sidhu GD, Stahl RE, Zolla-Pazner S, Leibowitch J, Popovic M. Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS) Science. 1983;220(4599):865–867. doi: 10.1126/science.6601823. [DOI] [PubMed] [Google Scholar]
  16. Gao F, Robertson DL, Morrison SG, Hui H, Craig S, Decker J, Fultz PN, Girard M, Shaw GM, Hahn BH, Sharp PM. The heterosexual human immunodeficiency virus type 1 epidemic in Thailand is caused by an intersubtype (A/E) recombinant of African origin. The Journal of Virology. 1996;70(10):7013–7029. doi: 10.1128/jvi.70.10.7013-7029.1996. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Gelmann EP, Popovic M, Blayney D, Masur H, Sidhu G, Stahl RE, Gallo RC. Proviral DNA of a retrovirus, human T-cell leukemia virus, in two patients with AIDS. Science. 1983;220(4599):862–865. doi: 10.1126/science.6601822. [DOI] [PubMed] [Google Scholar]
  18. Gottlieb MS, Schroff R, Schanker HM, Weisman JD, Fan PT, Wolf RA, Saxon A. Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. The New England Journal of Medicine. 1981;305(24):1425–1431. doi: 10.1056/NEJM198112103052401. [DOI] [PubMed] [Google Scholar]
  19. Kanki P. Epidemiology and natural history of human immunodeficiency virus type 2. In: DeVita VT Jr., Hellman S, Rosenberg SA, Curran J, Essex M, Fauci AS, editors. AIDS: Etiology, Diagnosis, Treatment and Prevention. 4. Philadelphia: Lippincott; 1997. pp. 127–135. [Google Scholar]
  20. Kanki PJ, McLane MF, King NW, Jr., Letvin NL, Hunt RD, Sehgal P, Daniel MD, Desrosiers RC, Essex M. Serologic identification and characterization of a macaque T-lymphotropic retrovirus closely related to HTLV-III. Science. 1985;228(4704):1199–1201. doi: 10.1126/science.3873705. [DOI] [PubMed] [Google Scholar]
  21. Kanki PJ, Travers K, Mboup S, Hsieh C-C, Marlink RG, Guèye-NDiaye A, Siby T, Thior I, Hernandez Avila M, Sankalé J-L, NDoye I, Essex ME. Slower heterosexual spread of HIV-2 than HIV-1. Lancet. 1994;343:943–946. doi: 10.1016/S0140-6736(94)90065-5. [DOI] [PubMed] [Google Scholar]
  22. Keele BF, Van Heuverswyn F, Li Y, Bailes E, Takehisa J, Santiago ML, Bibollet-Ruche F, Chen Y, Wain LV, Liegeois F, Loul S, Ngole EM, Bienvenue Y, Delaporte E, Brookfield JF, Sharp PM, Shaw GM, Peeters M, Hahn BH. Chimpanzee reservoirs of pandemic and nonpandemic HIV-1. Science. 2006;313(5786):523–526. doi: 10.1126/science.1126531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Korber B, Muldoon M, Theiler J, Gao F, Gupta R, Lapedes A, Hahn BH, Wolinsky S, Bhattacharya T. Timing the ancestor of the HIV-1 pandemic strains. Science. 2000;288(5472):1789–1796. doi: 10.1126/science.288.5472.1789. [DOI] [PubMed] [Google Scholar]
  24. Marlink R, Kanki P, Thior I, Travers K, Eisen G, Siby T, Traore I, Hsieh C- C, Dia MC, Gueye E-H, Hellinger J, Guèye-Ndiaye A, Sankalé J-L, Ndoye I, Mboup S, Essex M. Reduced rate of disease development after HIV-2 infection as compared to HIV-1. Science. 1994;265:1587–1590. doi: 10.1126/science.7915856. [DOI] [PubMed] [Google Scholar]
  25. Masur H, Michelis MA, Greene JB, Onorato I, Stouwe RA, Holzman RS, Wormser G, Brettman L, Lange M, Murray HW, Cunningham-Rundles S. An outbreak of community-acquired Pneumocystis carinii pneumonia: initial manifestation of cellular immune dysfunction. The New England Journal of Medicine. 1981;305(24):1431–1438. doi: 10.1056/NEJM198112103052402. [DOI] [PubMed] [Google Scholar]
  26. Piyasirisilp S, McCutchan FE, Carr JK, Sanders-Buell E, Liu W, Chen J, Wagner R, Wolf H, Shao Y, Lai S, Beyrer C, Yu XF. A recent outbreak of human immunodeficiency virus type 1 infection in southern China was initiated by two highly homogeneous, geographically separated strains, circulating recombinant form AE and a novel BC recombinant. The Journal of Virology. 2000;74(23):11286–11295. doi: 10.1128/JVI.74.23.11286-11295.2000. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Poiesz BJ, Ruscetti FW, Gazdar AF, Bunn PA, Minna JD, Gallo RC. Detection and isolation of type C retrovirus particles from fresh and cultured lymphocytes of a patient with cutaneous T-cell lymphoma. Proceedings of the National Academy of Sciences USA. 1980;77(12):7415–7419. doi: 10.1073/pnas.77.12.7415. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Qiu Z, Xing H, Wei M, Duan Y, Zhao Q, Xu J, Shao Y. Characterization of five nearly full-length genomes of early HIV type 1 strains in Ruili city: implications for the genesis of CRF07_BC and CRF08_BC circulating in China. AIDS Research and Human Retroviruses. 2005;21(12):1051–1056. doi: 10.1089/aid.2005.21.1051. [DOI] [PubMed] [Google Scholar]
  29. Renjifo B, Gilbert P, Chaplin B, Vannberg F, Mwakagile D, Msamanga G, Hunter D, Fawzi W, Essex M. Emerging recombinant human immunodeficiency viruses: uneven representation of the envelope V3 region. AIDS. 1999;13(13):1613–1621. doi: 10.1097/00002030-199909100-00003. [DOI] [PubMed] [Google Scholar]
  30. Rogers MF, Morens DM, Stewart JA, Kaminski RM, Spira TJ, Feorino PM, Larsen SA, Francis DP, Wilson M, Kaufman L. National case–control study of Kaposi’s sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 2. Laboratory results. Annals of Internal Medicine. 1983;99(2):151–158. doi: 10.7326/0003-4819-99-2-151. [DOI] [PubMed] [Google Scholar]
  31. Siegal FP, Lopez C, Hammer GS, Brown AE, Kornfeld SJ, Gold J, Hassett J, Hirschman SZ, Cunningham-Rundles C, Adelsberg BR, Parham DM, Siegal M, Cunningham-Rundles S, Armstrong D. Severe acquired immunodeficiency in male homosexuals, manifested by chronic perianal ulcerative herpes simplex lesions. The New England Journal of Medicine. 1981;305(24):1439–1444. doi: 10.1056/NEJM198112103052403. [DOI] [PubMed] [Google Scholar]
  32. Su L, Graf M, Zhang Y, von Briesen H, Xing H, Kostler J, Melzl H, Wolf H, Shao Y, Wagner R. Characterization of a virtually full-length human immunodeficiency virus type 1 genome of a prevalent intersubtype (C/B’) recombinant strain in China. The Journal of Virology. 2000;74:11367–11376. doi: 10.1128/JVI.74.23.11367-11376.2000. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. UNAIDS. (2006). Report on the Global AIDS Epidemic. Geneva: UNAIDS, Available online at http://www.unaids.org/en/HIV_data/2006GlobalReport/default.asp. Accessed on 9 February 2007.
  34. UNAIDS. (2007). AIDS Epidemic Update: December 2007. Available Online at http://www.unaids.org/en/KnowledgeCentre/HIVData/EpiUpdate/EpiUpdArchive/2007/default.asp. Accessed on 28 January 2008.

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