Shoulders To Stand On EC December/January Issue 2015
A Community’s Response To AIDS – A Pivotal Year 1984
The year 1984 was an extraordinary year for AIDS research, testing, drug treatment, and the politics of AIDS. Each of these threads is interwoven with a community’s fear and ever increasing numbers. The overwhelming effect of AIDS on Rochester is about to reach new heights. The year 1984 creates hope and at the same time the number of AIDS cases in Monroe County begins to grow exponentially. In Monroe County in 1984 there are 12 identified cases of AIDS, in 1985 there were 24, in 1986 there were 60, in 1987 there were 101, and the number was growing quickly.
From the earliest reports of a new disease, scientists around the world focused their efforts on finding the cause of AIDS. They circulated information informally; they held meetings to exchange ideas; and they published promising findings. A pioneer in this effort was Dr. Robert Gallo of the National Cancer Institute, who only recently had discovered the first two human retroviruses, HTLV-I and HTLV-II. In 1984, research groups led by Dr. Gallo, Dr. Luc Montagnier at the Pasteur Institute in Paris, and Dr. Jay Levy at the University of California, San Francisco, all identified a retrovirus as the cause of AIDS. Each group called the virus by a different name: HTLV-III, LAV, and ARV, respectively. As has happened many times in scientific history, contention emerged about who had been first. In 1987, the president of the United States and the prime minister of France announced a joint agreement on the issue–the first time a medical research question had reached this level of political negotiation. More importantly, the identification of that virus, renamed human immunodeficiency virus, or HIV, that mainly attacks T-4 cells (which help the production of antibodies) and renders the body’s immune system incapable of resisting infection, provided a specific target for blood-screening tests and for scientists around the world conducting research to defeat AIDS.
The who question becomes in some ways insignificant in comparison to the results. Now scientists were able to develop processes to mass produce the virus with the purpose of developing tools to conquer AIDS. By the fall of 1984, not only had a retrovirus been identified as the cause of AIDS, it also had been shown to have properties that would make it very difficult, if not impossible, to make a conventional vaccine against AIDS. By April, 1984, four thousand plus Americans were infected with the disease. By the end of 1984 that number would skyrocket to 10,000.
AIDS is the last stage in a progression of diseases resulting from a viral infection known as the Human Immunodeficiency Virus (HIV or AIDS virus). The diseases include a number of unusual and severe infections, cancers and debilitating illnesses, resulting in severe weight loss or wasting away, and diseases affecting the brain and central nervous system.
By January of 1984, new evidence was reported that AIDS can be spread heterosexually and transmitted even before a person shows outward manifestations of the disease. In fact, in May of 1985, an AIDS symptoms report in the New England Journal of Medicine indicated that the AIDS virus may persist without symptoms in infected people for more than four years. Prior to 2003, when effective therapies became available, and therefore from 1984 – 2002, about 10% of HIV infected people progressed to AIDS within 2 or 3 years of infection (rapid progressors). About 60% of adults/adolescents progressed to AIDS within 12–13 years (slow progressors).
Today, the percentages are somewhat different. Without treatment, 80-87% progress within 12 – 13 years (typical progressors); 3 – 5% are symptom free with good T4 cell counts after 8 – 15 years (non-progressors) and less than 1% control the infection to viral loads less than 50 copies in absence of treatment (elite controllers) and 10% progress rapidly (~2years).
Without treatment, HIV advances in stages, overwhelming your immune system and getting worse over time. The three stages of HIV infection are: (1) acute HIV infection, (2) clinical latency, and (3) AIDS (acquired immunodeficiency syndrome).
There is still no cure for HIV infection or AIDS nor is there a vaccine to prevent HIV infection. However, there’s good news: by using HIV medicines (called antiretroviral therapy or ART) consistently, you can prevent HIV from progressing to AIDS. ART helps control the virus so that you can live a longer, healthier life and reduce the risk of transmitting HIV to others. Currently anti-retroviral therapy is recommended for ALL patients with the goal of having no one progress to AIDS.
All treatment is based on the hypothesis that people will be tested to determine their status. In October, 1984 Abbott Laboratories received FDA approval for a diagnostic to screen blood for antibodies to virus believed to be the cause of AIDS. The test, named ELISA or EIA (Enzyme-linked Immunosorbent Assay), did not diagnose AIDS, but instead detected antibodies produced by the body’s immune system to fight HTLV-III (Human T-Lymphotropic Virus Type-3) which had been identified as the probable cause of AIDS. This Elisa Test would become known as the “AIDS Test”. In December, 1984, University of California researchers used the test to detect AIDS virus in as many as 10,000 samples taken from blood donor centers.
Shoulders To Stand On will continue to look at AIDS Testing and issues that arose because of testing then and now in the February issue of the Empty Closet. Shoulders To Stand On is in awe of the tremendous growth in knowledge and understanding of AIDS that took place in a very short period of time – 3 years from 1981 – 1984. Shoulders also recognizes the risks and risk takers – Dr. Robert Gallo of the National Cancer Institute, Dr. Luc Montagnier at the Pasteur Institute in Paris, and Dr. Jay Levy at the University of California, San Francisco – involved in learning about the disease and identifying the virus that causes AIDS.