Acquired Immune Deficiency Syndrome (usually referred to as AIDS) is a collection of diseases and symptoms which have been clearly and convincingly demonstrated to be caused by long-term infection with the human immunodeficiency virus (HIV).
- CD4 count less than 200 per microlitre blood, or
- CD4 percentage less than 14% of total lymphocytes, or
- any of the following illnesses: pulmonary TB, recurrent pneumonia, invasive cervical cancer, or
- expanded definition including 23 clinical conditions published elsewhere.
The World Health Organization uses a different staging method for HIV disease.
The illness was first recognized in the early 1980s as homosexual men presented to their doctors with a rare lung disease called Pneumocystis carinii pneumonia (PCP). Early on, the "gay disease" took on a variety of names, including "gay cancer" and "Gay-related immune deficiency" (GRID). The Centers for Disease Control noticed an increase in requests for drugs needed to treat this illness and launched an epidemiological investigation.
Although the first cases of the disease probably go back to the 1950s, the epidemic was not recognized until the early 1980s. The early epidemic occurred in two main branches; in the US and other developed countries, and in sub-Saharan Africa. In the US, the early epidemic was primarily spread by homosexual sex, intravenous drug use, and blood transfusions. In Africa, transmission was almost exclusively by heterosexual sex. Currently, most new infections worldwide are spread by heterosexual sex.
Social and political responses to the AIDS epidemic of the 1980s have included the 'safe sex' movement, with demands for greater availability of contraception, greater awareness of the risks of unprotected sex, and more comprehensive sex education. Sadly, however, the fact of the matter was that Ronald Reagan refused to mention AIDS on television until the disease had spread so widely it was no longer just an American but global pandemic. Reports from the CDC going back to 1980 were alerting the government of the numbers of infections and what that meant, but queers, dopers, and Haitian refugees can fuck themselves, according to the GOP. Only when Rock Hudson (Ronnie was allegedly his butch in the '50s) turned into a walking skeleton before everyone's eyes on television did the Gipper catch the drift. These movements have been met with some resistance from conservatives, who see them as implying approval of promiscuous lifestyles and hence contributing to moral decline.
After infection with HIV, the virus quickly replicates in lymphatic tissue and travels through the blood to infect most areas of the body. The largest consequence of this is the "hijacking" of certain immune cells (any that express the protein CD4, which is the target of the viral antigen), especially so-called Helper-T cells, or CD4+ (CD4 positive) cells. The virus capsid contains two proteins, called Reverse Transcriptase and DNA Integrase, along with the viral strand of RNA. Reverse Transcriptase performs reverse transcription on the viral RNA, thus converting it into DNA, and DNA Integrase then "injects" the viral DNA into the host DNA in the cell nucleus. One of the primary methods of control in HIV-positive patients is therefore Reverse Transcriptase Inhibitors (RTIs).
Early in the infection, the immune system holds the infection at bay, often causing "Acute Retroviral Syndrome", a flu-like illness. Patients often have swollen lymph nodes. After approximately 8–10 years of infection, the immune system begins to lose its battle. This is primarily seen in the loss of numbers of CD4+ cells, however the changes are somewhat more complex. When the CD4+ cell level drops low enough, AIDS becomes apparent. The first symptoms of the illness are generally night sweats, weight loss, and oral thrush.
 Opportunistic Infections (OIs)
The hallmark of AIDS is the appearance of opportunistic infections, meaning infections with organisms that do not usually cause human disease, unless given the right "opportunity". This opportunity is the reduction in cell-mediated immunity, first seen in patients with certain cancers or on anti-rejection drugs for organ transplantation.
These infections include:
- Pneumocystis jiroveci, previously Pneumocystis carinii
- Candida albicans (the cause of thrush and vaginal yeast infections)
- Staphylococcus aureus (primarily causes skin infections)
- Toxoplasma gondii
- Streptococcus pneumoniae (the primary cause of pneumonia in AIDS patients)
- Mycobacterium tuberculosis (TB)
- Mycobacterium avium complex (atypical mycobacterium)
- Cryptococcus neoformans (a cause of meningitis)
- Epstein Barr virus (leads to a type of lymphoma)
- Human herpesvirus-8 (causes Kaposi's sarcoma)
 AIDS and fundamentalism
Since AIDS initially appeared to be impacting only the gay community, some religious fundamentalist groups, especially Christian ones, proclaimed that the disease was a divine retribution for homosexuality, or for promiscuity and moral decline. Analogies were made to Sodom and Gomorrah, and semi-biblical slogans such as "if you live by the flesh, you will die by the flesh" were coined; and of course references were made to biblical predictions that plagues would mark the beginning of the apocalypse.
These ideas have lost weight among most religious groups, although a few obnoxious extremists still cling to them, including Pat Robertson, Fred Phelps and the late Jerry Falwell. Placards held by members of Phelps' Westboro Baptist church in their homophobic picketing activities regularly include slogans such as "Thank God for AIDS".
 Other superstitions
Many other myths and superstitions have grown up surrounding AIDS, including the belief that the disease originated from a man having sex with a monkey or ape, and contracting a simian disease from it. In societies with a poor education or awareness of AIDS, or a high level of prejudice, sufferers are often ostracised in the false belief that any kind of contact could spread the disease.
In southern Africa, there a widely held belief that an infected individual can 'cleanse' themself of AIDS by having sex with a virgin. Similar beliefs regarding sexually transmitted diseases have existed for centuries, but the growth of this superstition during the AIDS pandemics of recent years is particularly shocking, in that it has led to thousands of rapes of children and even babies in Africa.
 Quack medical treatments
There is no cure or vaccine for AIDS as of yet. The only effective treatment is management with an antiretrovirus cocktail such as AZT, and these treatments can only slow the progression of the disease.
Thus, unsurprisingly, there has grown a field of useless quack medical treatments purporting to treat AIDS. These treatments are ineffective and range from the harmless but worthless (homeopathy) to potentially deadly (oxygen therapy). Cases exist where drinking Kombucha tea, falsely claimed as an immune system builder, has led to opportunistic infections in HIV-positive patients.
 See also
- ↑ http://www.cdc.gov
- ↑ http://www.merckmedicus.com/ppdocs/us/hcp/content/merck/hiv/hivaids/aidsdefi.htm
- ↑ http://www.cdc.gov/MMWR/preview/mmwrhtml/00018871.htm
- ↑ http://www.aids-ed.org/aetc/aetc?page=cm-105_disease
- ↑ New England Journal of Medicine, Volume 344:1764-1772 June 7, 2001 Number 23
- ↑ Pneumocystis pneumonia -- Los Angeles. MMWR Morb Mortal Wkly Rep 1981;30:250-252)
- ↑ http://www.avert.org/his81_86.htm
- ↑ http://www.cellsalive.com/hiv2.htm
- ↑ http://www.cellsalive.com/hiv3.htm
- ↑ http://www.aidsmap.com/cms1031992.aspx
- ↑ Almost as though the ideas themselves were suffering from AIDS symptoms....
- ↑ "South African men rape babies as 'cure' for Aids", Telegraph online, 11 Nov 2001.