30 years of AIDS Still no cure in sight?

30 years of AIDS: still no cure in sight?

06/06/2011

Thirty years ago the first public report was made about the immunodeficiency syndrome Aids. The immunologist Michael S. Gottlieb from Los Angeles, USA wrote in the „Morbidity and Mortality Weekly Report“ of the Center for Disease Control on 5 June 1981 on the special susceptibility to infection, which had led to conspicuous rare diseases in five patients. Since the five affected men were all homosexual, the immunologist suspected a connection. On December 1, 1981 AIDS was finally detected as a separate disease.

According to the World Health Organization (WHO), around 25 million people have died from the effects of the immunodeficiency syndrome since the first scientific mention of AIDS diseases thirty years ago. Even today, thousands of people are infected with the Human Immunodeficiency Virus (HIV) on a daily basis, with alarming levels of new HIV infections particularly in Sub-Saharan Africa and the Eastern European countries. Although AIDS is considered incurable and the consequences are potentially fatal, those affected can use drugs to live reasonably normal lives, but these are far from being available to all those in need.

AIDS was discovered 30 years ago
When the US immunologist Michael S. Gottlieb reported AIDS for the first time in 1981, neither the cause nor the way of infection of the examined patients was clear. However, it was noticeable that all five men between the ages of 29 and 36 suffered from extremely rare diseases. For example, all five had pneumonia caused by pathogens that primarily affect people with a weak immune system. Also, they suffered from a particular herpes virus infection, the corresponding herpes virus should actually be warded off by a healthy immune system. However, the herpesvirus infection resulted in considerable health problems for the men examined. In addition, the oral mucous membranes of the subjects showed the yeast infection thrush, which was expressed in yellowish-white spots on the mucous membranes. Since all five men were homosexual, Michael S. Gottlieb suspected a connection between the occurrence of the disease and the sex life of the subjects. After AIDS was recognized as an independent disease in late 1981, the search for the causes and the possible transmission routes intensified considerably. Soon thereafter, the HI virus was discovered and determined as the transmission of body fluids. HIV can be transmitted both with the blood and through vaginal secretions, semen and breast milk. In addition to unprotected intercourse, HIV is spread among drug addicts mainly through the use of contaminated syringes.

Spread of the AIDS pandemic
In the early 1980s, more and more people died as a result of HIV infection, and the new disease spread rapidly across the globe. In 1982, the first AIDS disease was reported in Germany at the Robert Koch Institute (RKI). Today, according to the RKI, around 70,000 people in this country suffer from HIV infection, with 3,000 new infections recorded last year. Around 550 people die every year in Germany as a result of AIDS. According to UNAIDS (United Nations Joint Program on HIV / AIDS), around 2.6 million people worldwide were infected with HIV in 2009, and 1.8 million people died as a result of AIDS. In total, about 33 million people worldwide currently live with HIV infection. However, although research in recent decades has increasingly sought the development of possible treatment methods and achieved far-reaching success in terms of life expectancy and quality of life of those affected, a cure of immunodeficiency disease is not yet possible.

Millennium Goal: stopping the spread of AIDS
The international community has set itself the Millennium Development Goals to halt the spread of HIV infection by 2015. But given the millions of new infections annually, the set goal seems more than endangered. Especially in the developing and emerging countries of Eastern Europe and in the sub-Saharan African countries, thousands of people are still living with HIV today. And while Aids patients in industrialized countries can be helped to live a relatively normal life with the help of available medicines, infection with HIV in very poor countries is often a death sentence. In the more affluent industrialized countries, on the other hand, the life expectancy after HIV infection could be significantly improved with the help of the developed drugs. Already in 1987, the first AIDS drug came onto the market. Drug „azidothymidine“ , which was previously tried unsuccessfully in the treatment of cancer, showed a very positive effect in HIV infections. It sat „azidothymidine“ on the multiplication mechanism of HI viruses.

AIDS medications achieved far-reaching results
Normally, HI viruses invade certain defense cells of the immune system, the so-called T lymphocytes, and use their environment to rewrite their single-stranded genetic information (ribonucleic acid, RNA) into double-stranded deoxyribonucleic acid (DNA) with the aid of the enzyme reverse transcriptase. This new viral DNA can then be integrated into the DNA of the T lymphocytes with the help of another enzyme and the T lymphocytes serve from then on the HI virus for their own propagation. The active substance „azidothymidine“ continues the process of transcribing single-stranded to double-stranded genetic information and blocks the conversion of RNA into DNA. Although the HI viruses were still able to penetrate into the T lymphocytes, they did not subsequently multiply. However, the viruses developed relatively quickly resistance to this one available drug. Therefore, the combination therapy with the use of two drugs of different action was another milestone in the AIDS therapy. Finally, in 1996, the highly active antiretroviral therapy (HAART), which employed three different antiretroviral drugs, significantly improved the treatment of AIDS patients. Today, according to the experts, people living with HI infection in Germany live on average only about ten years shorter than the rest of the population.

UNICEF warns: Millennium Goal is under threat
Although the treatment options for HIV infection have improved significantly in the last thirty years and, according to the experts, there are good prospects in the future to cure the immunodeficiency syndrome with the help of medication. But the UN Children's Fund UNICEF recently warned about the dramatic spread of HIV infection among children and adolescents in developing and emerging countries. 2.5 million adolescents are infected with HIV, according to UNICEF. Most of them live in dire circumstances in poor conditions, which makes an adequate supply of medicines almost impossible. Every day, according to the UN Children's Fund, there are 2,5000 new HIV infections among the adolescents. UNICEF Executive Director Anthony Lake said „Neglect, exclusion and violence“ as major causes of HIV infection among adolescents. Especially in Eastern Europe, according to UNICEF, drug addiction and prostitution also play an essential role „Perspectives and hopelessness and lack of support from their families and communities“ the most common causes are, „that adolescents resort to drugs or prostitute themselves“, Anthony Lake explained. The UN Children's Fund warned that, given the current numbers of infections, the Millennium Goal to stop the spread of AIDS by 2015 is seriously threatened. (Fp)

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Picture: Rike