The difficult fight against AIDS

After 30 years, still no cure for AIDS

21/05/2013

In 1983, a virus was first described that causes the immune deficiency HIV. The French researchers Luc Montagnier and Françoise Barré-Sinouss were awarded the 2008 Nobel Prize for Medicine for the discovery of the HI virus. But until today there is no cure for AIDS despite intensive research. More than 35 million people worldwide are affected by the immune deficiency. Since 1997, however, the number of new infections has been declining. According to the Robert Koch Institute (RKI), the number in the group of men who had sexual contacts with men has risen slightly since 2011 in Germany.

So far no cure of HIV and AIDS possible
The so-called human immunodeficiency virus (HIV) is transmitted through contact with the body fluids blood, semen, vaginal secretions, breast milk and cerebrospinal fluid. Infection with HIV is therefore much more severe than, for example, influenza viruses, where transmission via droplet infection is possible. Nonetheless, since the 1980s, the spread of immunodeficiency has become a pandemic, affecting around 35 million people worldwide.

Thirty years ago, the French researchers Luc Montagnier and Françoise Barré-Sinouss first described the HI virus, which, if untreated, causes Acquired Immune Deficiency Syndrome (Aids). The US scientist Robert Gallo made parallel to the two French also this discovery. On May 20, 1983, therefore, two contributions of historical significance appeared in the journal „Science“. At that time, the life-threatening immunodeficiency, whose cause was unknown until then, was rampant, especially among homosexual men. The researchers independently recognized that the Human Immunodeficiency Virus (HIV) was responsible for the enigmatic disease. Since then, researchers from all over the world have been developing medicines for AIDS. But there is no cure yet.

Antiretroviral therapy in HIV and AIDS
However, science has made great progress in the field of AIDS research over the past 30 years. So-called antiretroviral drugs can prevent the onset of AIDS in most cases. However, if an HIV infection is not treated, the affected person's immune system is weakened so severely that the outbreak of AIDS is very likely to occur. This disease stage is characterized mainly by the occurrence of the so-called opportunistic infections caused by bacteria, fungi, viruses or parasites, by malignant tumors such as Kaposi's sarcoma and lymphatic cancer, HIV-related changes in the brain (HIV encephalopathy) and wasting Syndrome, diseases that may subsequently lead to the death of the person affected.

If an HIV infection is treated in time, however, the outbreak of AIDS can usually be prevented. For some time, antiretroviral drugs have been used successfully in HIV, so that the life expectancy of those affected has increased significantly today. Although the combination of different drugs often causes the viral load to be no longer detectable in the patients' blood, antiretroviral therapy (ART) can not bring about definitive cure. The drugs, however, prevent the further multiplication of the virus and must therefore be taken by a person affected for a lifetime.

In HIV often late for a doctor
According to information from the Robert Koch Institute (RKI), HIV is often detected very late or in some cases even not at all, since many affected people go to the doctor very late. The earliest possible diagnosis is particularly important in order to minimize the risk of further new infections and to start an effective treatment. Of approximately 3,400 new infections in 2012, just under half are so-called „Late Presenter“ in which the AIDS disease has already broken out or at least the immune system was already severely weakened. The very late detection of HIV, however, reduces the chances of success of antiretroviral therapy. Often, shame, repression or ignorance are the cause of a late visit to the doctor. In many cases, HIV infection still means stigmatization in the working environment, but also in the circle of friends and family when the disease becomes known. In some cases, the symptoms, which include diarrhea, fever, weight loss and swelling of the lymph nodes, but also by the doctors are not directly associated with HIV. Only a corresponding blood test can finally provide information about a possible HIV infection. (Ag)

Picture: Gerd Altmann