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Acquired immunodeficiency syndrome (AIDS)

Today, despite the continuing production of better antibiotics since the discovery of penicillin, we are facing an infectious disease against which all these drugs are virtually powerless. This disease is spreading inexorably, killing more people and more people each year. AIDS does not know no national boundaries and does not discriminate by race or sex. It is rampaging not only throughout the United States, but also through Africa, India, China, Russia, Europe, South America, and the Caribbean countries. Even infants and children are at risk.

AIDS is similar to the bubonic plague or the “BLACK DEATH” that killed perhaps one-third in Europe in the 14th century. Yet, the difference from the “Black Death” and AIDS is that it is in slow motion because the infectious agent that causes AIDS can remain dormant in a person’s body for several years before it causes illness, and because death from AIDS can be slow and drawn out once symptoms appear. AIDS is essentially a disease of the immune system. The body’s defenses are destroyed and the patient becomes prey to the infections and cancers that would normally be fought off without any trouble.

In 1984 it was proved that AIDS is caused by the human immunodeficiency virus (HIV). A virus is a minute infectious particle that enters and kills the immune cells, or lymphocytes. Because it destroys the very mechanism humans rely on for protection, prior to 1996 contracting Aids was considered a death sentence. For many years, 85 to 90 percent of all AIDS patients died within three years. They might have recovered from one infection only to succumb to another a few months later. Between infections they remain weak, emaciated and unable to work or carry on normal activities.

In late 1996, almost 15 years after the first reported AIDS cases, researchers made the discovery that a certain combination of newly developed drugs could substantially prolong life in some AIDS patients. But AIDS is a fiendish virus. When researchers cleared it out of a patient’s bloodstream, it hid in the lymph nodes. Scientists, figured out how to banish it from the lymph nodes, they found the virus lurking in the brain. Although, there is hope for a cure because they have done some experiments isolating a gene and it has had good results in some people infected with AIDS.

The area that many people are concerned is with Southeast Asia-particularly India. At 900 million, India’s population is almost double that sub-Saharan Africa, which, with 13. 3 million HIV-positive adults, accounts for 60 percent of the world’s total adult infections. The major reasons for such spread in India and following Africa is the high rate of their population, poverty rate, and other risk factors all point to a likely explosion. The number of HIV infections worldwide doubled between 1991 and 1996-and that number is expected to double again by the year 2000.

By the turn of the century, about 44 million people will have fallen victim to the virus that causes AIDS. The signs of hope do not stop by the reason of Prevention Programs which they have succeeded in reducing HIV-infection rates dramatically among young men in Thailand and young women in Uganda-two of the countries hit hardest by the3 disease. The rate of new infections have also dropped sharply among gay men in the United States, Australia, Canada, and western Europe. However, many ingredients of the AIDS epidemic are still mystery.

The cause of AIDS remained uncertain for several years after its discovery. Even now, there are questions about how efficiently the AIDS virus spreads, whether it will kill everyone who gets it, and why the virus is do devastating to the immune system. It’s initial spread was in the United States was among groups that are frowned upon by society-homosexuals and intravenous(drug users)- AIDS has a stigma associated with it. This makes the disease difficult to confront rationally. However, people are terrified even by the word of AIDS.

The virus does not get transmitted by any body contact neither through the air. However, the disease does not pass from one person to another through the air, by sneezing, on eating utensils, by shaking hands, or through body contact in sports. There are only four ways it can be spread: through injection with a needle contaminated with HIV, which it can happen when drug addicts share needles; by receiving a transfusion of contaminated blood; or-in the case of infant with an HIV-positive mother-having the virus transmitted through the placenta before birth, or the mother’s milk after birth.

For years, some people to refused to admit AIDS was a problem. Although, the disease first received national attention in 1982, when the Centers of Disease Control (CDC) noticed an alarming rate of rare cancer (Kaposi’s sarcoma) in otherwise healthy gay men. Three patients examined by Dr. Gottlieb were very ill. Interestingly, they had several striking features in common. All had unusual infections such as thrush, which is the growth in the throat of a fungus called Candida; or a rare type of pneumonia caused by a parasite called Pneumocystis.

Also, they had been infected by less-common viruses, such as Epstein-Barr virus, which causes mononucleosis, or by cytomegalovirus (CMV). Taken together, the infections pointed to a serious defect in the patients’ immune systems. Sure enough, when Dr. Gottlieb drew a vial blood from each patient and measured special kind of immune cell called a T-helper lymphocyte, all three patients’ tests gave the same startling result. They were virtually devoid of T-helper cells, Dr. Gottlieb found. It was clear that they had seriously deficient immune systems. The three men had something else in common: they were all homosexuals.

At that time it was not clear that the patients’ homosexuality was related to the illness; a patients’ sexual preference had never before been considered the determining factor of a medical disorder. That situation was about to change radically. Early symptoms of HIV, lasting between one and four weeks, can mimic that of mononucleosis, with symptoms such as swellings of the lymph nodes, headache, fever, loss of appetite, weight loss, sweating and sore throat. Often of these symptoms are mistaken for the flu or another viral-type infection, so people may not even be aware that they have been infected with HIV.

Even if the patient has seen a doctor, the physician may dismiss the symptoms as a viral infection. In nearly all the cases, this stage dissipates due to the healthy immune system’s ability to fight the initial infection. Early symptoms may include: *Herpes zoster (shingles), a skin rash that appear on the chest, abdomen, and/or back. *Herpes simplex, a common sexually transmits disease that affects the rectal, genital, esophageal regions of the body. Painful lesions can erupt into ulceration’s of the area. In HIV/AIDS patients, this may become a chronic condition.

Thrush, a white coating on the walls of the mouth, gums, and on the tongue, that is caused by a fungus called Candida Albicans. *Excessive bruising and bleeding that occurs when a person develops antibodies which attack the body’s platelets-cells which help blood to clot. This condition can go unnoticed, and is often not detected until a routine blood test is performed. *Chronic or intermittent diarrhea, found both in early and late stages of HIV infection. As the immune system becomes increasingly compromised, the body is not able to fight off more serious infections that a normal intact immune system could suppress.

Some of these life threatening infection include: *Pneumocystis pneumonia (PCP), caused by parasite called pneumoncytis carinii. Symptoms include fever and respiratory complications that often lead to death. *Kaposi’s sarcoma, a condition in which tumors of the blood vessels develop on the skin, in the gastrointestinal tract, mouth, lungs, groin, brain liver, and lymph glands. The mall, nonpainful lesions usually are a red, brown, or purple color. *Tuberculosis (TB), which can occur in both early and late stages of HIV. Symptoms include night sweats, fever, cough, and weight loss.

One of the major problems with this aspect of the disease is the development of TB strains resistant to drugs, making it harder and harder to treat. *Mycobacterium avium complex, which produces fatigue, chills, night sweats, fever, weight loss, diarrhea, and abdominal pain. *HIV related lymphoma, swollen lymph glands in the neck, groin region, or under the arms. This requires radiation and chemotherapy treatment. *Toxoplasmosis encephalitis, caused by a parasite, which produces an infection in the brain leading to neuro logical impairment and seizures.

Symptoms include headaches, fever, lethargy, confusion, and loss of balance or coordination. *Cytomegalovirus (CMV) infection, a viral infection distributed to all parts of the body through bloodstream and causing infections in the eyes, lungs, and other organs. About 90 percent of AIDS patients eventually develop cytomegalovirus. *Crytococcosis. Produced by a fungus found in the soil. This causes a brain infection. Symptoms include fatigue, fever, nausea and vomiting, altered mental state, memory loss, confusion, and behavioral changes.

Crytosporidosis, an infection developed drinking and contaminated water, produces severe diarrhea and weight loss. If the infectious disease specialists were puzzled, several New York dermatologist were even more perplexed. These doctors, who specialize in skin diseases, were seeing a number of patients with an extremely rare kind of cancer called Kaposi’s sarcoma spot on the skin, further examination reveals the presence of the cancer in an internal organ, such as the stomach, as well. Kaposi’s sarcoma had been a disease of elderly men in the Mediterranean origin; in New York City it began to appear in young men of every ethnic background.

It had been known as a slow-growing cancer that could be treated successfully; in these new, young patients the sarcoma was spreading fast and damaging internal organs. A cancer of the skin and internal organs does not sound like it would be related to rare infections of the lung and the brain. But there is a strong connection-the immune system. It is one of the principles of the science of immunology that immune cells are essential in protecting the body from tumor cells. If a small colony of cancers, a tumor, become established, lymphocytes (part of the immune system) are supposed to find it and destroy it before it can grow.

So Kaposi’s sarcoma in these young gay men could be seen as opportunistic cancer, taking advantage of the breakdown in the patients’ defenses, just as the infectious organisms were doing. There was also a more concrete reason for the doctors to know that the cases of Kaposi’s sarcoma in young gay men signaled a breach of these person’s protective mechanisms: Kaposi’s is relatively common in patients whose immune systems were surprised by medical treatment. Patients taking drugs that suppress the immune system are also prone to lymphoma, or cancer of the immune system, Soon this cancer started showing in gay men, too.

Dr. Currant’s statement implied two things. One, that there was an infectious organism underlying the unusual diseases (perhaps an infectious organism that attacked the immune system). Two, that the homosexual lifestyle was somehow unique. It would be three years before the suspicion of an infectious agent that attacked immune cells was verified by the isolation of the AIDS virus. But it was already known that gay men’s sexual habits differed from those of the most heterosexuals. They found that two other diseases were very common in homosexual men and that are sexually transmitted-hepatitis B and gonorrhea.

The first thought was that the occurrence of the Pneumocystis pneumonia and Kaposi’s sarcoma in homosexual men might involve sexual transmission. The men with Kaposi’s reported having an average of 61 different partners in the previous year; the public clinic patients and the men from private physicians said they had had 25 different sexual partners in the past year. Both of these numbers are much higher than the two to five sexual partners per year common among nonmonogamous (sexually active with more than one partner)heterosexuals.

The ill men reported contacting a much higher percentage of their partners in “gay baths”, public places where gay men can go for anonymous sex. The men with Kaposi’s had met with half of their partners in the baths; the clinic patients had made one-fourth of their sexual contacts in the baths; and the healthy private patients averaged only one anonymous partner per year. Homosexual men have higher rates of sexually transmits diseases than heterosexual men and women because gay men tend to have larger numbers of different sexual partners, more often engage in furtive (anonymous) sexual activities, and more frequently have anal intercourse.

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