. Wednesday, October 1, 2008
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Yes, there is fear. Yes, there is confusion. But you should also know that AIDS can easily be prevented and there is hope for a cure.

“AIDS is absolutely preventable. There need not be another person who gets it,” says F. Doughlas Scutchfield, M.D., director of the Graduate School of Public Health at San Diego State University. “If you abstain from sex or are in a mutually monogamous relationship, and don’t do intravenous drugs, you need not be worried about AIDS. It’s that simple.”

Knowing the Enemy

Researchers have learned much about acquired immune deficiency syndrome (AIDS) sine it first became a worldwide concern in 1981. They know that human immunodeficiency virus (HIV), the virus that causes AIDS, can invade the body through unprotected sexual intercourse, shared use of intravenous needles (a common practice among drug addicts) or blood transfusions. Cases of AIDS have also been passed between doctor (dentist) and patient when there has been direct exposure to infected blood, but such cases are extremely rare.

There are at least two viruses, HIV-1 and HIV-2, that cause AIDS. The two are slightly different, but they are transmitted in the same ways and have the same deadly consequences. Worldwide, the two viruses infect an equal number of people. But for now, HIV-1 is much more prevalent in North America.

Once it enters the body, the AIDS virus attacks the immune system, specifically disabling the disease-fighting white blood cells. As the number of these cells decreases, the body’s ability to combat illness withers. Initially, the body is able to fight backs and develops antibodies to a portion of the virus (when a person tests HIV positive, it means those antibodies are present in the blood). But for some reason that still puzzles researchers, the lethal portions of the virus remain invisible to the immune system––much like a stealth bomber isn’t detected by radar––and aren’t destroyed. Eventually the virus wins the battle, and the person is overwhelmed by a series of diseases such as pneumonia, tuberculosis and Kaposi’s sarcoma (a rare form of cancer) that take advantage of the body’s weakened defenses.

After infection, it can take years––perhaps up to ten years––for HIV to paralyze the immune system and allow AIDS to develop a stranglehold on the body. But occasionally symptoms of AIDS begin appearing within one to two years after the person has been infected, Dr. Scutchfield says.

The federal Centers for Disease Control (CDC) in Atlanta estimates that at least one million Americans are currently infected with HIV. Unfortunately, experts predict that number will grow significantly throughout the 1990s. It’s possible that 5 to 10 percent of the people who are infected with HIV will never develop AIDS, says Daniel Hoth, M.D., director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases. But so far everyone who has been infected by the virus has later developed the disease.

Getting Tested

One reason that AIDS is still spreading is that many people mistakenly believe they can’t get it, says Fred Kroger, director of the National AIDS Information and Education Program at the CDC.

“The public still thinks AIDS is something that happens to other people. They have this uncanny ability to disassociate themselves from the individuals who get the disease,” he says. “Whatever the group, whatever the risk behavior, it’s not applicable to their situation. They think things like ‘I haven’t had sex with 250 people, I’ve only had sex with 17, so I can’t be at risk.” The public’s understanding of a risk behavior is terribly weak.”

Intravenous drug users and homosexual and bisexual men account for 75 percent of the AIDS cases in the United States, but a growing number of heterosexual men and women are also contracting the disease. Worldwide, 80 percent of AIDS infections have been contracted through heterosexual intercourse, Dr. Hoth says.

If you have any reason to suspect that you may be infected, ask your doctor to test your blood for AIDS. Not knowing if you have AIDS not only puts your sex partners at risk, it also delays treatment that may extend your life. “For most people, it’s better to know than to no know,” Dr. Hoth says. “It’s better not only for medical reasons but also for psychological reasons. That way they can plan their life around this disease.”

Playing It Safe

For now, AIDS is virtually 100 percent fatal. But also is virtually 100 percent preventable. Here’s how.

Practice safe sex. Abstinence or maintaining a mutually monogamous relationship is the best way to prevent AIDS. If that’s not possible, use a condom and avoid promiscuous practices. Multiple partners and unprotected sex greatly increase your risk of contracting AIDS. Condoms––as long as they don’t slip off or break during intercourse––effectively prevent the transmission of HIV from person to person.

Don’t share needles or syringes. AIDS is transmitted through the blood and can easily be contracted by injecting yourself with a needle used by another person.

Don’t get a blood transfusion just anywhere. Although sterilization techniques and testing for AIDS have virtually eliminated the risk of contracting AIDS through blood transfusion in the United States, that’s not true elsewhere in the world. “I wouldn’t get a blood transfusion in Africa if my life literally depend on it,” Dr. Scutchfield says. If you’re traveling, consider coming home before undergoing nonemergency surgery.

Destroying the Myths

All the evidence about AIDS indicates that the virus can’t be passed on by casual contact. But doctors worry that many people are being misled by false beliefs.

For example, some people think you can get AIDS by hugging, kissing or sharing food with someone who is infected. Others believe that having an infected person sneeze or cough at you will transmit the disease. Still others think that you can get the disease by being bitten by insects such as mosquitoes. In truth, there is no evidence that AIDS can be transmitted in any of those ways, Dr. Scutchfield says.

You also can’t get AIDS by sitting on a toilet seat. In fact, the AIDS virus is so fragile that it dies almost immediately when exposed to open air, Dr. Scutchfield says. In addition you can’t get AIDS from donating blood, because the sterile needles used to extract blood from your body are only used on you, then discarded.

“That’s been a big problem. People associated blood with HIV and stopped donating,” Dr. Scutchfield says. “There is absolutely no way you can get AIDS from donating blood.”

Losing the Battle, Winning the War

Fortunately, for those who do get AIDS, new drugs and improved treatments have increased life span significantly since the disease was first detected. “People who used to die within three months are now living for several years,” Dr. Scutchfield says.

Drugs such as zidovudine (AZI), dideoxyinosine (ddI) and dideoxycytidine (ddC) can temporarily halt the replication of the virus in the body, but so far no drug or vaccine has been developed that will eradicate the virus completely. However, more than 88 drugs are in development, and researchers are working on a number of vaccines that may eventually turn the tide in this deadly war.

“I’m very optimistic that in the long run, we’re going to find effective AIDS drugs,” Dr. Hoth says. “We will get there. We will knock this disease out. But it’s not going to happen overnight. It’s going to take a while.”



Finding a way to smother the raging wildfire called AIDS may be closer than you think. In fact, there is a good possibility that medications to both prevent and treat the deadly disease may be available by the year 2000.

“I’m not sure there will be a single vaccine. It’s possible that there will be a cocktail of vaccines to help the immune system,” says Jim Kahn, M.D., associate director of the AIDS program at San Francisco General Hospital.

Researchers are currently working to make it easier for white blood cells to detect and attack proteins attached to HIV, the culprit in AIDS. It’s believed that the body may not be able to “see” these proteins, and as a result, the virus can do its deadly work unmolested by the immune system.

Several prototype vaccines are already under investigation. For example, investigators at Walter Reed Army Institute of research in Rockville, Maryland, were the first to produce a genetically engineered vaccine that seems to stabilize and maybe even boost the immune systems of HIV-infected people.

In one study, 30 volunteers, all infected with the AIDS virus, received injections over ten months. Of the 30, 19 wound up with stable white blood cell counts and produced antibodies to the protein. In other words, in more than half the volunteers, the immune system began detecting an HIV protein that it previously didn’t notice.


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