|
|
 |
|
Health
|
|
|
|
Aids - a short history
In 1981 in their weekly news letter the Centre for Disease Control and Prevention (CDC) in the USA reported for the first time the appearance of rare symptoms which had been observed amongst homosexual men between the ages of 20 and 40 on the east coast of America. From October 1980 to May 1981 there were five cases of Pneumocystic-carinii-pneumonia, a rare inflammation of the lungs. In July 1981 the CDC reported 26 cases of a hitherto rare tumour - the so-called Kaposi-Sarcoma - which had appeared in the preceding 30 months. Previously almost without exception only older men were affected by Kaposi's Sarcoma. Soon medical journals were reporting further cases of Kaposi's Sarcoma and numerous infectious diseases amongst young men. It did not take long for the medical world to recognise that they were dealing with a new disease that today we call Aids - Acquired Immuno Deficiency Syndrome.
|
|
|
|
|
|
A world-wide search for the cause was begun. From the beginning the epidemiological phenotype of Aids was reminiscent of infectious jaundice. It was therefore suspected that an infectious agent could cause Aids and in fact a hitherto unknown virus: the Human Immuno-deficiency Virus (HIV) was discovered by Luc Montagnier in 1983 in France and later by Robert Gallo in the USA. Today this virus is regarded as the trigger for immune-system failings. It may be that other factors influence the course of immune-system failure but the prerequisite for the Aids disease is infection by the HI-virus. Even before the HI-virus was recognised as the trigger for Aids the main transmission channels were known. The majority of new infections arose from unprotected sexual intercourse or the use of used syringes and needles during drug taking. However, the virus can be passed from mother to child during pregnancy, birth or breast feeding. Until 1987 infection was also possible through blood transfusions and other blood products. Since then all blood donors in all European countries are tested. However, there remains a statistical risk that about one in 600,000 blood transfusions can lead to infection.
|
|
|
|
|
|
For infection to take place it is necessary not only for fluid containing the virus but also an entry point through which the virus can enter the body. With HIV this can be the blood stream or the mucous membrane of the vagina, anus or urethra. Undamaged skin offers effective protection against HIV. The virus is not transmitted through the air nor by insect bites, coughs and sneezes, touching, kissing, shared use of glasses and crockery, toilets and baths. Not every contact with HIV leads to infection. In contrast to other viruses such as the common cold, measles and jaundice HIV is less infectious, i.e. not every contact leads to infection. There are cases of couples where one partner has the virus in the body but despite regular unprotected sexual intercourse over several years there is no infection. On the other hand there are cases where the virus was transmitted through a single incidence of sexual contact. The probability of infection during a single act of unprotected sexual intercourse is indeed small, but because of the possible consequences every risk is too great. The probability of infection through the exchange of used syringes however is relatively high because a direct transfer of virus-containing blood takes place. On the other hand, generally speaking, the HI-virus in the air is no longer infectious after a few hours. How can one protect against infection? In everyday situations with people with HIV and Aids there is no danger of the virus being passed on. There are only a few occasions when protection against infection is necessary and the following should be observed. Do not use used syringes. During sexual intercourse: use contraceptives unless the couple are in a long-standing, mutually faithful and loving relationship and neither is an intravenous drug user. During oral sex care must be taken to ensure that neither sperm nor vaginal fluid during menstruation come into contact with the mucous membrane of the mouth. There is no vaccine against HIV. At present there is no vaccine which can prevent infection by HIV. One reason for this is that the HI-virus has certain properties which allow it to evade the effects of conventional vaccines; a phenomenon which to a lesser extent applies to the development of anti-influenza vaccines. Furthermore not enough is known about the characteristics of the virus nor of the human defence mechanism to develop an effective vaccine. Many research groups are engaged in the search for vaccines and several are currently undergoing clinical trials. Treatment, Advice, Care. At present HIV infection is incurable. However, progress is being made in the treatment of the disease.New therapy combinations against HIV have the effect of limiting the ability of the virus to multiply thus allowing the defence system to recover. This leads to an improved state of health and a reduced susceptibility to further chance infections. Most people consider these effects desirable and essentially more important than the limitations and side-effects associated with the medication. In addition to progress in the treatment of HIV-infection there has also been some success in dealing with secondary infections and the prevention and treatment thereof can now be better adapted to suit the needs of people with HIV and Aids. Most cases can be treated as out-patients i.e. there is no need for hospitalisation. In some ways the infection can be compared with other chronic illnesses such as diabetes or high blood- pressure in that by careful monitoring of medication intake and results possible side-effects and the appearance of complications can be avoided. The long-term benefit of mostly simple treatment of these well-known and widespread diseases is recognised. Treatment of HIV-infection is more complicated and the experience of combined therapies against HIV is so far limited to a few years. Therefore people with HIV/Aids often feel insecure. They are afraid of side-effects and relapse. It is important for those caring for people with HIV and Aids to bear these facts in mind. The quality of life of those with HIV and Aids is considerably better today than it was a few years ago. An indication of this is the fact that the number of those hospitalised with HIV and Aids and the length of stay have decreased noticeably. Georg Linsi, AIDS-Hilfe Switzerland
|
|
|
|
|
|
|
|
|
