The risk group is humanity
On December 1, humanity celebrates World AIDS Day for the 20th time. From 2005 to 2010, such days are held under the slogan "Stop AIDS, fulfill the promise!". We are talking about the commitment of the leaders of developed countries to provide access to modern methods of treatment and prevention of a deadly infection for all the inhabitants of the planet who need them no later than 2010.
According to the World Health Organization (WHO), since its inception in 1981, the HIV pandemic has led to 25 million deaths worldwide. The annual number of victims of infection is steadily increasing, and, according to recent forecasts, will increase until 2012, reaching a peak of approximately 2.5 million deaths per year. This year, according to WHO estimates, approximately 2.2 million people on Earth will become victims of HIV.
Already, mortality from HIV-related diseases has a powerful negative impact on demographic processes and socio-economic development of a number of regions. HIV does all this/AIDS is one of the most destructive and deadly epidemics in the history of mankind.
How did it all start?The official start of the HIV epidemic/
AIDS is considered June 5, 1981, when the weekly report of the Centers for Disease Control and Prevention of the United States reported an unusual group disease of pneumocystis pneumonia in homosexuals in Los Angeles. During the following months, similar groups of patients were identified in other American cities. In addition, it turned out that the same patients have a number of other infections characteristic of immunodeficiency states. In 1982, California epidemiologists suggested that the cause of unusual symptoms is some kind of infection transmitted through same-sex contacts. The alleged disease has received the conditional name "gay-related immunodeficiency" (gay-related immune deficiency, GRID).
Soon, however, it became obvious that the unidentified infection affects not only gay men: similar diseases were observed among injecting drug users of both sexes, as well as patients who regularly received blood transfusions. At first, Puerto Rican origin was also recognized as an independent risk factor. As a result, in August 1982, the disease received its modern name: acquired immunodeficiency syndrome, or AIDS (Acquired Immune Deficiency Syndrome, AIDS).
However, the causative agent of the new disease was still unknown. In May 1983, a group of scientists from the Louis Pasteur Institute, led by Luc Montagnier, isolated a new retrovirus from the punctate of the patient's lymph nodes. French researchers dubbed their discovery lymphadenopathy-associated virus (LAV). A year later, American virologist Robert Gallo confirmed the discovery of his French colleagues by suggesting his own name – human T-lymphotropic virus type III (HTLV-III).
The following year, a number of independent groups of researchers confirmed that Montagnier and Gallo described the same virus, which is the cause of acquired immunodeficiency syndrome. In 1986, a new pathogen finally got its modern name – human immunodeficiency virus, or HIV.
In 2008, Luc Montagnier and his co-author Francoise Bar-Sinoussi shared the Nobel Prize in Medicine and Physiology with the German virologist Harald zur Hausen, who showed a link between cervical cancer and the human papillomavirus (HPV).
African rootsShortly after the discovery of the immunodeficiency virus, it became obvious that before it was discovered in the United States, it had been circulating in African countries for a long time.
The earliest, at the moment, HIV samples were isolated from tissue samples of several patients who died in the early late 50s - early 60s of the last century. All of them were either Africans or had lived in Africa for a long time.
The closest relatives of the immunodeficiency virus are viruses that affect two species of African monkeys: common chimpanzees (Pan troglodytes) and smoky mangobeys (Cercocebus atys). According to the calculations of geneticists, monkey viruses overcame the species barrier and began to spread among humans between 1884 and 1924 in Central Africa. Under what circumstances this happened, it is not fully known, but the most likely version is the infection of hunters as a result of a bite or when cutting up the carcasses of killed animals.
Disappointments and hopesIn 1986, a group of reputable American virologists announced that an effective vaccine capable of protecting a person from infection with the immunodeficiency virus would be created within ten years.
More than 20 years later, one of the authors of the initial assessment, David Baltimore, admitted that scientists around the world have made little progress in finding a life-saving drug. The end of last year 2007 was marked by one of the saddest disappointments in the history of numerous attempts to create a vaccine against HIV infection: in clinical trials, the most promising drug not only did not reduce, but also slightly increased the risk of HIV infection among vaccinated volunteers from risk groups.
Somewhat more optimistic are the prospects of creating a therapeutic vaccine that does not protect against infection, but slows down the development of AIDS in HIV infection. According to Nobel laureate Luc Montagnier, such a drug may appear in four years.
And yet, the long-term efforts of doctors and scientists are already bringing practical results. The data of recent epidemiological studies indicate that modern antiretroviral drugs prolong the life of patients for decades. Thus, the life expectancy of a hypothetical resident of Europe or the United States with HIV infection is currently 32 years from the moment of diagnosis. This means that in recent years HIV has moved into the category of controlled chronic diseases like diabetes, and patients with this infection have every reason to expect many years of a full life, provided proper treatment.
Unfortunately, such bright prospects are guaranteed only to citizens of developed countries. The vast majority of infected inhabitants of the planet are still deprived of access to life-prolonging medicines: providing all those in need with expensive treatment is beyond the power of health systems in developing countries, and multibillion-dollar subsidies from sponsor countries have not changed this situation to date.
The HIV pandemic/AIDS has already put the population of several areas of South Africa on the brink of survival. In particular, in South Africa, carriers of incurable infection, according to WHO estimates, are up to 20 percent of adult men and women. If the rate of spread of the disease does not change in the near future, South Africa and other states of South Africa will face an inevitable catastrophe.
HIV in RussiaHowever, in the case of HIV, the problems of the "black continent" are not so far from the Russian reality.
According to the latest estimates of the WHO HIV Program/AIDS (UNAIDS) the number of carriers of HIV infection in the Russian Federation can reach one and a half million people. This puts Russia among the countries with a carrier level of 1 to 2 percent – on a par with Benin, Ghana or the Democratic Republic of the Congo.
The Russian authorities, through the mouth of Gennady Onishchenko, have repeatedly accused UNAIDS of publishing unreliable or inflated data on the HIV epidemic in the country. However, Rospotrebnadzor's own statistics – 448 thousand registered cases of HIV infection with 33.7 thousand detected only this year - are quite compatible with the estimated estimates of UNAIDS, assuming that the majority of infected people are still unaware of their status.
In addition to the difference in estimates, the constant tension in the relations of UNAIDS with Russian colleagues is caused by Russia's unwillingness to introduce methadone replacement therapy for injecting drug users, as well as from time to time renewed attempts to curtail or limit the activity of charitable organizations engaged in the exchange of disposable syringes in large cities of the Russian Federation.
It should be noted, however, that over the past three years, the attitude of the Russian authorities to the HIV problem has undergone significant changes. Since 2006, large funds have been allocated from the budget to provide patients with highly active antiretroviral therapy – now more than 37 thousand Russians receive the necessary medicines at the expense of the state. Since the same time, the number of citizens of the Russian Federation who have undergone preventive examinations for HIV infection has been steadily increasing: this year there are already more than 20 million people. On the eve of World AIDS Day, the State demonstrates its readiness to further increase efforts to combat the epidemic. In this regard, we can hope that the fate of South Africa will still pass our country.
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