On World AIDS Day: the chronology of a still fatal disease

Even four decades after its discovery, AIDS continues to be responsible for the deaths of hundreds of thousands of people. Now, of all things, the corona pandemic could contribute to the production of a first vaccine.

The first AIDS cases were diagnosed 40 years ago – but at that time there was neither the name AIDS nor more precise information about the cause of the immune deficiency disease. Since then, 36.3 million people around the world have died of AIDS, but significant progress has been made in combating the disease.

World AIDS Day on Wednesday is a reminder that this pandemic has not yet been defeated either. The following chronology shows the course from the first discovery to today’s vaccine research.

40-year history: from “4H” to AIDS

On June 5, 1981, the CDC reported a rare form of pneumonia in young homosexuals in California. It is the first official warning about AIDS – at the time, however, nobody knew that it was a new disease. In late 1981, health officials found the same infections in drug users, and in mid-1982 in hemophiliacs receiving blood transfusions and in Haitians who immigrated to the United States.

Therefore, first of all, the “4H” disease is spoken of, which stands for homosexuals, heroin addicts, Haitians and “hemophiles”, that is, hemophiliacs. The name AIDS was coined in 1982 and is the abbreviation of “acquired immune deficiency syndrome”.

In January 1983, French researchers isolate a new virus they call LAV, which they believe “could be involved” in AIDS. On April 23, 1984, the USA announced that the US virologist Robert Gallo had found the “probable” AIDS pathogen, a virus baptized HTLV-III. LAV and HTLV-III ultimately turn out to be the same pathogen that was given the name Human Immunodeficiency Virus in 1986, or HIV for short.

Virus is getting bigger and bigger in the 90s

Science is already making rapid progress. In March 1987, the first antiretroviral therapy with zidovudine was approved in the USA. It is expensive and has significant side effects.

Meanwhile, the deadly virus continues to spread among the population. US actor Rock Hudson becomes the first star to die of AIDS in October 1985. It was followed by Queen frontman Freddie Mercury in November 1991 and ballet star Rudolf Nureyev in January 1993. A year later, AIDS finally became the most common cause of death in the United States between the ages of 25 and 44.

First successes of combination therapies

In 1995 and 1996, the introduction of two types of drugs marked a turning point in AIDS therapy: protease inhibitors and reverse transcriptase inhibitors (RTIs). This is the beginning of combination antiretroviral therapies, which are proving to be very effective against HIV. In 1996 the number of AIDS victims in the USA fell for the first time.

A report by the World Health Organization (WHO) and the UN AIDS Program (UNAIDS) published in November 1999 states that 50 million people have been infected with the HIV virus worldwide since the first onset of AIDS. 16 million of them died. Africa is the hardest hit continent with 12.2 million people infected.

After the signing of an agreement between UNAIDS and five pharmaceutical giants in 2000 to distribute affordable AIDS drugs in poor countries, a compromise was reached in the World Trade Organization (WTO) the following year. Developing countries are now allowed to manufacture inexpensive copycat products for AIDS drugs, so-called generics.

Corona pandemic restricts AIDS therapies

It will take until July 16, 2012 for the first preventive HIV treatment to be approved in the United States. The so-called HIV pre-exposure prophylaxis (PrEP) for people not infected with HIV consists of an antiretroviral drug cocktail called Truvada. Treatment in which people at high risk of HIV infection take a tablet as a preventive measure has established itself as an effective protection.

In 2017, for the first time, more than half of those who carry HIV will receive antiretroviral treatment. According to UN figures, the proportion has risen to around three quarters to date: 27.5 million of 37.7 million people infected worldwide are receiving suitable therapy.

However, the corona pandemic is also proving to be a specific threat here. The global spread of the coronavirus and the restrictions imposed on it are putting the UNAIDS goal of ending AIDS as a threat to public health by 2030 at risk. Because of the pandemic, access to health systems, AIDS tests and therapies is restricted around the world.

Still no vaccine in sight

Within a few months, science has developed several vaccines against the new coronavirus. Doctors have been working on an injection against AIDS for decades – without success.

The HI viruses are particularly complex and therefore difficult to neutralize. “They infect cells of the immune system” and integrate their genetic material into their DNA, says Olivier Schwartz from the Pasteur Institute in Paris. While most people recover from an infection with SARS-CoV-2 on their own and are then immune for the time being, this is not the case with HIV.

Previous vaccine trials have provided insufficient protection

In addition, the HI virus mutates much more easily than the corona virus, says Schwartz. Therefore it is “more difficult to generate antibodies with a broad spectrum that could block the infection”. A vaccine was recently tested in southern Africa to protect against several types of HIV. But the attempt was stopped because the vaccination was inadequate.

As is so often the case, when it comes to manufacturing a vaccine, the main thing is that there is a lack of money. Huge sums of money have been made available for the development of the corona vaccines. These funds are not available to AIDS research. 38 million people are currently living with AIDS. Vaccination is the only way to eradicate the disease.

Is an mRNA vaccine the solution?

Several dozen AIDS vaccines are currently being tested. The biotechnology company Moderna launched an mRNA vaccine against HIV in the summer that is based on the same technology as the successful corona vaccine.

“The use of this technology opens up new possibilities and that gives hope for viruses like HIV,” says Gilles Pialoux, AIDS specialist at Tenon Hospital in Paris. However, the final results are not expected for a few years. The fight against HIV could ultimately benefit from the corona pandemic.


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