AIDS at 30: Remarkable Progress, Still
Far to Go

SUMMARY June 5th marks the 30th anniversary of the first report of what would come to be known as AIDS, an occasion to look at progress in the field, but also acknowledge what remains to be done.

The June 5, 1981, issue of Morbidity and Mortality Weekly Report (MMWR) included an article about a mysterious cluster of Pneumocystis pneumonia (PCP) cases among formerly health gay men in Los Angeles. The July 4 issue soon thereafter described 2 dozen cases of PCP and a rare cancer, Kaposi sarcoma, in California and New York.

Before long, similar cases began appearing throughout the country and around the world, affecting not only gay and bisexual men but also hemophiliacs, recipients of donated blood, injection drug users, and children born to women in these categories. It soon became apparent that there was a new pathogen -- one that seemed to be both blood-borne and sexually transmitted -- that ravaged the immune system, leaving infected individuals susceptible to a wide range of life-threatening illnesses.

HIVandHepatitis.com today features a retrospective from long-time AIDS activist Matt Sharp, who was infected during these early years, describing his fight to stay on the cutting edge of HIV/AIDS treatment.

Anthony Fauci, now director of the National Institutes of Allergy and Infectious Diseases (NIAID), was an infectious disease doctor who treated some of the earliest AIDS patients and devoted his career to the disease. Fauci wrote an op-ed on the epidemic's progress to date and remaining challenges in the May 27, 2011, Washington Post.

"The early years of AIDS were unquestionably the darkest of my career, characterized by frustration about how little I could do for my patients," he wrote. "At hospitals nationwide, patients were usually close to death when they were admitted. Their survival usually was measured in months; the care we provided was mostly palliative. Trained as a healer, I was healing no one."

The first major breakthrough came in 1983 with the discovery of HIV, but the first drug to show some efficacy -- albeit short-lived -- was not approved until 1987. Fauci, who was named NIAID director in 1984, recounts how he was pressured from both sides, by scientists who felt AIDS would divert resources from other important diseases and by activists who believed the government was not doing enough.

"There is a stunning contrast between how I felt as a physician-scientist in the 1980s and the optimism I feel today as more infections are prevented and lifesaving drugs increasingly become available throughout the world," Fauci wrote. "In the 1980s, patients received a prognosis of months. Today, a 20-year-old who is newly diagnosed and receives combination anti-HIV drugs according to established guidelines can expect to live 50 more years. Furthermore, HIV treatment not only benefits the infected individual but can reduce the risk of transmitting the virus to others."

Fauci also gave a lecture on his perspective from involvement with HIV/AIDS over 30 years in Washington, DC, on May 31. A recorded webcast will be available soon at www.niaid.nih.gov/news/events/meetings/2011HIVAIDS/Pages/default.aspx.

In addition, Fauci and NIAID Division of AIDS director Carl Dieffenbach published an overview of HIV testing, new prevention tools, and the search for a cure in the May 31, 2011 online edition of the Annals of Internal Medicine.

An article on the recent resurgence of HIV cure research by HIVandHepatitis.com editor-in-chief Liz Highleyman appears in this week's Bay Area Reporter.

The first 2 MMWR reports of AIDS are included in The Body's comprehensive archive of articles on the history of the HIV/AIDS epidemic.

6/3/11

Reference

CW Dieffenbach and AS Fauci. Thirty years of HIV and AIDS: Future challenges and opportunities. Annals of Internal Medicine (free full text). May 31, 2011 (Epub ahead of print).
Other Sources

AS Fauci. After 30 years of HIV/AIDS, real progress and much left to do. Washington Post. May 27, 2011.

AS Fauci. Thirty Years of HIV/AIDS: A Personal Journey. NIH webcast. May 31, 2011.

L Highleyman. The quest for a cure. Bay Area Reporter. June 2, 2011.