HIV/AIDS Pandemic Hits 30-Year Mark With Hope

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Heady times

The early years were both "exciting and fascinating" in a scientific sense, she said, but also unspeakably tragic in a personal and clinical sense.

"Remember, all of our patients died -- 100 percent," Hamilton said. All a doctor could do was try to help them die with a maximum of dignity and a minimum of suffering.

Looking back from 2011, it seems as if progress was relatively swift. After the initial report, it was only three years until, in 1984, the virus was isolated. A year later, the first diagnostic test was licensed and in 1987 AZT, the first anti-HIV drug, was approved.

But at the time, it seemed horribly slow, according to Dr. Sten Vermund, a pediatrician at Vanderbilt University School of Medicine in Nashville, Tenn., and also a member of the IDSA Center for Global Health Policy and Advocacy.

In the 1980s, when Vermund was working in New York, "things looked like they were progressing very slowly because of the death that just permeated our city," he told MedPage Today.

"HIV washed over us like a slow tsunami," he said.

There were treatments for the various opportunistic infections that were killing HIV-positive people, he said, but the drugs "just didn't get a clinical response."

Now, of course, we know why -- HIV had knocked out the immune system cells that are the key allies of any drug therapy.

Then, in 1996, doctors could suddenly offer long-term hope, with the advent of highly active anti-retroviral therapy, or HAART. Drug "cocktails" could now keep people with HIV from progressing to AIDS and dying.

The End of the Beginning

To paraphrase Winston Churchill, the battle against HIV/AIDS was not at an end, nor even at the beginning of the end. But it was, perhaps, at the end of the beginning.

For people like Carol Hamilton, it was "miraculous." From helping people to die -- she once said she felt like a "midwife of death" -- she could now help them live.

Although the early years of the pandemic were terrifying and frustrating for those on the front lines, it's fair to say that scientific progress over the past 15 years has been constant.

Indeed, Fauci goes so far as to call it "breath-taking" as dozens of new drugs were developed and several new methods of prevention were discovered and shown to work.

Indeed, within the past month, a landmark study has shown that treating people with HIV can reduce the chance they'll transmit the virus by 96 percent.

Dr. Michael Saag, of the University of Alabama Birmingham, says that finding puts an additional value on treatment.

"Not only can we treat people and keep them alive for a normal lifetime," he told MedPage Today, but as an "added bonus" the treated people will be highly unlikely to transmit HIV.

"To me, treatment is prevention," he said.

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