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30th Anniversary of the first reported cases of AIDS

5th June 2011 was the date of the Sunday that just passed. I slept in because my wife and I had a late Saturday night enjoying a film that studied a variety of wildlife in conjunction with the sacred practice of ancient Chinese martial arts a.k.a Kung Fu Panda 2.

When we woke it was already late morning. We went through our usual routine of preparing the baby for his weekly session at the baby gym. We were ultimately disappointed when we found out that the building that housed the baby gym was flooded out due to the torrential downpour in the early morning.

So it was off to lunch at Grandma’s house followed by a relaxing walk around the Botanical Gardens. A bit of nature is always good for the baby. This was followed by dinner at the club and back home for an early night for Mondays demand an early start.

A beautifully mundane day and what I would describe as a perfect day.

It must have been an equally ordinary day for most people exactly 30 years ago on 5th June 1981 when Kim Carne’s Bette Davis Eyes was number 1 on the billboard charts. Except, it was on this day that the US CDC published in their MMWR 5 cases of previously healthy young men who were struck down by Pneumocystis Carinii Peumonia (PCP). Little did the scientists know that they had reported the very first cases of AIDS. A new disease that would eventually kill millions of people, challenge everything we thought we knew about infectious diseases and bring us to question the morality behind the commercialization of life saving therapy.

Today, we take a lot of what we know about HIV and AIDS for granted. This was not the case 30 years ago. It is hard to imagine the fear amongst the medical community as they were forced to watch helplessly as the young healthy die from infections that even children can easily fight off. No one knew if it was a bacteria or virus or fungus or maybe even a genetic disease causing this. Whatever it was, it had completely destroyed the immune system of these poor victims leaving them to be consumed alive by the first infection that came upon them.

As more and more reports of similar cases poured in from around the world, scientist scrambled to get a hold of the situation. Like a really bad episode of CSI, they fell back on epidemiology to provide some clues. What was it that the victims had in common? Find the link and find the killer.

It soon surfaced that all the patients suffering from this new disease had a similar biological marker. A specific immune cell called the CD4+ T-Cell was consistently found to be in abnormally low levels in all the victims. Something was targeting, finding and killing the CD4+ T-Cells in their body. CD4+ T-Cells were an essential part of the immune system and without it, patients were left defenseless against the most simple infections.

As it turns out, there had been a recent discovery of a virus known as Human T-Cell Leukemia Virus (HTLV). HTLV was part of a family of viruses know as retro-virus and until very recently, it was thought that retro-viruses could not infect humans. Fortunately, despite this wide held belief, some scientists held strong and pushed on with their research, developing new research techniques that made great strides in discovery that contributed significantly to the discovery of the HIV virus.

HTLV was transmitted through blood and sexual contact and also from mother to child. This fit all the evidence that has been collected on this new disease. The final piece of the puzzle came when it was found some victims caught this new disease via receiving transfusions of filtered blood. These filters would remove all micro-organisms larger than a virus so the conclusion was it had to be a virus causing this disease that by that time, was given the name AIDS.

With all these evidence in place, scientists started looking for a virus in AIDS victims that looked like the HTLV virus. 2 labs, one in the US and one in France spearheaded the efforts to identify this mystery virus.

Identifying the virus was more challenging than was realized. AIDS was a disease that took years to develop and patient usually had numerous other infections. Thus even if a virus was identified in a patient, it was difficult to tell if it was the cause of the disease or just another opportunistic infection that the patient has because of his poor immune system.

In 1983, a candidate virus was identified that seemed to fit the bill. As more research was done, this same virus was consistently identified in patients suffering from AIDS. Also, it was found that this virus was strongly attracted to CD4+ T-Cells. Similar viruses were also isolated from Macaques who had AIDS. All these evidences led the scientific community to accept HIV as a cause of AIDS in 1984. And in 1985, a blood test was developed and made available to blood-transfusion centers thus nearly eliminating the transmission of HIV via blood transfusion.

On 10th December 2008, very likely another mundane day for the most of us, Françoise Barré-Sinoussi and Luc Montagnier ascended the stairs of the Stockholm Concert Hall and received the Nobel Prize for medicine for their role in the discovery of the HIV virus. No doubt a perfect day for the both of them.

About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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11 Comments

  1. Hello Doctor,

    For months on end now I have suffered(on and off) severe discomfort and inflamation in my outer vagina. It gets soo uncomfortable and itchy and the itching causes sores. I have used treatment (cream -canesten and tablet- gynodaktarin) as was recommended by my physician and this only relieved for a while. It just came back again; this time with a white odourless liquid discharge. Any ideas on what could be causing this? I also need advise on how to treat my long term partner because I suspect that I gave it to him and he could be re-infecting me each time we have sex after I am fully treated.

    A very concerned Miss Chang

    • Recurrent severe discomfort with sores. Sounds like Herpes. White liquid discharge could be anything but taking your situation in context, could very well be an infection. Aside from Herpes, any number of infections can be causing this from STD realted ones to non-STD related ones. You need to see a doctor and get a vaginal swab test to see what’s wrong. Also, try to see the doctor when you are having the sores. This will help with diagnosis. Please post any follow up questions on http://www.askdrtan.com

  2. 陳醫師你好:

    因為我的英文能力不好,所以需要以中文向您提問

    我的狀況如下:

    1.我在2011/11/26號,有與一位泰國女子危險性交,僅放入約5~10秒(感覺對方陰道裡面很乾燥),之後將手指伸入女方陰道指交,直到對方陰道有大量分泌物,之後戴上套子完成性交。

    2 我在2011/12/6 ,與另一名泰國女子有帶保險套性交,但我是一個毛囊炎患者,在屁股,以及性器官的上方(恥毛處)有大量毛囊炎傷口,如果對方的陰道分泌物大量的流在毛囊炎的部位,會有可能得到hiv嗎?

    最後補充

    我個人在12/10號,在泰國康明醫院檢驗,陰性。

    第一名泰國女子在12/31,CMIA檢驗,陰性。

    第二名泰國女子在2012/1/2,Ela陰性。

    我又在1/4,非康明醫院,抗體檢查,陰性。

    請問,我還需要三個月去複檢嗎?? 我是否已經排除了危機呢??

    非常感謝醫生你的協助

    祝你新年快樂,萬事如意!

  3. Thanks, I really appreciate ur prompt reply and grateful for ur words.

    Just a last question.

    Does ur clinic offer treatment for HIV or I will be referred to CDC for treatment if tested positive.

    Thanks again

    With a heart
    Jasp

    • Hi Jasper,

      We do not offer treatment. We will either refer you to a doctor in Singapore eg. CDC or a doctor from Bumrungrad Hospital in Bangkok.

      rgds

      Dr Tan

  4. Hi Dr Tan,

    I’ve been having some symptoms which I’ve believe that I’m infected with HIV.

    I’m having bad endless toothache sometimes at night and I have a blister on the sole of my feet which is causing pain to me while walking for like weeks. Skin rashes on my face for months.

    All of this symptoms as mentioned was like half a year to a year after my first sexual experience in my whole life with a prostitute.

    I’m really afraid to go to the clinic outside and get tested positive. And end up jobless and etc.

    Please advise

    Thanks

    Rgds
    Jasp

    • Hi Jasper,

      It is really no use to keep worrying and putting yourself through such anguish. You must get yourself tested. If you are infected then so be it. Get treatment. You will still lead a relatively normal life. Any HIV positive people reading this please give Jasper some support. However, it is much more likely that you are NOT infected. Your symptoms really do not sound like ARS symptoms to me. Neither does the timing of your symptoms fit. What is more important is to find our what exactly is causing your symptoms and get treatment. There are a lot of other things worse than HIV that you can have. Be brave, bite the bullet and see a doctor. That is the only thing you need and must do.

      rgds

      Dr Tan

  5. Dr,

    My condom broke while having sex with a sex worker last night, I immediately withdrew and used a fresh one , I had not ejaculated at that time. Please advise when and what to do, I am so depressed and anxious. She is from Vietnam.

    • Hi chau,

      You should see a doctor and discuss with him whether or not you should be on PEP.

      rgds

      Dr Tan

  6. hello dr i had unprotected insertive anal sex i had an 9 day hiv rna and 31 day hiv rna test less than 20 copies i also had an 31 day and 88 day hiv dna pcr test negative i also had an third generation hiv test at 88 days negative i also had an 102 day rapid blood oraquick hiv test negative can i get on with my life i have been so stressed please help me if you can thank you for taking the time to answer my questions

    • Hi hector,

      You have multiple tests that conclusively prove you do not have HIV. There is no reason for you to be stressed. You do not have HIV and you really should forget about the whole thing and get on with your life. Anal sex is a very risky sexual activity in terms of contracting HIV. Please stay safe and use protection in the future.

      rgds

      Dr Tan

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