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'''Acquired Immune Deficiency Syndrome''' (usually referred to as '''AIDS''') is an (at present) incurable disease caused by long-term infection with the [[HIV|Human Immunodeficiency Virus]].  

In 2017, the ''Specialty Pharmacy Times'', "When combatting viruses such as [[HIV]], several enzymes in the immune system may malfunction and cause cancer-related mutations, according to a new study published by Nature Communications."<ref>[https://www.specialtypharmacytimes.com/news/fighting-hiv-other-viruses-could-trigger-cancer-mutations Fighting HIV, Other Viruses Could Trigger Cancer Mutations], ''Specialty Pharmacy Times'', 2017</ref>

In September 2010, [[Reuters]] reported: "Nearly one in five gay and bisexual men in 21 major U.S. cities are infected with HIV, and nearly half of them do not know it".<ref>https://www.reuters.com/article/2010/09/23/us-aids-usa-idUSTRE68M3H220100923</ref> A September 2010 report of the [[Centers for Disease Control and Prevention]] (CDC) declared : "[[Homosexuality|Gay]], [[bisexual]], and other men who have sex with men (MSM) represent approximately 2% of the US population, yet are the population most severely affected by [[HIV]] and are the only risk group in which new HIV infections have been increasing steadily since the early 1990s. In 2006, MSM accounted for more than half (53%) of all new HIV infections in the United States..."<ref>https://www.cdc.gov/hiv/topics/msm/index.htm</ref> In August 2009, LifeSiteNews reported: "An official with the [[Centers for Disease Control and Prevention]] (CDC) announced the CDC's estimate Monday that in the [[United States]] [[AIDS]] is fifty times more prevalent among men who have sex with men ('MSM') than the rest of the population."<ref>https://www.lifesitenews.com/news/archive/ldn/2009/aug/09082609</ref>  See also: [[Homosexuality and AIDS]]


== Diagnosis ==

According to the CDC's 1993 guidelines,<ref>https://www.cdc.gov</ref><ref>http://www.merckmedicus.com/ppdocs/us/hcp/content/merck/hiv/hivaids/aidsdefi.htmAIDS is defined</ref> as follows:
HIV infection ''plus'' any of the following:
*[[CD4]] count less than 200 or
*CD4 percentage less than 14% of total lymphocytes or
*Any of the following illnesses: pulmonary TB, recurrent pneumonia, invasive cervical cancer.
*Expanded definition including 23 clinical conditions published elsewhere<ref>https://www.cdc.gov/MMWR/preview/mmwrhtml/00018871.htm</ref>

The World Health Organization uses a different staging method for HIV disease.<ref>http://www.aids-ed.org/aetc/aetc?page=cm-105_disease</ref>

It should be noted that there are a large number of types and subtypes of HIV, some of which are extremely rare in most countries, such as HIV-2, and HIV-1 Group O, and as a result, routine screening tests in some countries may not be designed to test for those particular, extremely rare, variations.<ref>http://www.avert.org/hiv-types.htm</ref>

== History ==

''See also:'' [[Gay bowel syndrome]]

The illness was first recognized in the early 1980s<ref>New England Journal of Medicine, Volume 344:1764-1772  June 7, 2001  Number 23</ref>  as homosexual men presented to their doctors with a rare lung disease called ''Pneumocystis carinii'' pneumonia (PCP).<ref>Pneumocystis pneumonia -- Los Angeles. MMWR Morb Mortal Wkly Rep 1981;30:250-252</ref> Early on, the "[[gay disease]]" took on a variety of names, including "gay cancer" and "Gay-related immune deficiency" (GRID). The [[Centers for Disease Control]] noticed an increase in requests for drugs needed to treat this illness and launched an epidemiological investigation.  

Although the first cases of the disease probably go back to the 1950s, the epidemic was not recognized until the early 1980s.[http://www.avert.org/his81_86.htm] The early epidemic occurred in two main branches; in the US and other developed countries, and in sub-Saharan Africa.  In the US, the early epidemic was primarily spread by homosexual sex, intravenous drug use, and blood transfusions (prior to the introduction of testing).  In Africa, transmission was almost exclusively by heterosexual sex.  Currently, most new infections worldwide are spread by promiscuous heterosexual sex and prostitution.

Former U.S. President [[Ronald Reagan]] made this statement in 1990 with regard to the case of Ryan White (who had refused admission to school after being diagnosed with AIDs):
<blockquote>
We owe it to Ryan to make sure that the fear and ignorance that chased him from his home and his school will be eliminated. We owe it to Ryan to open our hearts and our minds to those with AIDS. We owe it to Ryan to be compassionate, caring and tolerant toward those with AIDS, their families and friends. It's the disease that's frightening, not the people who have it.— April 11.
</blockquote>

== Natural History ==

After infection with [[HIV]], the virus quickly replicates in lymphatic tissue and travels through the blood to infect most areas of the body.  The largest consequence of this is the "hijacking" of certain immune cells, especially so-called T-Helper, or CD-4, cells.  Early in the infection, the immune system holds the infection at bay, often causing "Acute Retroviral Syndrome", a flu-like illness.  Patients often have swollen lymph nodes. After approximately 8–10 years of infection, the immune system begins to lose its battle.  This is primarily seen in the loss of numbers of CD4 cells, however the changes are somewhat more complex.  When the CD4 cell level drops low enough, AIDS becomes apparent.
The first symptoms of the illness are generally night sweats, weight loss, and oral thrush.

== Opportunistic Infections (OIs) ==

The hallmark of AIDS is the appearance of ''opportunistic infections'', meaning infections with organisms that do not usually cause human disease, unless given the right "opportunity".  This opportunity is the reduction in cell-mediated immunity, first seen in patients with certain cancers or on anti-rejection drugs for organ transplantation.
These infections include:

*[[Candida albicans]]. Caused by the candida fungi, resulting in thrush (mouth) and vaginal yeast infections. Most common HIV-related fungus infection. 
* Cryptoccoccal Menigitis. A yeast-like fungus infection that usually involves the brain and lungs, although it can affect almost any organ. Most often occurs when a person's CD4+ T cell count falls below 100 cells per cubic millimeter of blood.
*Cryptococcus neoformans (a cause of meningitis).
*[[Cytomegalovirus]].  Virus can affect the entire body, but it commonly affects the eye's retina, causing blurry vision and in severe cases, blindness. Most likely to occur when a person's CD4+ T cell count falls below 100.
*Epstein Barr virus (leads to a type of lymphoma).
*Human herpesvirus-8 (causes Kaposi's sarcoma). Results in reddish-purple lesions that usually appear on the skin. 
* Liver Disease. One of the leading causes of death among AIDS patients, 
*Mycobacterium avium complex (atypical mycobacterium). Bacterial infection that can cause persistent fever, night sweats, fatigue, weight loss, anemia, abdominal pain, dizziness, diarrhea and weakness. Most likely occurs when the CD4+T cell count falls below 50.
*[[Mycobacterium tuberculosis]] (TB). 
*Pneumocystis jiroveci, previously [[Pneumocystis carinii]]. Condition occurs when a fungus infects the lungs. Symptoms may include night sweats and fatigue, fever, cough, difficulty breathing, weight loss. Most likely to occur when the CD4+ T cell count falls below 200.
* Progressive Multifocal Leukoencephalopathy (PML)  Rare disorder of the nervous system caused by a common human polyomavirus, JC virus. Can occur when the CD4+T cell count falls below 200.
* Recurrent Pneumonia. Most likely to occur when the CD4+ T cell count falls below 200 
*Staphylococcus aureus (primarily causes skin infections).
*Streptococcus pneumoniae (the primary cause of pneumonia in AIDS patients).
*[[Toxoplasma gondii]]. Condition occurs when a parasite infects the brain. Symptoms include confusion or delusional behavior, severe headaches, fever, seizures and coma. Most likely occurs when the CD4+ T cell count falls below 100.<ref>[http://www.ucsfhealth.org/adult/medical_services/infect/hiv/infections.html Infections Associated with AIDS, UCSF Medical Center.]</ref>

== Dissent ==
Among many medical professionals and biologists, there is general agreement that HIV causes AIDS.  In this, those of Koch's postulates that apply to viral diseases have been clearly fulfilled, and basic science research has shown the same.  Specific drugs have been developed that treat HIV infection and AIDS, helping show the causal relationship.  That being said, there is a vocal minority of people, scientists and non-scientists alike, who do not believe that HIV causes AIDS.  Foremost among these is Dr. Peter Duesberg.  Details about these "re-thinkers" and their arguments can be found at several websites,<ref>Peter Duesberg on AIDS - Duesberg.com - HIV/AIDS research website for Peter H. Duesberg http://www.duesberg.com/</ref> but not in any reliable peer-reviewed journals. This viewpoint has also received some official support from the government of [[South Africa]], where a nurtitional policy based on beetroot and garlic sources has found effective in combating the county's severe AIDS problem, despite a concerted effort by liberal scientific groups and the pharmaceutical industry (who would stand to benefit financially from continued association of AIDS with HIV) to discredit it. It is estimated that over $1 trillion has been siphoned off from health care worldwide for antiretroviral drugs to treat AIDS, despite growing evidence that a good general diet can be just as effective.

==AZT controversy==
In Bruce Nussbaum's 1990 book, ''Good Intentions: How Big Business And the Medical Establishment Are Corrupting the Fight Against AIDS'', 
a large portion is about how [[Anthony Fauci]], head of the [[National Institutes of Health]] (NIH), used the federal bureaucracy to block all research on the development of a drug to treat AIDS in the late 1980s. Fauci pushed his patented Interleukin 2, a derivative of which became the highly toxic and controversial AZT.<ref>https://www.amazon.com/Good-Intentions-Business-Establishment-Corrupting/dp/0871133857</ref>

In Celia Farber's 1989 expose on the scandal surrounding AZT, ''Sins of Omission'', newspapers across America banner headlined that AZT had been proven to be effective in antibody positive, [[asymptomatic]] patients even though one of the main concerns was that the drug should only be used as a last resort for critically ill AIDS patients because of the drugs extreme toxicity. Fauci, head of the National Institute of Health, was pushing to expand its use, and implied in a later interview that he either was inspired to do so due to [[ACT-UP]]'s terrorism, or otherwise used it as an excuse to do so.<ref>https://www.youtube.com/watch?v=wy3frBacd2k</ref> The [[FDA]]'s traditional concerns had been set aside. AZT was already being by an estimated 20,000 people in sixty countries.  Not only had no new evidence dispelled the initial concerns regarding AZT's toxicity and safety, but the follow-up data that had been promised was ignored. The beneficial effects of the drug had been proven to be temporary. the toxicity however stayed the same.  

AZT had been approved faster than any drug in FDA history, and activists considered it a victory. The price paid for the victory however was that almost all government trials focused on AZT, while over 100 other promising drugs were left uninvestigated. The pharmaceutical manufacturers' stock price went through the roof when the announcement was made. AZT was the most expensive drug ever marketed. 

On August 17, 1989 the government announced that 1.4 million healthy antibody positive Americans could benefit from taking AZT even though they showed no symptoms of the disease.  New studies have proven that AZT is effective in stopping the progression of autoimmune deficiency syndrome in asymptomatic and early cases.

==Progress in treatments==
While there has been no announcement to the end of AIDS, it seems scientists have successfully treated a baby born with HIV. Further studies will be needed to see if the baby, in fact, has been successfully treated in the long term.<ref>https://www.cbsnews.com/8301-204_162-57572271/baby-born-with-aids-virus-appears-to-have-been-cured/</ref>

==Cold War propaganda==
There are several discredited beliefs about AIDS, many of which are the result of a deliberate disinformation campaign for political purposes.  In the 1980s, the [[KGB]] initiated [[Operation Infektion]], claiming that the virus was formulated by military contractors on an American military base.  Since the widespread dissemination of this misinformation, HIV has been the subject of widespread [[Conspiracy theories]].  Louis Farrakhan, leader of the Nation of Islam, has long held that the virus was created to exterminate blacks.<ref>[https://www.poz.com/article/The-Secret-Plot-to-Destroy-African-Americans-7602-7053 The Secret Plot to Destroy African Americans]</ref>

== See also ==

* [[AIDS in Africa]]
* [[AIDS prevention]]
* [[Gay bowel syndrome]]
* [[Homosexuality]]
* [[Homosexuality and health]]
* [[Mortality]]

==External links==
*[http://newsbusters.org/blogs/robert-knight/2007/12/01/some-questions-media-wont-ask-today-about-aids Some Questions the Media Won't Ask Today About AIDS], Robert Knight, [[NewsBusters]], December 1, 2007
* [http://www.ucsfhealth.org/adult/medical_services/infect/hiv/infections.html Infections Associated with AIDS], University of California, San Francisco

==References==
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