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history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
history of HIV
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history of HIV

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    • 1. collected by Dr MZ
    • 2. Mid-1970's-1980 history collected by Dr MZ Current pandemic started in the mid-to late 1970s approximately 100,000- 300,000 persons may have been infected 1978 gay men in the US and Sweden and heterosexuals in Tanzania and Haiti begin showing signs of what will later be called AIDS.
    • 3. 1981 History collected by Dr MZ 8 cases of KS among young gay men June 5, 1981: 5 cases of PCP in gay men from UCLA (MMWR)
    • 4. 1981: Initial Reports <ul><li>June 5, 1981: 5 cases of PCP in gay men from UCLA (MMWR) </li></ul><ul><li>July 3, 1981: 26 additional cases </li></ul><ul><li>Dec 10, 1981: 3 NEJM papers describe cases </li></ul>collected by Dr MZ Gottlieb MS NEJM 2001;344:1788-91
    • 5. 1982 History collected by Dr MZ GRID (gay-related immune deficiency) <ul><li>Community-Acquired Immune Dysfunction </li></ul><ul><li>1 st cases in women reported </li></ul><ul><li>1 st transfusion &amp; vertically transmitted cases reported </li></ul>AIDS by August
    • 6. 1982 History <ul><li>AIDS specific voluntary organizations </li></ul><ul><li>1. San Francisco AIDS foundation (SFAF) </li></ul><ul><li>2. AIDS project Los Angeles (APLA) </li></ul><ul><li>3. Gay Men’s Health Crisis (GMHC) </li></ul>collected by Dr MZ CDC reported first cases of possible MTCT A child died of AIDS after multiple blood transfusion
    • 7. 1983 History collected by Dr MZ Dr Robert Gallo from National Cancer Institute isolated the virus – HTLV III Dr Montagnier et al isolated the virus at Pasteur Institute France – called LAV 1984 History of the HIV epidemic, Marshall J. Glesby, Associate Professor of Medicine and Public Health, Weill Medical College of Cornell University
    • 8. 1985 History collected by Dr MZ FDA licensed the first blood test for AIDS for commercial production, First international Conference on AIDS held in Atlanta WHO consider the AIDS pandemic &amp; initiate Worldwide action
    • 9. 1985 History <ul><li>The actor Rock Hudson died of AIDS on October 3rd 1985 </li></ul><ul><li>A new WHO definition for AIDS was adopted </li></ul>collected by Dr MZ
    • 10. 1986 History collected by Dr MZ International Committee on the Taxonomy of Viruses ruled HIV A drug called azidothymidine (AZT) slowed down the attack of the AIDS virus
    • 11. collected by Dr MZ
    • 12. 1987 History <ul><li>FDA approved AZT as the first antiretroviral drug for AIDS treatment. </li></ul>collected by Dr MZ AIDS became the first disease ever debated on the floor of the UN General Assembly. WHO also reported that an estimated 5 to 10 million people were infected with HIV worldwide
    • 13. 1988 History <ul><li>A world summit was held in London to discuss a common AIDS strategy </li></ul><ul><li>Focused on AIDS prevention which emphasize </li></ul><ul><li>Education, free exchange of information &amp; </li></ul><ul><li>Experience, need to protect human rights &amp; </li></ul><ul><li>dignity </li></ul>collected by Dr MZ Announced by the Director-General of the World Health Organization as world AIDS day
    • 14. 1989 History <ul><li>A major drug trial known as ACTG01, AZT could slow progression to AIDS in HIV positive individuals with no symptoms at all </li></ul>collected by Dr MZ The second drug for the treatment of AIDS, dideoxyinosine (ddI) started to be made available to people with AIDS
    • 15. 1991 History <ul><li>The third antiretroviral drug dideoxycytidine (ddC) was identified. </li></ul>collected by Dr MZ Earvin (Magic) Johnson announced that he had tested HIV positive and that he was retiring from professional basketball. The red ribbon became an international symbol of AIDS awareness during 1991
    • 16. collected by Dr MZ
    • 17. 1993 History <ul><li>The tennis player Arthur Ashe died </li></ul><ul><li>Scientists had found that HIV &apos;hides out&apos; in lymph nodes and similar tissue early in the course of infection. </li></ul><ul><li>CDC had expanded the definition of AIDS to include additional OIs, as well as HIV infected adults with a CD4 count of less than 200. </li></ul>collected by Dr MZ
    • 18. 1994 History collected by Dr MZ Dual nucleoside therapy better than monotherapy (Delta, ACTG 175, ZDV/3TC) <ul><ul><li>ACTG 076: AZT reduces </li></ul></ul><ul><ul><li>mother-to-child transmission of HIV </li></ul></ul>History of the HIV epidemic, Marshall J. Glesby, Associate Professor of Medicine and Public Health, Weill Medical College of Cornell University
    • 19. 1995 History <ul><li>It was reported from Tanzania, that treating people for STIs substantially reduced people&apos;s risk of becoming infected with HIV. </li></ul><ul><li>Nelson Mandela called on all South Africans to speak out against the stigma, blame, shame and denial that has thus far been associated with this epidemic. </li></ul>collected by Dr MZ
    • 20. 1995-1996: The New Treatment Era <ul><ul><li>HIV viral load testing became available </li></ul></ul><ul><ul><ul><li>Clinicians could directly assess the effect of antiretrovirals on viral replication (HIV RNA) </li></ul></ul></ul><ul><ul><li>First protease inhibitor (Saquinavir) approved by FDA </li></ul></ul>collected by Dr MZ
    • 21. 1996: The Era of HAART <ul><li>Paradigm: Aim to achieve durable suppression of HIV viremia </li></ul><ul><li>Striking reductions in HIV-related morbidity and mortality </li></ul><ul><li>Aggressive treatment guidelines: “Hit hard, Hit early!” </li></ul><ul><li>Mathematical models suggested that 3 years of viral suppression would result in eradication </li></ul>collected by Dr MZ History of the HIV epidemic, Marshall J. Glesby, Associate Professor of Medicine and Public Health, Weill Medical College of Cornell University
    • 22. 1996 History collected by Dr MZ UNAIDS became operational on January 1st 1996 the FDA approved the drug Viramune (nevirapine), aggressive treatment with multiple drugs can convert deadly AIDS into a chronic, manageable disorder like diabetes
    • 23. 1996 History <ul><li>At the end of the year UNAIDS estimated </li></ul><ul><li>3 million people, mostly under the age of 25, newly infected with HIV, </li></ul><ul><li>23 million the total number of infected people. </li></ul><ul><li>6.4 million people; 5 million adults and 1.4 million children, had already died. </li></ul>collected by Dr MZ
    • 24. collected by Dr MZ
    • 25. 1998 - 2000 Realism <ul><li>HIV eradication is not possible with current therapy </li></ul><ul><ul><li>viral “reservoir” in resting T-memory lymphocytes </li></ul></ul><ul><ul><li>viral replication continues in lymph nodes even when HIV RNA in plasma is &lt;50 copies/mL </li></ul></ul><ul><li>Awareness that HIV is a chronic disease </li></ul><ul><li>Recognition of long-term toxicities: </li></ul><ul><ul><li>fat redistribution (lipodystrophy) </li></ul></ul><ul><ul><li>metabolic abnormalities (insulin resistance, diabetes, increased lipids) </li></ul></ul><ul><li>2000: Durban AIDS conference – momentum builds to bring antiretrovirals to the developing world </li></ul>collected by Dr MZ History of the HIV epidemic, Marshall J. Glesby, Associate Professor of Medicine and Public Health, Weill Medical College of Cornell University
    • 26. 1998 History <ul><li>the company AIDSvax started the first human trial of an AIDS vaccine </li></ul><ul><li>San Francisco started a pioneering Post Exposure Prophylaxis </li></ul>collected by Dr MZ The FDA approved Sustiva (EFV), another drug in the NNRTI group
    • 27. 1998 History <ul><li>A study found that </li></ul><ul><li>LSCS + AZT reduce risk of MTCT less than 1% </li></ul><ul><li>NSVD + AZT reduce risk of MTCT to 6.6% </li></ul>collected by Dr MZ Initial findings from a joint Uganda-US study identified a single oral dose of NVP, as being both more affordable and effective in reducing mother to baby transmission of HIV.
    • 28. 1998 History collected by Dr MZ In South Africa, Gugu Dlamini, an AIDS activist, was beaten to death by her neighbours after revealing her HIV positive status on Zulu television. In Botswana, Namibia, Swaziland and Zimbabwe, the estimates showed that between 20% and 26% of people were living with HIV or AIDS
    • 29. 1999 History <ul><li>In February 1999, a group of researcher from university of Alabama announced a type of SIVcpz was almost identical to HIV 1. </li></ul>collected by Dr MZ
    • 30. 1999 History <ul><li>In the United States a doctor who injected his former lover with HIV infected blood, was sentenced to 50 years in prison </li></ul>collected by Dr MZ In the UK a judge ordered that a five-month-old baby girl should be tested for HIV against her parents&apos; wishes.
    • 31. 2000 History <ul><li>In order to publicise the importance of HIV testing to African-Americans, reverend Jesse Jackson publicly took an oral HIV test. </li></ul>collected by Dr MZ The research suggested that in about 7% of cases, the virus was likely to have been transmitted during oral sex
    • 32. 2000 History <ul><li>Israel lost one of its most successful singers, Ofra Haza, from what was believed to be an AIDS-related complication. </li></ul><ul><li>Since her death the number of people coming forward for anonymous HIV testing and contacting helplines increased considerably. </li></ul>collected by Dr MZ
    • 33. 2001 History <ul><li>After years of denial, China finally admitted that HIV/AIDS threatened its public health and economic security. </li></ul><ul><li>Infections were predicted to grow from about 600,000 to 6 million by 2005. </li></ul>collected by Dr MZ
    • 34. 2001 History <ul><li>Indian drug company Cipla offered to make AIDS drugs available at reduced prices to the international aid organization, MSF. </li></ul><ul><li>Cipla&apos;s offer to produce drugs at a price less than US$ 1 day </li></ul>collected by Dr MZ
    • 35. 2001 History <ul><li>&amp;quot;In this effort, there is no us and them, no developed and developing countries, no rich and poor- only a common enemy that knows no frontiers and threatens all people.&amp;quot; </li></ul><ul><li>Kofi Annan at the G8 summit in Genoa </li></ul>collected by Dr MZ A few weeks after, it was announced that the Global AIDS and Health Fund was not only going to target AIDS as first suggested, but to also include TB and malaria . he fund was officially named as The Global Fund to fight AIDS, Tuberculosis and Malaria. GFATM
    • 36. 2001 History <ul><li>&amp;quot;At the time, I read the report with great interest, but I never imagined I was looking at the first sign of an epidemic, that in just 20 years would have infected 60 million people, killed 22 million and achieved the status of the most devastating epidemic in human history.&amp;quot; </li></ul><ul><li>Peter Piot recalling the first mention of the virus </li></ul>collected by Dr MZ
    • 37. 2001 History <ul><li>Kofi Annan appointed Stephen Lewis as his &apos;special envoy for AIDS in Africa&apos;. </li></ul>collected by Dr MZ
    • 38. 2001 History <ul><li>It was reported that some Asian countries had reduced the transmission of HIV through widespread condom use. In Thailand, new infections had plummeted from 143,000 in 1991 to 20,000 in 2000. </li></ul>collected by Dr MZ Without 100% condom programme 100% condom programme HIV infection
    • 39. 2002 History <ul><li>The US Secretary of State Colin Powell strongly advocated condom use to prevent the spread of AIDS and other sexually transmitted diseases </li></ul>collected by Dr MZ The UN Secretary General, Kofi Annan said the fear of stigma leads to silence and when it comes to fighting AIDS, silence is death&apos;
    • 40. collected by Dr MZ
    • 41. 2003 History <ul><li>Swaziland was believed to have the world&apos;s highest rate of HIV with almost four out of 10 adults infected with HIV </li></ul>collected by Dr MZ In February, a rare case of female-to-female sexual transmission of HIV was reported.
    • 42. 2003 History <ul><li>In November, the AIDS vaccine also failed in clinical trial in Thailand. </li></ul>collected by Dr MZ <ul><li>The UNAIDS warned that the efforts to stem the world&apos;s AIDS epidemic were &apos;entirely inadequate&apos;. </li></ul><ul><li>It was estimated that every day in 2003, an estimated 14,000 people got infected with HIV. </li></ul><ul><li>It was estimated that 40 million around the world including 2.5 million children were living with HIV/AIDS. </li></ul>
    • 43. 2003 History <ul><li>CDC announced a new four -part initiative to reduce the number of new HIV infections in the US </li></ul><ul><li>introducing HIV testing as a routine part of med care </li></ul><ul><li>use of rapid test </li></ul><ul><li>offer HIV-positive women routine HIV testing as part of their antenatal care </li></ul><ul><li>increased focus on people who are already infected with HIV and their partner tracing </li></ul>collected by Dr MZ
    • 44. 2003 History <ul><li>On World AIDS Day the WHO announced a new plan called &apos;3 by 5&apos; to provide HIV/AIDS treatment for many resource-poor countries. The WHO was hoping to have 3 million people in resource poor countries on AIDS drugs by the end of 2005. </li></ul>collected by Dr MZ
    • 45. 2004 History collected by Dr MZ In May, five Bulgarian nurses and a Palestinian doctor accused of deliberately infecting children with HIV were sentenced to death by a Libyan court. Mohammed Dica, was the first person in 137 years to be convicted in England and Wales for sexually transmitting a disease
    • 46. 2004 History <ul><li>President Bush&apos;s $15 billion initiative to combat the global AIDS pandemic, by now known as PEPFAR (President&apos;s Emergency Plan For AIDS Relief) </li></ul>collected by Dr MZ
    • 47. 2005 History <ul><li>Only around 1.3 million people in low- and middle-income countries had been receiving antiretroviral treatment – less than half of the 3 million target. </li></ul>collected by Dr MZ
    • 48. 2006 History <ul><li>US National Institutes of Health revealed the results of two African trials of male circumcision as an HIV prevention method with clear evidence that the intervention reduced HIV transmission by around 50%. The WHO and other organizations suggested they would soon begin promoting male circumcision in areas with severe HIV epidemics. </li></ul>collected by Dr MZ
    • 49. 2001- 2006 <ul><li>Interest in PI-sparing regimens </li></ul><ul><ul><li>Emergence of NNRTI-based regimens </li></ul></ul><ul><li>Deferred initiation of antiretroviral therapy </li></ul><ul><li>Interest in treatment interruption strategies </li></ul><ul><ul><li>Ultimately not supported by clinical trials </li></ul></ul><ul><li>Simpler, once daily regimens with fewer pills </li></ul><ul><li>Optimism about new classes of drugs </li></ul>collected by Dr MZ History of the HIV epidemic, Marshall J. Glesby, Associate Professor of Medicine and Public Health, Weill Medical College of Cornell University
    • 50. collected by Dr MZ 25 years of AIDS 6 Highly Active Antiretroviral Treatment launched 7 Scientists develop the first treatment regimen to reduce mother-to-child transmission of HIV 8 UNAIDS is created 9 The UN General Assembly Special Session on HIV/AIDS. Global Fund to fight AIDS, Tuberculosis and Malaria launched 10 WHO and UNAIDS launch the &amp;quot;3 x 5&amp;quot; initiative with the goal of reaching 3 million people in developing world with ART by 2005 40 30 20 10 0 50 35 25 15 5 45 Million 1980 1985 1990 1995 2000 2005 7 1 First cases of unusual immune deficiency are identified among gay men in USA 2 Acquired Immune Deficiency Syndrome (AIDS) is defined for the first time 3 The Human Immune Deficiency Virus (HIV) is identified as the cause of AIDS 4 The first HIV antibody test becomes available 5 The first therapy for AIDS – zidovudine, or AZT -- is approved for use in the USA People living with HIV Children orphaned by AIDS in sub-Saharan Africa 1.1 1 2 3 4 5 8 9 10 6

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