Aids History of the Disease

By September 1981, the Center for Disease Control (CDC) in Atlanta had compiled a list of just over 100 deaths ascribed to Kaposi s sarcoma or to Pneumocystis carinii pneumonia or both. Ninety-five of these patients were gay white males. The number of such deaths rose to 270 by the end of the year, and all of the post-mortems revealed immune systems that were essentially devoid of T-lymphocytes with body organs engulfed by organisms like Staphylococcus aureus, E.coli and Cryptosporidium. Somewhat surprisingly, the numbers of B-lymphocytes, that is, the ones already committed to producing antibodies, were within normal levels, and so the disease was clearly highly specific for the T cell system. In particular, one class of lymphocyte, the CD4 lymphocyte, was absent or very severely diminished in numbers. 

This ignorance led to alarm as the first cases appeared in haemophiliacs, who had received the blood protein factor VIII. This was not only a serious health concern but also a major commercial problem, since worldwide sales of blood products was estimated to be around two billion US dollars. For haemophiliacs, the situation was dire. Because of the large quantity of blood plasma that had to be processed in order to obtain factor VIII, and the large number of injections they needed each year, it was estimated that each patient could be exposed to the blood of up to three million donors. At this time, the manufacturers of factor VIII did not use heat-treatment procedures, as they did from 1987, but nonetheless, the causative agent appeared to be pretty rugged. The appearance of the disease in haemophiliacs rendered the name GRID inappropriate for the condition, and this was now replaced by the term Acquired Immune Deficiency Syndrome or AIDS. 

There was still no real awareness of the potential seriousness of the epidemic. By March 1983, a mere 1350 cases of AIDS had been reported to the 

Center for Disease Control (CDC) in Atlanta, and all but a few of these were in the USA or Haiti. The Republican-controlled US Senate and the White House of Ronald Reagan were reluctant to recognise a condition that affected gays and Haitians The small number of European cases, most of whom had spent some time in Africa, seemed to imply an African origin for the infectious agent, with onwards transmission via Haiti to the USA. 

There is now a serious danger that alarm about the disease physicians call acquired immune deficiency syndrome (unhelpfully, AIDS for short) will get out of hand. For the characteristics of this previously unrecognized and perhaps non-existent condition are so alarming that the temptation to portray it as a disease invited by a decadent civilization - a kind of latter-day version of the fate of Sodom and Gomorrah - is almost irresistible. 

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