This page serves as an introduction to AIDS: the scope of the epidemic, current medical treatments, and information on other web sites with additional information.
The AIDS Epidemic
AIDS is rapidly becoming one of the top five causes of death in the world. Current conservative estimates are that about 33.2 million people are now HIV-positive, half women. Of these, over three million are children. Just last year, 2.5 million people were newly infected worldwide, and 2.5 million people died from AIDS. About seven thousand more people become infected each day, of whom 10% are babies.
In the US, since the first cases of AIDS were seen in 1980, approximately 470,000 Americans have died of AIDS. It is estimated that 980,000 Americans are currently infected with HIV, including over ten thousand children under fifteen. The Centers for Disease Control (CDC) estimates that forty thousand Americans are newly infected each year. For people between the ages of 25 and 44, AIDS is the leading cause of death.
The AIDS epidemic is escalating at a terrifying rate in the countries of sub-Saharan Africa and Asia. In parts of Africa, AIDS has caused the average life expectancy to shorten by 25 years. There are some countries in which one quarter or more of the adults are infected. At some prenatal clinics, as many as 70% of expectant mothers are HIV-positive. In these countries there is little or no money for treatment. There is not even enough money to perform tests so people can know whether they are infected.
Entire social and economic systems are collapsing under this pressure. In Uganda, the average number of people per nuclear family unit has tripled because friends and relatives have had to take in so many orphaned children whose parents died of AIDS. It is hard to imagine the ramifications of such drastic changes in family structure, especially since the families in these areas were already terribly poor. The United Nations estimates that 15 million children have been orphaned worldwide because of AIDS, and the number is rising each year.
AIDS is an ugly way to die. In one survey, more than half of San Francisco physicians admitted to illegally giving their terminal AIDS patients enough opiates so the patients could end their own lives.
In the face of these cold numbers, we remember the real, individual people we know and have known whose lives have been devastated by this disease. Each person lost to this disease is a separate tragedy.
AIDS research has focused on developing drugs which prevent HIV from reproducing. This so-called "war on HIV" has bought time, alleviated symptoms, and brought hope. It has not yet brought a cure. The consensus among researchers is that no drug will be able to make an HIV-positive person become HIV-negative again. (For a more detailed explanation see Note on "Cures".)
Even the most effective current treatments - combinations of older anti-retroviral drugs and newer protease inhibitors - fail frequently. In a 1997 study by the San Francisco General Hospital AIDS clinic, the combination treatments failed within six months for more than half of the people using them. In addition, there are a variety of problems associated with these "cocktail" treatments.
HIV mutates 6000 times faster than the common cold. As soon as researchers find a drug to directly control HIV in an infected person, an evolutionary process begins in the person's body to make versions of the virus that are immune to the drug. Drug resistance is rapidly becoming a serious problem. Furthermore, resistance to one drug frequently brings resistance to other drugs, a phenomenon called cross-resistance.
Already, only a few years after many of these drugs came onto the market, 26% of newly infected individuals carry strains of HIV which are resistant to one of the three classes of current AIDS drugs, and about 3% carry strains which are resistant to all three types. There is every reason to believe that drug resistance will continue to spread rapidly.
In order to control mutation rates, current drug regimens are extremely exacting. Large quantities of pills must be taken at precise times, sometimes to within a fifteen minute interval. Some pills must be taken with water, some with food, some on an empty stomach. Even slight deviations from the schedule can result in the virus rapidly becoming drug resistant. Two studies designed to simplify this regimen were halted early because the reduced treatments failed to keep the viral levels down.
In addition, scientists are discovering more and more harmful long-term side effects of these drugs, including dangerous fat deposits similar to Cushing's syndrome, and increased risk of diabetes and hemolytic anemia. Even less dangerous side effects are unpleasant enough that many people are unable or unwilling to take the drugs because of them.
Furthermore, current drugs are expensive, costing $15,000 or more per year for maintenance doses alone. The costs in both money and side effects increase dramatically during times of crisis or when drugs to prevent opportunistic infections are added.
Most people in the world cannot afford the current drugs. Some U.S. insurance companies and HMOs will not pay nearly this much for drugs, leaving even the insured unable to afford this treatment. Many programs that help pay for AIDS drugs have run out of money. Medicare, HMOs, private insurers, and the health budgets of entire nations are all running low on funds. Since December 1997, Medicare has funded these drugs only for people diagnosed with AIDS, and not for all of those infected with HIV. Consequently, care suffers. Few receive optimum treatment.
In addition, the high price of the drugs increases economic and ethnic disparities. Minority populations are already disproportionately underrepresented in clinical trials. The costs of drug treatments make them inaccessible for some of the very populations in which HIV is spreading most rapidly.
Despite these difficulties, current AIDS treatments have been life-saving for many people with AIDS. Because of the treatments, for several years the death rate due to AIDS in the United States was going down. Unfortunately, primarily because of increased drug-resistance, that trend has recently reversed.
Each year in the United States, more than $1 billion is spent on AIDS research. However, the vast bulk of this money is spent advancing basic research and the current types of therapies. As Dr. Martin Delaney of Project Inform put it, "We need more than just better versions of what we already have. We need whole new approaches to treatment."
The Institute for Applied Biomedicine has created and is developing a whole new approach to AIDS treatment. Please see Our AIDS Drug to learn more about our approach. We are a not-for-profit biotechnology firm. Our unique research is funded entirely by grants and charitable donations. Our progress relies on you to Support Our Research.
There are numerous sites on the World Wide Web that present information about AIDS and HIV. The references here are only a small sample. Many of them will refer you to other resources. The Institute has compiled this list as a public service and does not specifically endorse any of the information contained therein.
General Sites about HIV/AIDS
Sites about HIV/AIDS Treatment or Research
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