This month marks the 30th anniversary of an important event in medicine. During the summer of 1981 in Los Angeles and San Francisco, physicians and scientists were uncovering a disease process that would wreak havoc on the lives of millions of people across the world. The disease was blind to race, genetics, demographics, gender, and diet. It's scary for me to think that HIV/AIDS is only a little older than I am, and it seemed to spring up from nowhere. Maybe other devastating diseases are lurking in the shadows, and will make their appearance during my lifetime.
I think what makes HIV/AIDS unique is the amount of support and activism around the cause. A grass roots movement started with candlelight vigils in the streets of Los Angeles. Later we witnessed the global involvement of the U.S. Centers for Disease Control and Prevention's partnership with the World Health Organization. I still remember during medical school when, on World Aids Day, we sat outside the campus library and lent pedestrians phones to call our congressional representatives to encourage them to support the fight against HIV. To increase awareness we created a large ribbon on the lawn made from small red flags and held a fundraiser called "Cue for the Cure," a pool tournament, the proceeds of which benefited an orphanage for children with HIV/AIDS in Uganda.
I think the most interesting development during the whole HIV/AIDS epidemic has been our ability to stop transmission. Before babies are born, the mother can take medicine to decrease the chance of transmission by 90%. Furthermore, although the virus can cause great harm and make a person susceptible to a multitude of disease processes, we now have the pharmaceuticals to tame it, offering a person with HIV/AIDS the opportunity to enjoy a quality of life that's as good any healthy person's.
In my training program, unfortunately, I'm exposed to fewer HIV patients than my friends who are training in urban community hospitals. However, the limited number of patients with HIV that I treat in my outpatient clinic diligently take their medicine and rarely miss doctor's appointments. They are active in their communities and want to do everything in their power to keep the virus at bay.
The future of HIV treatment has much room to progress, as our researchers continue to discover new targets to attack. There have been case reports such as the one in the March 2011 issue of Blood that have described an HIV cure using CCR5Δ32/Δ32 stem cell transplantation (Blood 2011;117:2791-99). But this cure took a truly massive effort, so it's impractical to pursue on a large scale. Still, this discovery offers a glimmer of hope that during my lifetime we will have a vaccine that can be offered to prevent HIV/AIDS. Perhaps one day HIV/AIDS will be as rare as polio.