AIDS/HIV, Molecular and Cell Biology
117
9
Summary
The HIV epidemic is a global problem that
has been controlled but not eliminated in
the western world. The vast majority of
infected individuals live in sub-Saharan
Africa where access to treatment for the
v
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u
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t
sc
om
p
l
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c
a
t
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n
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se
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t
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em
e
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limited. SigniFcant loss of life and dis-
ruption of family and society has occurred
in this part of the world due to HIV. Re-
current suggestions that HIV may not be
the causative agent of AIDS have seriously
set back educational programs in a num-
ber of countries and are unfounded and
irresponsible. Countries that have taken
advice and help and approached the prob-
lem with a vigorous education campaign
such as Uganda have reaped the rewards
with the HIV positivity rate in the antena-
tal population halving over a period of less
than 10 years. Until vaccines are devel-
oped and antiretroviral therapy becomes
more widely available, these sort of ap-
proaches should be powerfully supported.
In the western world, antiretroviral ther-
apy has transformed the prognosis, and
conceivably, a middle aged person acquir-
ing HIV might now have a normal lifespan
given the additive effects of the slow onset
of clinical disease, the availability of an-
tiretroviral drugs, and the combined time
window these provide for the appearance
of new therapies. While the death rate
has fallen in the west, the incidence of
HIV infection has continued to rise. This
is partly because of increased longevity
of infected individuals and also from in-
creasing numbers of migrants from highly
endemic areas who may seek access to
western health resources. This trend is in-
creasing and will provide an increasing
burden on western healthcare services.
There is still no reason why an unin-
fected person cannot be protected against
HIV since transmission is preventable by
barrier methods of contraception, vaginal
virucidal agents, and so on. However, the
key to the control of HIV in the near future
in the developing and developed world is
education.
Acknowledgments
I would like to acknowledge S. GrifFn for
contributions to the Fgures.
See also
Genetic Engineering of
Vaccines; Genetics, Molecular Ba-
sis of; RNA Virus Genome Packag-
ing.
Bibliography
Books and Reviews
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tiretroviral Treatment of HIV Seropositive
Individuals. BHIVA Guidelines Co-ordinating
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Cohen, O.J., ±auci, A.S. (2001) Pathogenesis
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