Global HIV/AIDS Statistics and History

Global HIV and AIDS Statistics

• In 2023, 39.9 million people globally were living with HIV.
• 1.3 million people became newly infected with HIV in 2023.
• 630,000 people had died from AIDS-related illnesses in 2023.
• 30.7 million people were accessing antiretroviral therapy in 2023.
• Since the start of the epidemic, 88.4 million people have become infected with HIV.
• 42.3 million people have died from AIDS-related illnesses since the start of the epidemic.
• The pandemic started in the 1980s.
• AIDS was already pandemic in Africa around this time (“slim disease”).

A Brief Chronicle of HIV/AIDS

• Lecture covers the start of the HIV/AIDS pandemic as a deadly disease.
• Also covered were identification of the causing agent and its origin as well as scientific understanding of HIV and AIDS.
• It notes that HIV does not discriminate, highlighting the social battle and inequity.
• Furthermore, covered were life-saving antiretroviral drugs and disappointing HIV vaccine trials.
• There is hope of ending the HIV/AIDS pandemic.

Historical Events

• The first cases of AIDS were in 1981.
• Initially, it was not called AIDS.
• Patients with abnormal immune systems suffered from infections.
• The alarm was raised because people had unusual infections, such as Pneumocystis pneumonia.
• In 1983, the virus was discovered and called AIDS.
• Montagnier and Barre-Sinoussi worked together in Paris, while Gallo worked in the US, and each contributed to the discovery of HIV.
• Montagnier and Barre-Sinoussi shared the Nobel Prize in 2008, excluding Gallo.
• Gallo pioneered retrovirus studies and discovered HTLV-1 and 2, leading to the initial name for HIV as "HTLV-3."
• Early identification of CD4 as an HIV receptor allowed scientists to identify which cells were infected and killed in-vivo (CD4 T cells), which causes immunodeficiency and cancer.
• Cases of AIDS in the US numbered 762 in Europe.

Timeline of HIV Discoveries and Treatments

• A blood test for HIV was licensed by the FDA.
• The HIV genome was sequenced.
• A 13-year-old hemophiliac with AIDS, Ryan White, was banned from school, highlighting the stigma and isolation associated with HIV at the time.
• An International AIDS conference was held in Atlanta.
• LAV and HTLV-III were renamed HIV.
• AIDS was already known in Africa as "slim disease" because people lost weight.
• HIV-infected individuals were barred from entering the US until 2010.
• Princess Diana shook hands with an AIDS patient without gloves.
• AZT (Zidovudine) was the first antiretroviral drug, approved by the US FDA in 1987; only somewhat effective as a monotherapy due to quick resistance.
• The Ryan White CARE Act helped pay for HIV treatment.
• ddI was introduced as a second HIV drug, similar to AZT as a reverse transcriptase inhibitor, with AZT and ddC used in combination
• Mark Winberg's lab showed that 3TC can suppress HIV in culture
• AZT, ddI, and ddC aren't used as first-line drugs; however, 3TC remains one of the three drugs still used due to its effectiveness and tolerability.
• HIV protease inhibitor was approved, targeting the protease was more effective as it lowered the chances of mutations and resistance.
• Discovery that HIV infection required co-receptors (chemokine receptors) in addition to CD4.
• CCR4/CCR5 identified as HIV co-receptors, later learned the Europe have deletion in CCR5 being naturally immune, using CCR5 becoming a target for gene therapy.
• Nevirapine was also approved as a non-nucleoside HIV RT inhibitor, given to pregnant women to prevent congenital spread to baby.
• In 1996, use of HAART gave dramatic clinical and decrease from HAART.
• There have been issues with people on HIV drugs, and people would die before being examined
• The Welldone company cut AZT price by 75%
• There are many side effects of HARTS, lipodystrophy and fat distribution
• The transmission of multi-drug resistant was documented
• HIV can spread from non-human to humans, chimpanzees become HIV-1 and sooty mangabeys becoming HIV-2.
• The WHO announced AIDS was the fourth largest death at the time in 1999.
• In 2001, Cipla offered HIV drugs for less than $1 a day.
• In 2004, host factor Trim5alpha discovered.
• In 2005, Nelson Mandela's sons died of AIDS.
• In 2006, Atripla, a one-a-day pill, was approved
• In 2010, The travel ban was lifted in the USA.
• In 2011, early initiation of ART reduced by 96% with serodiscordant couples.
• In 2012, the FDA approved PrEP for HIV-negative people to prevent transmitting.
• In 2013, it was found that it was working in HIV and AIDS by almost 30%

UNAIDS Targets

• In 2014, UNAIDS’ "Fast Track" program aimed to eliminate the epidemic as a public health issue by 2030.
• UNAIDS launched the 90-90-90 targets for 2020 to diagnose 90% of those with HIV, provide ART to 90% of diagnosed individuals, and achieve viral suppression for 90% of those in treatment.
• In 2015, the WHO recommended antiretroviral treatment, soon as possible, regardless of CD4 count.
• In 2017, over 50% of all the global population with HIV were getting retroviral drugs.

Current Status

• An estimated 80 million people have been infected, 39 million are estimated to be living with HIV, and nearly 630,000 will die
• HIVsmart is a tool developed in McGill allowing ppl to check themselves, even diagnosing those who are positive easier.
• Education is needed, as well as having the drugs needed to combat it.

Future Strategies

• The present bubble is too big, need new drugs to combat is, and lower the amount.

Challenges That Still Exist

• Viral transmission and drug resistance still exist.
• The continued use of sub-optimal therapeutic regimens in developing countries is a risk too.
• Long lasting ARt's are needed, with some as little as 2X a month, as pill form.
• Current studies show the drugs are being looked at, such as F/TDF

Prevention of HIV

• PrEP
• Treatment as prevention
• Vaccines, although it would great if it as

HIV Vaccine Timeline

• Timeline of HIV vaccines, some were negative and there were also some that have a 30% effectiveness.