Chapter 15 HIV and AIDS

Overview

AIDS is a disease caused by the virus HIV.  HIV undermines the immune system, leaving the infected person vulnerable to other diseases. As we saw in Chapter 14, the immune system has several ways of protecting the body from disease. When people have AIDS, their immune systems no longer function properly, so they are at risk of becoming ill from infections that would barely affect a healthy person. There is currently no cure for AIDS, and, without proper treatment, many people with the disease suffer long and painful deaths. However, much progress has been made in developing drugs that can control replication of the HIV virus in infected people, allowing many who receive consistent drug therapy to live long and relatively healthy lives. AIDS was first identified in the United States in 1981, but it was soon recognized in countries around the world, making it a pandemic disease (see Chapter 16). It quickly became one of the most feared and widely discussed diseases of our time. According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), about 76 million people became infected with HIV from 1980 through 2019, around 33 million died from AIDS or its consequences, and another 38 million people were living with the disease in 2019.  Worldwide, more than 17 million children have lost one or both parents to this disease. HIV is spread from person to person in certain infected body fluids (blood, semen, vaginal and rectal fluids, and breast milk, but not saliva, urine, or feces). Sexual contact is one of the main routes of transmission; thus, AIDS is a sexually transmitted disease (see Chapter 16). Throughout the HIV/AIDS pandemic, infected individuals have been stigmatized, often due to misconceptions concerning the disease, and this has caused infected individuals to experience significant psychological and emotional burdens, as well as interfering with robust testing and treatment programs. In this chapter we describe the biology of HIV and the path to scientific understanding of the virus; we also address the current status of the HIV pandemic, modern HIV therapies, and the social aspects of HIV/AIDS.

Chapter Outline

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Review Questions

THE PURPOSE of these review quizzes is to guide students in where their knowledge and understanding is strong, where it is weak, and where time should best be spent in studying.

CHAPTER 15:

  1. What causes AIDS?  What are some of its symptoms?  How was it discovered that AIDS patients had suppressed immunity?  How was the cause of AIDS  discovered?  (If you cannot explain these things, or if you are not sure, then you need to reread Section 15.1.)
  2. Describe the life cycle of HIV.  How does it cause infection?  Why is it so difficult to treat?  What are Koch’s postulates, and why was their relevance to the study of AIDS controversial?  What is a retrovirus?  (If you cannot explain these things, or if you are not sure, then you need to reread Section 15.1.)
  3. What cells are attacked by HIV?  How does HIV infection progress to AIDS?  What is an opportunistic infection?  What drugs can help fight AIDS?  How effective are these drugs, and what are their limitations?  Why is it difficult to develop a vaccine against HIV? (If you cannot explain these things, or if you are not sure, then you need to reread Section 15.2.)
  4. Describe at least three ways by which HIV can be transmitted from one individual to another.  Explain what can be done to block each of these routes of transmission.  What are some high-risk or likely-risk behaviors?  What are some low-risk behaviors?  What social factors have made AIDS education difficult?  In the last few decades, how has the pattern of HIV infection changed in different parts of the world? (If you cannot explain these things, or if you are not sure, then you need to reread Section 15.3.)

Open Response Study Questions

These questions are designed to assess your understanding of the topics explored in this chapter. You can use these questions in three ways:

Before you start …

Read through the questions before you read the chapter to help prime you to read the text more carefully and strategically. Remember that you are just starting out on your learning journey, so don’t feel disheartened if you don’t know how to answer them yet!

Whilst you read …

As you work through the chapter, have another go at answering the questions to see how you are progressing. You can also answer the questions with the textbook open in front of you, in order to create model answers that can be used to refer back to later.

At the end …

Answer the questions once you have finished reading to see what you have learned. Check your responses against your model answers and use these to identify any gaps in your understanding.

DEFINITIONS:

In your own words, define ANY TWO of the following terms:

Opportunistic infection           ZDV (AZT)         reverse transcriptase            interleukin-2

ESSAYS:

Answer any two of the following questions.  Make sure to answer all parts of any question you choose.

1. (A) What kind of disease is Kaposi’s sarcoma?  (B) How did this disease help scientists discover the cause of AIDS?

    (C) How was it determined that AIDS was transmitted by a virus?

2. Explain why a vaccine to protect against AIDS is an especially difficult vaccine to develop.

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Chapter 16
New Infectious Threats