HIV: From death sentence to lifetime treatment

Part One

‘IT is bad enough that people are dying of AIDS, but no one should die of ignorance.”         —Hollywood actress Elizabeth Taylor

William, who grew up in Davao City, was only 18 when he went to Metro Manila to study in one of the country’s most prestigious schools. His parents wanted him to be a lawyer. He was an outstanding student during his first year. But after meeting some friends, everything changed.

His friends brought William to a pub one evening. There, the young man was introduced to a beautiful guest relation officer. And the rest, as they say, is history. Since then, William was picking up girls here and there.

Lately, however, he started suffering from a chronic cough that lasted for more than a month. He also experienced itching in several parts of his body, aside from having swollen lymph. William decided to see a doctor and told him his problem. After hearing his woes, the doctor asked William about his sexual lifestyle.

Quite surprised at the question, the young man told his story just the same. After conducting several blood tests on William, he was asked to return a week later.

“I am sorry to tell you this William,” the doctor told him when he returned, “but you are positive of HIV.” 

The doctor is referring to human immunodeficiency virus, an infectious particle that is too small to be seen with the naked eye or even a conventional light microscope. Bacteria are 1/1000 of a millimeter and can be seen with a light microscope. But with its HIV, it is 1/10000 of a millimeter in diameter and can only be seen with an electron microscope.

HIV causes Acquired Immune Deficiency Syndrome (AIDS), “a specific group of diseases that result from suppression of the immune system related to infection with the virus.”  Actually, HIV is a relatively weak virus outside the human body. But once it is inside, HIV cannot be killed.

The first case of HIV infection in the Philippines was reported in January 1984. But it was not until in 1992 that Filipinos came to finally see a person with HIV, when Ma. Dolzura Cortez told the Philippine Daily Inquirer how she got the dreaded virus.

Ceres P. Doyo, author of the series, won a Science and Technology Journalism Award from the Philippine Press Institute. In 1992 Cortez died and the following year, her life was made into a movie, Dahil Mahal Kita: The Dolzura Cortez Story, starring award-winning thespians Vilma Santos and Christopher de Leon.

In the beginning, having HIV was considered a death sentence.  Most of those who were infected in the early years of the disease died almost a year or two after they had been diagnosed.

The origin of AIDS is still a mystery. Several theories have been forwarded but none so far have been proven. As former Zambian President Kenneth Kaunda puts it: “It is not important to know where it came from but rather where it is going.”

AIDS was first clinically observed in 1981 in the US. Medical science was baffled of the epidemic of Pneumonoycustis carinii, a rare opportunistic infection, among injecting drug users and homosexual men in Los Angeles, California. In New York there was also an epidemic of a rare skin disease called Kaposi’s sarcoma among homosexual men. 

As it was a new disease, the US Centers for Disease Control and Prevention (CDC) coined the phrase “the 4H disease” as it seemed to affect heroin users, homosexuals, hemophiliacs and Haitians. The general press, however, used the acronym GRID, which stood for gay-related immune deficiency. 

It was not until in 1982 the name AIDS came into existence. The CDC defined it as “the presence of reliably define diseases that are due to an underlying immune deficiency and where the immune deficiency is not due to other known causes.”

In 1983 Dr. Luc Montagnier from the Pasteur Institute in France isolated a virus from the blood of AIDS patients, which he called lymphadenopathy associated virus (LAV). In 1984 Dr. Robert Gallo and his fellow workers at the US National Cancer Institute isolated a virus that they called the human T cell lymphotrophic virus (HTLV III). 

The two above viruses were found to be the same and in 1986 an international committee agreed to rename the virus as human immunodeficiency virus. The original virus was called HIV 1 while the second one was given the name HIV 2.

“It was found that there could be a period of up to 10 years between being infected with the virus and developing the symptoms of AIDS,” wrote John Hubley, author of The AIDS Handbook: A guide to the understanding of AIDS and HIV. “For each person with symptoms of AIDS, there could be more than 100 others who were carrying the virus but did not have the disease. These ‘HIV antibody positive persons’—sometimes called ‘HIV positive’, ‘seropositive’ or ‘carriers’—showed no signs of AIDS at that point in time but were able to infect others.”

HIV is spread through the exchange of body fluids with high viral load, like cerebral fluid, amniotic fluid, blood, semen, cervical and vaginal secretions and breastmilk. The virus is transmitted by sexual intercourse (vaginal, penile, anal and in some instances oral), blood and blood products (through transfusion) and shared needles.

A woman infected with HIV may spread the virus to her child during pregnancy, during birth or shortly after birth, and through breastfeeding.

In the late 1980s and early 1990s, most Filipino journalists were indignant about it. In addition, information about it was miniscule and mostly not factual but based on hearsay. In the National Media Practitioners’ Symposium on AIDS in those days, a publisher of a Visayas-based newspaper reportedly asked if rice from Thailand could cause the spread of HIV in the country. At that time, the Philippines was importing rice from Thailand because of rice shortage.

“In Thailand a good number of people are positive carriers of HIV,” the publisher was quoted as saying. “Now, I would like to know if it was good to import Thailand rice considering the situation.”

Because of this, the AIDS Society of the Philippines conducted an AIDS media contest among journalists from print, television and radio. The story I wrote for the Mod Magazine, “Who says AIDS doesn’t matter?” won the Best Feature Story in Print, which necessitated me to attend the AIDS Conference in Asia and the Pacific in Kuala Lumpur, Malaysia. 

It also paved way to attend two more international gatherings: in Melbourne, Australia, and Durban, South Africa. It was in the latter that I had an opportunity of meeting in person the Nobel Peace prize laureate Nelson Mandela.

At the said conference, one of the most controversial issues was the belief of then-South African President Thabo Mbeki that AIDS was caused by poverty and not HIV. Several Nobel laureates signed a manifesto telling the world that HIV is the cause of AIDS.

During the closing ceremony, Mandela asked his countrymen to support their president and his scientific enquiry, saying, “The president of this country is a man of great intellect who takes scientific thinking very seriously and he leads a government that I know to be committed to those principles of science and reason.”

Stressing the need for the world not to indulge in mud-slinging and worthless arguments, he reiterated, “The ordinary people of the world, particularly the poor—who on our continent will again carry a disproportionate burden of this scourge—would wish that the dispute about the primacy of politics or science be put on the backburner and that we proceed to address the needs and concerns of those suffering and dying. And this can only be done in partnership. History will judge us harshly if we fail to do so right now.” 

Mandela further said, “Wasting words and energy in worthless ridicule distracts us from our main course of action, which must be not only to develop an AIDS vaccine, but also to love, care for and comfort those who are dying of HIV/AIDS. A vaccine shall only prevent the further spread of HIV/AIDS to those not already infected; we must also direct our concern toward those who are already HIV positive.”

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