HIV/AIDS研究的相关重要事件

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pumcpzg 发表于 2009-4-1 14:47

HIV/AIDS研究的相关重要事件。

Key moments in our understanding of—and response to—HIV/AIDS

Since it surfaced in the early 1980s, a lot has happened in response to the HIV/AIDS epidemic.See the HIV/AIDS timeline below to learn about some key moments in HIV/AIDS history.

1982
After it is known as gay cancer, new pneumonia, and Gay-Related Immune Deficiency (GRID),the syndrome is renamed acquired immune deficiency syndrome (AIDS) by the CDC when it becomes clear that the epidemic is affecting broader populations than originally thought (Stine, 1993)

The CDC releases its first AIDS case definition, which “defines a case of AIDS as a disease, at least moderately predictive of a defect in cell-mediated immunity, occurring in a person with no known cause for diminished resistance to that disease” (AIDS ACTION, n.d.)

The National Institutes of Health (NIH) rejects a proposal for a research study to determine whether women get AIDS (AIDS ACTION, n.d.)

1983
Dr. Luc Montagnier and his team at the Institut Pasteur in Paris, France isolate a new virus linked to AIDS (Barre-Sinoussi et al, 1983; Kanabus & Fredricksson, n.d.a). The first governmental AIDS hotline is established by the federal Department of Health and Human Services. The first woman is diagnosed with AIDS (in San Francisco) (AIDS ACTION, n.d.)

1984
Dr. Robert Gallo and colleagues at the US National Cancer Institute also isolate an AIDScausing virus. Scientists later conclude that Drs. Montagnier and Gallo discovered the same virus, which is named HIV (human immunodeficiency virus) (Stine, 1993). Later epidemiological evidence continues to strongly support the argument that AIDS is caused by a virus (Cohen, 1998)

1985
The first International AIDS Conference is held in Atlanta, Georgia. At the conference, the CDC lists the signs and symptoms of AIDS so that healthcare providers and researchers can identify and report cases, determine the extent of the epidemic, and figure out the cause of AIDS (Cohen, 1998)

Researchers discover a second retrovirus in West Africa that is closely related to HIV. The virus is spread from person to person in ways similar to HIV, and it is related to many of the same symptoms and sicknesses as HIV (Stine, 1993). To distinguish the two highly similar viruses, the first discovered retrovirus is named human immunodeficiency virus type 1 (HIV-1) and the second human immunodeficiency virus type 2 (HIV-2). (In common usage, “HIV” usually indicates HIV-1 because HIV-2 is rare in most parts of the world [Cohen, 1998])

The first test to detect HIV antibodies (called Enzyme-Linked Immunosorbent Assay, or ELISA) is approved in the United States (Stine, 1993). The test makes it possible to screen blood products, to detect HIV infection in people who have not yet developed AIDS, and to identify seroconversion (the time when the body’s immune system begins reacting to HIV, often with flu-like symptoms)  in newly infected individuals (Cohen, 1998)

Research leads to a description of the stages of HIV/AIDS. Although researchers initially believe that during the earliest (latent) stage of infection, HIV is more or less dormant. They later learn that, during this stage, virus particles are actively replicating in people’s lymphoid organs (which produce white blood cells that protect the body against disease [Cohen, 1998])

1986
The Surgeon General issues a landmark federal report to the Reagan administration and to the public that calls for AIDS awareness education and condom use to prevent the transmission of HIV

1987
The US Food and Drug Administration (FDA) approve the first drug for HIV infection (Kanabus & Fredricksson, n.d.b). The drug works by interrupting HIV’s invasion of a person’s healthy cells

1990
The political AIDS activism group ACT UP conducts a protest at the National Institutes of Health (NIH), demanding more HIV treatments and the expansion of clinical trials to include more women and people of color

1991
The FDA approves the second drug for the treatment of AIDS. It is to be used in combination with the first drug in adult patients with advanced HIV infection. This is the first successful use of a combination of drugs to treat HIV infection (Kanabus & Fredricksson, n.d.b)

1993
Reports show that some people infected with HIV who have never taken HIV drugs already have resistance to the drugs. This occurs because people transmitting HIV have themselves taken HIV drugs and are transmitting a variant of HIV that is already resistant to the drugs (Kanabus & Fredricksson, n.d.c)

The female condom, a polyurethane (plastic) sheath worn by a woman inside the vagina during sex, is approved by the FDA, offering women a new way to protect themselves against contracting HIV

In recognition of the increasingly diverse populations affected by HIV/AIDS, the CDC revises the AIDS case definition to be more inclusive of women and injection drug users; therefore, the number of documented AIDS cases goes up in these populations. Similarly, the NIH implements new guidelines requiring that women and minorities are included in all clinical trials involving human subjects, unless there are scientific reasons not to do so


1994
The CDC announces that AIDS is the leading cause of death among 25- to 44-year-old Americans (AIDS ACTION, n.d.)
The first HIV saliva test (OraSure) is approved by the FDA for use in clinical settings (AIDS ACTION, n.d.)

1995
The first protease inhibitor (a new class of antiretroviral treatment), is approved (AIDS ACTION, n.d.). Antiretroviral treatment for HIV-positive patients consists of drugs that work against HIV infection itself by slowing down the replication of HIV in the body

1996
The use of three antiretroviral medications used in combination becomes the new standard of HIV care. This approach to HIV treatment is sometimes called Highly Active Antiretroviral Therapy (HAART), or simply antiretroviral therapy. The drugs used in HAART target different stages of the HIV reproductive cycle, making HIV less likely to reproduce and to mutate

1997
The effect of new treatments is clearly seen as the number of Americans newly diagnosed with AIDS drops for the first time since the epidemic began. People with HIV in some countries are able to return to work as a result of the improvement in their health thanks to antiretroviral therapy (Kanabus & Fredricksson, n.d.c)

1998
The number of American AIDS deaths drops 47% from the previous year; the drop is credited to the effectiveness of HAART. Nonetheless, problems with HAART are noted. Many patients experience difficult side effects, including nausea, kidney failure, body shape changes, and even hallucinations. Healthcare professionals note that adherence to the complicated HAART treatment is a major concern in their communities (AIDS ACTION, n.d.)

1999
The CDC begins funding the “Prevention for HIV Infected Persons Project” (PHIPP), asking certain jurisdictions to make prevention for people with HIV (eg, preventing further infection to themselves and others) a priority. Grants are awarded to five health departments around the country

2000
Nonoxynol-9 (N-9), a common spermicide formerly believed to be a potentially effective barrier against HIV, is shown to significantly increase the risk of HIV transmission. Before this discovery, prevention efforts actively encouraged individuals to use products containing N-9, assuming it had some microbicidal effect against HIV (AIDS ACTION, n.d.)

2001
In a historic session of the United Nations General Assembly on the AIDS epidemic, participants unanimously pass a resolution declaring AIDS a global catastrophe and calling for worldwide commitment to end the epidemic

2003
The CDC announces a new initiative to target people who are living with HIV to address their prevention, transmission, and care needs. Of the 40,000 new infections that occur each year in the United States, 27,000 are estimated to be the result of transmission from people who are unaware that they are infected, whereas 13,000 are the result of contact with people who are aware of their HIV-positive status

The Bill and Melinda Gates Foundation awards $60 million to the International Partnership for Microbicides, the largest grant ever awarded to support work in this field

Combinations of anti-HIV medications are credited with declines in HIV-related sickness and death (Simoni, Frick, Pantalone, & Turner, 2003).

Drug therapy is also found to reduce the spread of HIV from mother to child when given to the mother from the second trimester of pregnancy until delivery, during labor and delivery, and to the baby for 6 weeks after birth (Cohan, 2003).

Antiretroviral therapy remains expensive. As a result, although HIV disease rates have fallen in many industrialized countries, they continue to rise in those parts of the world that cannot afford antiretroviral therapy.

Today in the United States, the two groups most affected by AIDS are men who have sex with men and injection drug users (IDUs). Other high-risk groups include hemophiliacs, heterosexual partners of people infected with HIV, blood transfusion recipients, Central Africans, infants of HIV-infected
mothers, and infants of injection drug-using mothers (Cohen, 1998; Kanki & Essex, 2000).

Currently, ethnic and racial minorities represent the majority of new AIDS cases, the majority of Americans living with AIDS, and the majority of deaths among persons with AIDS in the United States (Henry J. Kaiser Family Foundation, 2004). Women also account for a growing proportion of cumulative reported AIDS cases (CDC, 2005).