Moses_Scurry

I'm a little late in the game on this one, but I'll offer a few tidbits in case they might help someone. I'm about to get a PhD in Virology with a focus on HIV viral entry, so you know I'm not some crackpot making this up.

1. The rate of transmission from a woman or homosexual man to the partner is significantly reduced if the partner is circumcised. They didn't know this in the mid-'80's, but men have been circumcised forever, so it would still come into play. There have been stories of doctors in Africa having huge lines of men waiting to be snipped.

2. There is a mutation that occurs primarily in people of European descent. It occurs at about a 10% frequency or so. The CCR5delta32 mutation is a mutation of the CCR5 receptor that renders the person immune to infection by CCR5-tropic HIV strains, except for VERY rare cases (there are only 5 or 6 known infected individuals that carry the mutation in the world!). People carrying the mutation don't show any signs of problems relating to it, but it is now starting to look like they are more susceptible to West Nile Virus. This would be a very realistic reason why the husband and child were uninfected in this particular story. However, this mutation was not discovered until the mid-90's, so the people in the story would not know why they were uninfected.


Hope this helps. I feel good using my newly acquired HIV knowledge!

EDIT: Here are a couple links. The first is for the CCR5 mutation, and the second is for transmission and circumcision. I was wrong in that they knew about the circumcision correllation in the late '80's, but I doubt that
the characters in the story would know about it unless they were scientists!

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_DocSum

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_DocSum

avesjohn

Thanks.

What can you or anyone else tell me about AIDS treatment in the early '90s? Would it be possible for the HIV to go completely undetected until after the birth of her child in '92, and by the time it is first identified inside her a short time later, could it already be in the AIDS stage? (How are the two stages differentiated?)

What would be the typical treatment (medicines, procedures, etc.) that the character(s) would go through from approximately '92 till her death in '96? About how long would it take for her to go from fairly healthy to absolutely confined to her hospital bed? When AIDS finally kills, what usually causes it? (Is a certain kind of cancer, or combinations thereof, that tend to be the ultimatum of sufferers?)

Maybe I'm being redundant, and if so, I apologize. Oh well. I'm just trying to be accurate.

I need to know treatments that are consistent with the time period (again, 1992-1996), though, so I can know what the characters will have to deal with.

Thanks in advance for all the help.

Moses_Scurry

Well, since I've only been in the field for a few years, I'll do what I can.

The first ever treatment that was approved was AZT, so I would say to start by doing a wikipedia search for AZT. In the early nineties, people were taking "the cocktail" (a casual name for HAART), which was a combination of three or more medications, depending on their stage in the disease. A good google or wikipedia search would be HAART (Highly active anti-retroviral therapy).

Back in the early nineties, the quality of life for people on HAART was not good. Some had to take 20 or more pills a day. SOme pills had to be taken with food while others had to be taken on an empty stomach. Also, some of the pills had to be taken at very specific times of day, even if it meant having to wake up at one in the morning to take a pill. The side effects were pretty brutal. All of the therapies were designed to keep an HIV positive person from progressing to clinical AIDS. Clinical AIDS is pretty much the end of the line. Now people still take new versions of the "cocktail", but the medicines are much better and only have to be taken once a day.

The actual definition of clinical AIDS, I believe, is when the T cell count of the person drops below 200/ml. It is also the point where opportunistic infections start to take over. Most people die from Kaposi Sarcoma, which is a rare form of cancer. Other ways to die include Pneumonia and Toxoplasmosis. The time it takes for an HIV person to progress to clinical AIDS in the absence of therapy is very variable from person to person, so yes it would be possible for someone to not know about it for a very long time. Some people have naturally stronger immune systems, and it can also depend on the strength of the viral strain. Now they make you take an HIV test when you are married in some states, when you apply for health insurance, and when you're pregnant, so I don't think your scenario would work now. I'm not sure about 1992.

For a person to find out they are HIV positive in 1992 and die in 1996 after taking HAART, it would have to be a very strong strain of HIV or they would have to have contracted it many years before finding out. Most people who correctly take their medications live many years. THere's no definite timeline for when a person goes from being healthy to being bedridden. You can pretty much write that as it works for you. Once a person has shifted to clinical AIDS, they generally don't live much longer. I would give her a year tops with much of it being spent in the hospital. They also can suffer from "AIDS-related dementia" which has symptoms like Alzheimer's disease.

That's about all I can give you off the top of my head. Do a search for AZT and HAART to find the timelines. I think they were pretty much done using AZT by the mid-'90's.

Creator

Or maybe, that fellow has got a natural resistance to the HIV virus? It's unlikely but it's one in a million chance. And since males pass down genes, the baby would probably be immune.

In the case of cockroaches, if a certain pesticide has killed the mom, the babies will be immune to that pesticide. I heard of this somewhere long time ago.

Just my two cents, I hope I do not sound too silly.....

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Banzai

You heard it wrong then. If mummy cockroach has been killed, mummy cockroach isn't going to be having any baby cockroaches. If one cockroach in twenty has an immunity to a certain pestacide, and that pestacide is used, then only one will survive, and that one will pass the immunity on to it's children, thereby producing a cockroach population entirely immune to said pestacide. If the thing dies, it isn't immune.

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"Who is the third who walks always beside you?
When I count, there are only you and I together
But when I look ahead up the white road
There is always another one walking beside you"
-"The Wasteland" by T.S. Elliot

avesjohn

This is a more unconventional question, not directly concerned with the disease itself, but how the media handled it...googling it hasn't been much help so far, hence my asking it here.

Knowing that the initial CDC report concerning the 5 gay men in Los Angeles diagnosed with the rare form of pneumonia was published on June 5, 1981 (although AIDS wasn't officially named as such until the following summer), when exactly did this information make it into the mainstream media? Was it immediately thrown onto the airwaves and the front page of newspapers (I doubt it, but I wasn't there, so I can't answer that), or did the media wait until the death toll really started to rise? And, on a less essential note, how did the media handle it at first, before it was obvious the disease was reaching epidemic levels?

As always, thanks in advance.