Epidemics and pandemics (2): AIDS

Just over 40 years ago, in June 1981, a paper appeared in Morbidity and Mortality Weekly Report (MMWR) describing an opportunistic lung infection in otherwise healthy gay men.   The lung condition was pneumocystis pneumonia, and this was the first description of what came to be known as AIDS.   That first description, first article, was a case series, of five people, and therefore not evidence from particularly high up the traditional evidence pyramid.  I may have pointed this out to students when discussing evidence based practice and that pyramid.

There is more about this in this post from Circulating Now at the National Library of Medicine, with a link to a 1996 reprint of the article, reprinted as part of commemorations of the 50th anniversary of the CDC.

The 1981 article has been cited by 218 other things, according to its PubMed record, including some articles to commemorate the 40th anniversary of its publication. Like this one, which cites the first descriptions of the causative agent, published in 1983 and 1984.

The earliest article in PubMed that uses the name AIDS seems to be from MMWR in 1982, where the title has it as acquired immune deficiency syndrome and the abstract acquired immunodeficiency syndrome.    The abbreviation is used too.   Anything earlier that uses the abbreviation seems to be about hearing aids, teaching aids, and so on.   The earliest one not in MMWR was in the New England Journal of Medicine, and by the following year there was a journal called AIDS Research.  

I started in medical libraries in 1986, and AIDS was a current, hot, topic.   My memory is that it was thought to be (or perhaps more accurately portrayed as) something that affected gay men only, but as the NLM article above makes clear, in 1982 there were reports of cases in babies and adults that had received blood transfusions.   I had also noticed cases in Edinburgh among users of intravenous drugs - I graduated from there in the same year I started in medical libraries.  

The NLM has a virtual tour of its historical collections about HIV and AIDS.     

The Guardian has a piece that tells the stories of people who remember the early days of this particular outbreak, 

World AIDS Day - some reading

Today is World AIDS Day.  

Here are some relevant books and chapters.   The University of Leicester Library has these as ebooks, your library might have too.

ABC of HIV and AIDS / edited by Michael W. Adler, 2012 (this is the latest edition)

AIDS: global status / Stephen Berger, 2015 (published by GIDEON, the infectious diseases database)

AIDS between science and politics / Peter Piot and Laurence Garey, 2015.   (Piot was founding director of the UN AIDS programme)

Then there are chapters in larger textbooks:

Oxford Textbook of Medicine, 2020
Chapters 8.5.23 and 8.5.24 (8.5.24 discusses low and middle income countries).

Two in Clinical Key Student Nursing and Midwifery:

Alexander’s Nursing Practice, 5th ed.
Chapter 33

Lewis’s Medical Surgical Nursing, 11th ed. 
Chapter 14

Two in Clinical Key Physician (Professional):

Mandell Douglas and Bennett’s Principles and practice of infectious diseases, 9th ed.
Chapters 118-129 (chapter 126 is on HIV and AIDS in women, chapter 127 on HIV and AIDS in children)

Goldman-Cecil’s Textbook of Medicine, 26th ed.
Chapters 360-367

And one in Lippincott Health Library:

Schaechter’s Mechanisms of microbial disease, 5th ed.
Chapter 38.

There will be more on specific aspects of HIV and AIDS, to be found through Library Search.   Put the book titles above into Library Search to get links.

Books about HIV and AIDS

I was making a reading list about HIV and AIDS.   

What follows is an observation, not systematic research.

On the shelves we had:

• ABC of AIDS / edited by Michael W. Adler, 2001.

• The AIDS knowledge base : a textbook on HIV disease from the University of California, San Francisco, and San Francisco General Hospital / editors, P.T. Cohen, Merle A. Sande, Paul A. Volberding , 1999.

• Aids and other manifestations of HIV infection / edited by Gary P. Wormser, 2004.

• AIDS : etiology, diagnosis, treatment, and prevention, 1997.

• HIV infection in women / Johnson, Margaret A., 1993.

• HIV treatments directory / edited by Virginia Differding, 2010.

All old.   I can find no newer editions of most of them - there was a later edition of Adler (but 2012 - we have an ebook) and of Differding (2011).

We have newer but different things as ebooks (a reflection of the way we now acquire things).   Two of them involve Merle Sande or Paul Volberding, but nothing is newer than 2012.  I don't think there are newer editions of any of those either.

The Medical core collection has only a few items, (not including Adler’s ABC) but again nothing newer than 2012.

I feel confident in withdrawing most of the older print books, but I wonder if Johnson might still have material of relevance (amongst the material that is likely to be very out of date).    Perhaps this is a close equivalent, but it is also 2012.

In addition to books on the specific topic, there are also chapters in books like Schaechter’s mechanisms of microbial disease and Mandell Douglas and Bennett, the latest editions of which are a bit newer.

Why no new editions since 2012?    Perhaps there has been a stabilisation of knowledge and there has been nothing new to report since 2012.  Or perhaps newer editions are being prepared now.   It would be interesting to know if the same looks to be the case in other fields of medicine, or more specifically infectious diseases or sexual health.    But that is a subject for another post.

HIV

American actor Charlie Sheen recently announced on a television chat show that he was living with HIV, which has got some media coverage, including some that suggested that not everyone knows how HIV is spread.   

I don't know how typical this Guardian story is, but it does suggest that some people do need more information, and up to date accurate information, about HIV.

When I started working in health libraries in 1986, AIDS was a very current topic.  I remember hearing ideas about who was most at risk, and what some people said definitely conveyed the idea that it was a condition that affected gay men, and not anyone else.  I also remember learning about Edinburgh, where I had just moved from, that the group most affected there was not that group at all.  Richard Holloway, who became Bishop of Edinburgh the year after I left the city, realised when he moved there that the community affected in Edinburgh was not the same as the one affected in Boston, Massachusetts, where he had lived and worked before.

Then there was the government's television advert and leaflet, "Don't Die of Ignorance", preserved here at the National Archives.

For today's information about HIV, including how it is spread, and all the developments in treatment and pre- and post-exposure prophylaxis, have a look at these:

NHS Choices: symptoms, causes, diagnosis, prevention and living with HIV and AIDS, plus stories, details of clinical trials, and a discussion forum.

Clinical Knowledge Summaries: for primary care health practitioners, covering diagnosis and management, with scenarios.  CKS links to supporting evidence, but in this case it is guidelines and review articles, with no information about anti retroviral treatments, which are beyond the scope of the information.  CKS information was last updated in September this year.  CKS is one of the sources picked up by NICE Evidence Search, which you should try for other sources.

The Terrence Higgins Trust, founded in 1982 and named after one of the first men to die of AIDS, has publications, information on sexual health and on living with HIV, and the history of the Trust gives an insight into the history of what is known about HIV and AIDS.  There is also information on the activities of the Trust itself, and its local centres.

Thanks to the THT site, I know that National HIV Testing Week begins today, 21st November.

In the United States there is information at Aids.gov (managed by the Department of Health and Human Services), CDC, and Aidsinfo, from the NIH.  Aidsinfo uses Google Translate to provide information in other languages, and the other sites are available also in Spanish.

The World Health Organization has information, including data and statistics, information on treating children, on mother to child transmission, and on co-infections.  Use the links at the top right to get the information in Arabic, Chinese, French, Russian and Spanish.

25 years since discovery of HIV as cause of AIDS

When I was working in my first library job, a one year post between University and library diploma, there was much talk of AIDS, not all of it terribly enlightening. There had recently been the two research groups that had isolated HIV - HTLV-3, I think was a name that was given to it by one group - and I had work colleagues who could stop themselves thinking about it seriously by viewing it only as a "gay disease" (straight colleagues, presumably - perhaps there still are such people). Anyway, I am made to ramble like this by an editorial in Science, looking at where HIV and AIDS research has got to in those 25 years.

The editorial is:

Bernstein A. AIDS and the Next 25 Years. Science 2008; 320(5877): 717. Available at: http://www.sciencemag.org/cgi/content/summary/320/5877/717

This will work on campus only for University of Leicester members.