HIV AIDS
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History of HIV/AIDS
AIDS is caused by a human immunodeficiency virus (HIV), which originated in non-human primates in Central and West Africa. While various sub-groups of the virus acquired human infectivity at different times, the present pandemic had its origins in the emergence of one specific strain – HIV-1 subgroup M – in Léopoldville in the Belgian Congo (now Kinshasa in the Democratic Republic of the Congo) in the 1920s.
There are two types of HIV: HIV-1 and HIV-2. HIV-1 is more virulent, more easily transmitted, and the cause of the vast majority of HIV infections globally. The pandemic strain of HIV-1 is closely related to a virus found in chimpanzees of the subspecies Pan troglodytes troglodytes, which live in the forests of the Central African nations of Cameroon, Equatorial Guinea, Gabon, the Republic of the Congo, and the Central African Republic. HIV-2 is less transmissible and is largely confined to West Africa, along with its closest relative, a virus of the sooty mangabey (Cercocebus atys atys), an Old World monkey inhabiting southern Senegal, Guinea-Bissau, Guinea, Sierra Leone, Liberia, and western Ivory Coast.
HIV Origin Story
by Zoltan Fehervari 11/18/2018 Nature
More recent molecular timing and modeling studies have pushed back the earliest appearance of M group HIV-1 to around the beginning of the twentieth century. This would suggest that HIV-1 was circulating cryptically in Africa for generations before factors such as urbanization and mass movement of people propelled it onto the global stage. AIDS was first described as a new disease in 1981 (MILESTONE 1), and the causative lentivirus that came to be known as HIV-1 was identified a couple of years later (MILESTONE 2). However, the origins of HIV-1 and the reasons for its explosive appearance and rapid transformation into a global epidemic remained a mystery. The inklings of an answer began to emerge from two West African patients presenting with an antigenically distinct AIDS-causing virus that subsequently came to be known as HIV-2 (MILESTONE 6). Genetically distant from HIV-1, HIV-2 was instead shown to be closely related to a lentivirus infecting an African monkey—the sooty mangabey. Subsequent studies confirmed that lentiviruses are endemic to many species of African monkeys and some apes—and these have collectively become known as simian immunodeficiency viruses (SIVs). Sooty mangabeys in particular were found to be naturally infected with a lentivirus known as SIVsmm (with the subscript indicating the name of the infected species), and genetic evidence showed that this virus was transmitted to humans, generating the HIV-2 epidemic.
HIV before the Age of AIDS
As soon as HIV was identified in 1983, scientists started trying to understand where it had come from, when it had arisen, and why it had spread. Were they too late? To answer most of their questions, they would have had to witness the virus's evolution. Scientists can track new pathogens such as SARS and avian flu because they produce obvious symptoms almost immediately. But HIV is a stealth virus that takes as many as 10 years to present symptoms; by the time researchers knew enough to wonder about its origins, those origins were in the distant past.
Aids: Origin of pandemic 'was 1920s Kinshasa'
An international team of scientists say a "perfect storm" of population growth, sex and railways allowed HIV to spread.
The Origin of AIDS
by All Things Considered 15/7/200 npr
NPR's Richard Knox reports from Durban, South Africa on a little-noticed study at this year's AIDS Conference. It found that the Human Immunodeficiency Virus, or HIV, is older than anyone suspected.
Researchers Clear 'Patient Zero' From AIDS Origin Story
[https://www.npr.org/sections/health-shots/2016/10/26/498876985/mystery-solved-how-hiv-came-to-the-u-s by Michaeleen Doucleff 26/10/16 npr]
By genetically sequencing samples from people infected early on, scientists say they have figured out when and where the virus that took hold here first arrived. In the process, they have exonerated the man accused of triggering the epidemic in North America.
Study pushes back origin of AIDS pandemic to 1908
by Julie Steenhuysen 1/10/08 Reuters
CHICAGO, Oct 1 (Reuters) - The deadly AIDS virus first began spreading among humans at the turn of the 20th century in sub-Saharan Africa, just as modern cities were emerging in the region, U.S. researchers said on Wednesday.
Origin of AIDS Linked to Colonial Practices in Africa
Monday marks the 25th anniversary of the first report of AIDS. But only recently have scientists come to conclusions about where HIV came from. The current thinking is that the colonial horrors of mid-20th-century Africa allowed the virus to jump from chimpanzees to humans and become established in human populations around 1930.
New Evidence Shows HIV's Spread Got Earlier Start
The new evidence lay in a box in a musty storage room at the University of Kinshasa in the Democratic Republic of the Congo. "It looked like it had been gathering dust since the 1960s," says Dr. Michael Worobey of the University of Arizona, an author of a new report on the origins of HIV in the Oct. 2 issue of the British journal Nature.
AIDS, 1981: Mystery of an Emerging Epidemic
In 1981, most Americans were oblivious to an emerging sickness that was overtaking gays. Throughout the spring and summer that year, a mystery would slowly unfold in U.S. metropolitan areas. It was the beginning of an epidemic of biblical proportions that has left no part of the world untouched.
Multimedia Feature An AIDS timeline, a look at the disease by the numbers, plus a narrated slideshow profiling how the disease has affected people around the world.
Trains ‘transported’ HIV across the world
The virus causing AIDS was assisted by train transport and the sex trade, facilitating its spread from the city of Kinsasha to the rest of the continent and eventually around the world, infecting some 75 million people.
=====https://www.independent.co.uk/news/uk/polio-vaccine-trials-are-ruled-out-as-origin-of-aids- 1559242.html===== by Steve Connor 24/10/1992 INDEPENDENT
The allegations, which surfaced in the Lancet and Rolling Stone magazine in March, centre on the relationship between the simian Aids virus, SIV, found to infect a high proportion of African green monkeys, and the human Aids virus, HIV. Many scientists believe HIV evolved from SIV by crossing from monkey to man.
HIV's Family Tree
There are two forms of human AIDS virus, human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2). Related simian immunodeficiency viruses (SIVs) are found in more than 30 species of primates in sub-Saharan Africa; each species has its own form of SIV. HIV-1 is classified into three groups, M, N and O. HIV-2 is also classified into multiple groups, but only groups A and B have been found in more than one person.
‘Tinderbox’: How Colonialism Shaped the HIV/AIDS Epidemic
by JEFFREY BROWN 10/4/12 PBS NEWS
Ray Suarez speaks with authors Craig Timberg and Daniel Halperin about how "shadows of colonialism" hang over the spread of HIV from Africa. The topic is explored in their book "Tinderbox: How the West Sparked the AIDS Epidemic and How the World Can Finally Overcome it."
THE AGE OF AIDS
In the second year that I was teaching school in the Congo, two Haitians came to our school under contract from the Congolese government to teach. It turns out they were part of a large population, relatively large. No one knows exactly how many, but somewhere between probably 5,000 and 10,000 Haitians came over to the Congo to help fill needs that were brought on by independence, when most of the Belgians left. There were ... very few Congolese schoolteachers, lawyers, doctors, other professionals who normally would have helped to run the country, so they had this contract with the Haitian government to send people over to help fill these gaps. Two of those teachers came to teach in our primary school.
Robert Fullilove: Inside the “Two Worlds of AIDS” in America
by Jason M. Breslow 10/7/12 FRONTLINE
Robert Fullilove is a professor of clinical sociomedical studies at Columbia University. He tells FRONTLINE that the fight against HIV/AIDS, particularly in the black community, has been made harder “because the majority of Americans no longer see HIV/AIDS as a problem.” The nation should care more, Fullilove says, “because you don’t want people cut down in the flower of youth by a debilitating condition that costs us so much money.” This is the edited transcript of an interview conducted on May 6, 2011.
Search for a Vaccine
The U.S. government alone spends $200 million a year on a hunt for a vaccine against AIDS. At the forefront of that search stands Dr. David Baltimore, chairman of the National Institute of Health's AIDS Vaccine Research Committee. Currently president of the California Institute of Technology as well, Baltimore won the 1975 Nobel Prize in Physiology or Medicine. Betsey Arledge, producer of the NOVA film "Surviving AIDS," interviewed a cautiously optimistic Baltimore on the current state of the search for a vaccine.
Origin story
by Zoltan Fehervari 28/11/18 nature portfolio
AIDS was first described as a new disease in 1981 (MILESTONE 1), and the causative lentivirus that came to be known as HIV-1 was identified a couple of years later (MILESTONE 2). However, the origins of HIV-1 and the reasons for its explosive appearance and rapid transformation into a global epidemic remained a mystery.
Tracing the origin and history of the HIV-2 epidemic
by Philippe Lemey, Oliver G. Pybus, Bin Wang, +2 , and Anne-Mieke Vandamme 12/5/03 PNAS
In this study we date the introduction of HIV-2 into the human population and estimate the epidemic history of HIV-2 subtype A in Guinea-Bissau, the putative geographic origin of HIV-2. The evolutionary history of the simian immunodeficiency virussooty mangabey/HIV-2 lineage was reconstructed by using available database sequences with known sampling dates, and a timescale for this history was calculated by using maximum likelihood methods.
Gene Loss and Adaptation to Hominids Underlie the Ancient Origin of HIV-1
by Lucie Etienne 17/7/13 ScienceDirect
HIV-1 resulted from cross-species transmission of SIVcpz, a simian immunodeficiency virus that naturally infects chimpanzees. SIVcpz, in turn, is a recombinant between two SIV lineages from Old World monkeys. Lentiviral interspecies transmissions are partly driven by the evolution and capacity of viral accessory genes, such as vpx, vpr, and vif, to antagonize host antiviral factors, such as SAMHD1 and the APOBEC3 proteins. We show that vpx, which in other lentiviruses antagonizes SAMHD1, was deleted during the creation of SIVcpz.
The origin and diversity of the HIV-1 pandemic
by Joris Hemelaar 3/12 ScienceDirect
This review examines the enormous progress that has been made in the past decade in understanding the origin of HIV, HIV genetic variability, and the impact of global HIV diversity on the pandemic. Multiple zoonotic transmissions of simian immunodeficiency virus (SIV) have resulted in different HIV lineages in humans. In addition, the high mutation and recombination rates during viral replication result in a great genetic variability of HIV within individuals, as well as within populations, upon which evolutionary selection pressures act.
Origin of the HIV-1 group O epidemic in western lowland gorillas
Understanding emerging disease origins is important to gauge future human infection risks. This is particularly true for the various forms of the AIDS virus, HIV-1, which were transmitted to humans on four independent occasions. Previous studies identified chimpanzees in southern Cameroon as the source of the pandemic M group, as well as the geographically more restricted N group.
Endogenous Origins of HIV-1 G-to-A Hypermutation and Restriction in the Nonpermissive T Cell Line CEM2n
by Eric W. Refsland 12/7/12 PLOS
The DNA deaminase APOBEC3G converts cytosines to uracils in retroviral cDNA, which are immortalized as genomic strand G-to-A hypermutations by reverse transcription. A single round of APOBEC3G-dependent mutagenesis can be catastrophic, but evidence suggests that sublethal levels contribute to viral genetic diversity and the associated problems of drug resistance and immune escape.
HIV Originated With Monkeys, Not Chimps, Study Finds
by Stefan Lovgren 3/5/21 NATIONAL GEOGRAPHIC
Researchers believe the chimpanzee virus is a hybrid of the SIVs naturally infecting two different monkeys, the red-capped mangabey (Cercocebus torquatus) and the greater spot-nosed monkey (Cercopithecus nictitans). Chimps eat monkeys, which is likely how they acquired the monkey viruses. The hybrid virus then spread through the chimpanzee species, and was later transmitted to humans to become HIV-1.
Contaminated polio vaccine theory refuted
by Michael Worobey 22/4/04 nature
Despite strong evidence to the contrary1,2,3,4,5, speculation continues that the AIDS virus, human immunodeficiency virus type 1 (HIV-1), may have crossed into humans as a result of contamination of the oral polio vaccine (OPV)6,7,8. This ‘OPV/AIDS theory’ claims that chimpanzees from the vicinity of Stanleyville — now Kisangani in the Democratic Republic of Congo — were the source of a simian immunodeficiency virus (SIVcpz) that was transmitted to humans when chimpanzee tissues were allegedly used in the preparation of OPV6,7.
Origin and Epidemiological History of HIV-1 CRF14_BG
by Inês Bártolo Inês 28/9/11 PLOS One
C2V3C3 env gene sequences were obtained from 62 samples collected in 1993–1998 from Portuguese HIV-1 patients. Full-length genomic sequences were obtained from three patients. Viral subtypes, diversity, divergence rate and positive selection were investigated by phylogenetic analysis. The molecular structure of the genomes was determined by bootscanning. A relaxed molecular clock model was used to date the origin of CRF14_BG. Geno2pheno was used to predict viral tropism. Subtype B was the most prevalent subtype (45 sequences; 73%) followed by CRF14_BG (8; 13%), G (4; 6%), F1 (2; 3%), C (2; 3%) and CRF02_AG (1; 2%).
Understanding the origins and prevalence of AIDS conspiracy beliefs in the United States and South Africa
by Nicoli Nattrass 25/4/12 WILEY
The human immunodeficiency virus (HIV) originated from cross-species transmission of the simian immunodeficiency virus from primates to humans. Yet a significant minority of people in the United States (US) and South Africa believe that HIV was deliberately created by scientists as a bioweapon. Scholars in the humanities emphasise the historical context, socially situated character and psycho-social dimensions of such aetiological narratives.
HIV-1 origins and spread
by Orli Bahcall 29/10/14 nature genetics
Although 13 cases of cross-species transmission of a simian immunodeficiency virus (SIV) into humans have been reported, only HIV-1 group M has led to a pandemic. Oliver Pybus, Philippe Lemey and colleagues now report a phylogenomic analysis of HIV-1 sequences isolated from central Africa, providing insights into what distinguished the origins and spread of HIV-1 group M (Science 346, 56–61, 2014).
The causes and consequences of HIV evolution
by Andrew Rambaut 1/1/04 nature reviews genetics
AIDS is arguably the most serious infectious disease to have affected humankind. Not only are an estimated 42 million people carrying the virus at present1, but its case fatality rate is close to 100%, making it an infection of devastating ferocity. In 2002 alone, 5 million people became infected with the causative agent — the human immunodeficiency virus (HIV) — and, of these, 70% live in sub-Saharan Africa. Although a succession of antiviral agents has made HIV/AIDS a more manageable disease in some industrialized nations, and several vaccines are about to enter Phase III clinical trials, HIV will doubtless continue to impose a terrible burden of morbidity and mortality (Box 1).
HIV's Origins Traced to 1930s
Using one of the world's most powerful supercomputers, a machine typically used to crunch numbers for physicists and astronomers, Bette Korber, PhD, and colleagues from the Los Alamos National Laboratory in New Mexico analyzed a global database of the genetic sequences of variants of HIV-1. By applying mathematical modeling techniques used to study evolution on the molecular level, the team extrapolated from some 160 HIV variants to predict when such variants converged back to a common origin.
Tracing the Origin and Northward Dissemination Dynamics of HIV-1 Subtype C in Brazil
by Edson Delatorre,José C. Couto-Fernandez, 12/9/13 PLOS One
Previous studies indicate that the HIV-1 subtype C epidemic in southern Brazil was initiated by the introduction of a single founder strain probably originating from east Africa. However, the exact country of origin of such a founder strain as well as the origin of the subtype C viruses detected outside the Brazilian southern region remains unknown. HIV-1 subtype C pol sequences isolated in the southern, southeastern and central-western Brazilian regions (n = 209) were compared with a large number (n ~ 2,000) of subtype C pol sequences of African origin.
Conspiracy beliefs and knowledge about HIV origins among adolescents in Soweto, South Africa
by Robert Hogg 2/2/17 PLOS One
We examined adolescents’ knowledge regarding the origin of HIV/AIDS and correlates of beliefs surrounding conspiracy theories in Soweto, South Africa. Now, a decade post-AIDS denialism, South Africa has the largest antiretroviral therapy roll-out worldwide. However, conspiracy theories stemming from past AIDS denialism may impact HIV prevention and treatment efforts.
Direct evidence of extensive diversity of HIV-1 in Kinshasa by 1960
by Michael Worobey 2/10/08 nature
Human immunodeficiency virus type 1 (HIV-1) sequences that pre-date the recognition of AIDS are critical to defining the time of origin and the timescale of virus evolution1,2. A viral sequence from 1959 (ZR59) is the oldest known HIV-1 infection1. Other historically documented sequences, important calibration points to convert evolutionary distance into time, are lacking, however; ZR59 is the only one sampled before 1976. Here we report the amplification and characterization of viral sequences from a Bouin’s-fixed paraffin-embedded lymph node biopsy specimen obtained in 1960 from an adult female in Léopoldville, Belgian Congo (now Kinshasa, Democratic Republic of the Congo (DRC)), and we use them to conduct the first comparative evolutionary genetic study of early pre-AIDS epidemic HIV-1 group M viruses. Phylogenetic analyses position this viral sequence (DRC60) closest to the ancestral node of subtype A (excluding A2). Relaxed molecular clock analyses incorporating DRC60 and ZR59 date the most recent common ancestor of the M group to near the beginning of the twentieth century.
On the origin and evolution of the human immunodeficiency virus (HIV)
by EDWARD C. HOLMES 31/1/07 WILEY Online Library
The human AIDS viruses – HIV-1 and HIV-2 – impose major burdens on the health and economic status of many developing countries. Surveys of other animal species have revealed that related viruses – the SIVs – are widespread in a large number of African simian primates where they do not appear to cause disease. Phylogenetic analyses indicate that these SIVs are the reservoirs for the human viruses, with SIVsm from the sooty mangabey monkey the most likely source of HIV-2, and SIVcpz from the common chimpanzee the progenitor population for HIV-1.
HIV / AIDS as a model for emerging infectious disease: Origin, dating and circumstances of an emblematic epidemiological success
by Francis Barin 9/22 ScienceDirect
In June 1981, the Centers for Disease Control (CDC) "Morbidity and Mortality Weekly Report" described the first cases of what was to be known as the Acquired Immunodeficiency Syndrome (AIDS). Two years later, the agent responsible for the disease, the human immunodeficiency virus (HIV), was identified. Since then, according to the World Health Organization an estimated 40 million people have died from the disease. Where does this virus come from, and why such an emergence in the late 20th century?
The origins of AIDS: from patient zero to ground zero
The HIV/AIDS pandemic has so far caused about 35 million deaths, while 34 million individuals currently live with HIV.1 ,2 Even if this will have no impact on the course of the epidemic, understanding the factors that allowed the successful emergence of HIV-1 is important, first as a moral obligation towards the victims, but also to draw lessons that could ultimately help mankind avoid facing similar threats in the future.
Where did HIV come from?
Human immunodeficiency virus is closely related to the simian immunodeficiency virus (SIV) found in chimpanzees in central Africa. This virus is called SIVcpz to distinguish it from forms of SIV less closely related to HIV, found in other primates. (Sharp) SIVcpz causes an AIDS-like illness in chimpanzees. (Keele)
HISTORY OF HIV AIDS
by CANADIAN FOUNDATION FOR AIDS RESEARCH
In the US, reporting of unusually high rates of the rare forms of pneumonia and cancer in young gay men begins. The disease is initially called Gay-Related Immune Deficiency (GRID) because it is thought it only affects gay men. Cases are also reported in Injection Drug Users by the end of the year.
HIV pandemic's origins located
by UNIVERSITY OF OXFORD 3/10/14
An international team, led by Oxford University and University of Leuven scientists, has reconstructed the genetic history of the HIV-1 group M pandemic, the event that saw HIV spread across the African continent and around the world, and concluded that it originated in Kinshasa. The team’s analysis suggests that the common ancestor of group M is highly likely to have emerged in Kinshasa around 1920 (with 95% of estimated dates between 1909 and 1930).
The Puzzling Origins of AIDS
by Jim Moore ,AMERICAN Scientists
Soon, virologists identified the culprit: a simian immunodeficiency virus (SIV) that is found naturally in a West African monkey species, the sooty mangabey (Cercocebus atys), but is harmless to that host. This virus, denoted SIVsm, is genetically similar to a weakly contagious form of the AIDS virus that is largely restricted to parts of West Africa, HIV-2, and thus is considered its likely precursor. More recent work has shown that the closest relative of the primary human immunodeficiency virus (HIV-1) is another simian immunodeficiency virus, one carried by chimpanzees (SIVcpz).
Origin of HIV and AIDS
The origin of the Human Immunodeficiency Virus (HIV) has been a subject of scientific research and debate since the virus was identified in the 1980s. There is now a wealth of evidence on how, when and where HIV first began to cause illness in humans.
A Timeline of HIV and AIDS
The HIV.gov Timeline reflects the history of the domestic HIV/AIDS epidemic from the first reported cases in 1981 to the present—where advances in HIV prevention, care, and treatment offer hope for a long, healthy life to people who are living with, or at risk for, HIV and AIDS.
40 years of HIV discovery: the first cases of a mysterious disease in the early 1980s
AIDS epidemic is unfortunately still topical with 1.5 million new infections worldwide in 2021. Research on this disease is part of a “tradition” that has now spanned 40 years at the Institut Pasteur, in Paris. This longtime expertise was marked in the first place by the identification of the retrovirus causing AIDS, published in May 1983 in Science.
The evolution of HIV-1 and the origin of AIDS
The major cause of acquired immune deficiency syndrome (AIDS) is human immunodeficiency virus type 1 (HIV-1). We have been using evolutionary comparisons to trace (i) the origin(s) of HIV-1 and (ii) the origin(s) of AIDS. The closest relatives of HIV-1 are simian immunodeficiency viruses (SIVs) infecting wild-living chimpanzees (Pan troglodytes troglodytes) and gorillas (Gorilla gorilla gorilla) in west central Africa.
Origin and Epidemiology of HIV/AIDS
Your client, Mr. Glover, has been diagnosed with HIV. You don’t know much about HIV and are concerned whether you can “catch” HIV by working with him or even shaking hands. You recognize your need to be better educated so you can give appropriate care without bias or fear. You know that quality care can be given when you have a sound understanding of the disease, risk factors, diagnostics, clinical symptoms, and treatments. Becoming culturally sensitive to the unique needs of your patients requires you to better understand your patient’s values, definitions of health and illness, and preferences for care.
America’s HIV outbreak started in this city, 10 years before anyone noticed
by Nsikan Akpan 26/10/16 PBS NEWS
HIV arrived in New York City precisely 10 years before doctors first noticed the disease, a conclusion that’s based on new research published today in Nature. The finding solves a 35-year-old mystery surrounding the origins of America’s outbreak, the first in the world to be noticed by doctors.
HIV 'may have an ancient origin'
HIV, which causes Aids, emerged in humans in the 20th Century, but scientists have long known that similar viruses in monkeys and apes have existed for much longer.
The origin of HIV
by Keith Dorwick 18/11/25 Britannica
Details of the origin of HIV remain unclear. However, a lentivirus that is genetically similar to HIV has been found in chimpanzees and gorillas in western equatorial Africa. That virus is known as simian immunodeficiency virus (SIV), and it was once widely thought to be harmless in chimpanzees. However, in 2009 a team of researchers investigating chimpanzee populations in Africa found that SIV in fact causes AIDS-like illness in the animals.
The Discovery of HIV as the Cause of AIDS
by Robert C. Gallo, M.D., and Luc Montagnier, M.D. 11/12/2003 THE NEW ENGLAND JOURNAL of MEDICINE
Progress in scientific research rarely follows a straight path. Generally, it entails many unexpected meanderings, with a mix of good and bad ideas, good and bad luck. The discovery of the human immunodeficiency virus (HIV) as the cause of AIDS did not avoid this pattern.
Aids: Origin of pandemic 'was 1920s Kinshasa'
by James Gallagher 3/10/14 BBC NEWS
An international team of scientists say a "perfect storm" of population growth, sex and railways allowed HIV to spread.
HIV BEFORE THE AGE OF AIDS
As soon as HIV was identified in 1983, scientists started trying to understand where it had come from, when it had arisen, and why it had spread. Were they too late? To answer most of their questions, they would have had to witness the virus's evolution. Scientists can track new pathogens such as SARS and avian flu because they produce obvious symptoms almost immediately. But HIV is a stealth virus that takes as many as 10 years to present symptoms; by the time researchers knew enough to wonder about its origins, those origins were in the distant past.
History of AIDS
In the 1980s and early 1990s, the outbreak of HIV and AIDS swept across the United States and rest of the world, though the disease originated decades earlier. Today, more than 70 million people have been infected with HIV and about 35 million have died from AIDS since the start of the pandemic, according to the World Health Organization (WHO).
Origin and progression of HIV-1
AIDS does not develop in monkeys
where HIV originated from. How come?
Progress Through Innovation and Activism
The first published report of what would ultimately become known as HIV and AIDS appeared in the Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report in June 1981.1 When these initial cases emerged, very little was known about the disease; it did not have an agreed-upon name, researchers had not yet determined what caused it, there were no tests or recognized treatments, and by the time most patients presented with symptoms, they had only months to live.2
