AIDS stands for Acquired Immunodeficiency Syndrome, the end stage of HIV infection (see Human Immunodeficiency Virus). It occurs about 8-10 years after getting infected with HIV. We say “AIDS” if you get any of a group of “Opportunistic Infections”(“O.I.’s” for short). It was called a “syndrome” at first, instead of a disease, because nobody knew what was happening, except that certain people, especially gay men and injection drug users, were getting all sorts of weird infections. AIDS was recognized in 1981; HIV was discovered as the cause in 1984.
O.I.’s are caused by germs that never cause disease in people with normal immune systems. We all have some of these germs in us, often from childhood, but our immune system walls them off. Picture a lonely germ inside a clump of white blood cells; if HIV destroys the white blood cells, the germ take advantage of the “opportunity” to multiply and thrive. See our topic Germs: Differences Among Them.
Before HIV medicines were invented, we had antibiotics to prevent a few of these infections. We could cure others. But the person would keep getting sick with infection after infection (sometimes also with unusual cancers). Once the first AIDS-related O.I. occurred, 50% of patients were dead within a year, 100% within 4 years.
Some of these germs include:
- Pneumocystis, causing a pneumonia that begins slowly with a dry cough and shortness of breath, then gets vicious
- Toxoplasmosis, causing brain abscesses with strokes
- Cryptococcus, a fungus that causes meningitis
- Yeast in the esophagus, causing terrible pain with every swallow
- Cytomegalovirus in the eye, causing blindness
- Mycobacterium avium, an unusual bacteria in the blood causing constant fevers
- Kaposi’s sarcoma, an incurable cancer, covers the skin with bruises, can destroy lung or stomach
- Herpes, causing an ulcer which gets bigger & bigger, doesn’t go away
By the way — none of this will happen if a person gets HIV Treatment, and takes it correctly without missing doses (or only rarely misses). One of my patients had 7 O.I.’s between 1993-1995, and was about to die from his 8th. But he got access to one of the newly-invented medicines, by lottery (there wasn’t enough supply for everyone). His immune system returned to practically normal, he regained 50 lbs. and went back to work. People too young to remember 1981-1996 have no idea how miraculous this seemed.