The Origins of AIDS

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Release Date: 
October 17, 2011
Cambridge University Press
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“The Origins of AIDS is a fascinating and important read that tells how it came to be that over 60 million global citizens are either now infected or have died of HIV.”

If there is any question about the impact humans have made on each other’s lives, one simply needs to listen to Billy Joel’s song “We Didn’t Start the Fire.”

Several phrases come to mind, but one phrase in particular will ring through your head as you read The Origin of AIDS by Jacques Pepin—“Belgians in the Congo.” By meticulous writing of his research and observations, Dr. Pepin will help you understand the zoological, political, social, and medical climate that both allowed and augmented the spread of human immunodeficiency virus (HIV) within the Congo and beyond.

His case is scientifically sound, and the pooling of evidence when combined with an epidemiological thought process will give you that sinking feeling of “What have we done?”—colonization and independence both being factors.

Dr. Pepin is, among other things, a Professor in the Department of Microbiology and Infectious Diseases at the Universite de Sherbrooke, Canada. He has conducted research on infectious disease in 16 African countries and defines for us various theories of the origins and spread of HIV, but uses epidemiologic and genetic principles to either rule in or rule out their credibility.

What we are left with is a comprehensive story of HIV: chimpanzee virus to human transfer, genetic diversification of HIV over time, unintended spread via medical clinic injections (iatrogenic spread), and the process by which HIV spread throughout the Congo, Central Africa, Haiti, and globally to other nations.

At times the detail is tedious, depending on your interests, but there are descriptions of chimpanzee sexuality, molecular clocks, and phylogenic trees, Central African politics and migration of peoples, sex work in Central Africa, and organized medicine within Central Africa.

For the uninitiated, The Origins of AIDS may be difficult reading; however, persistence pays off. The Origins of AIDS provides an absolutely stunning perspective of how well-intentioned programs designed to help people (and some shadier sides of cost-control in Baby Doc’s plasma rendering) implanted an unknown virus that readily adapted and took over humans it acquired.

Maps of Africa, a multitude of graphs (some are difficult to read), references for each chapter, and an index are provided to illuminate the facts. What will help the reader to absorb all the detail will be time and some rereading, but the core of the book is based on irony.

French and Belgium medical doctors treated over a million people for trypanosomiasis (sleeping sickness), leprosy, malaria, yaws, and syphilis with several million injections of pentamidine, mercurials, arsenicals, and other injectable medications with essentially unsterilized and reused syringes and needles. The irony here is that millions of patients were saved from either tropical or sexually transmitted infections, but these treatments have quite possibly led to the death of 29 million people from HIV infection.

“Transmission of HIV-1 is ten times more effective through the sharing of needles and syringes than via sexual intercourse because the minute quantity of blood from the first user which remained in the syringe or needle is then injected IV, directly into the next user’s blood, where HIV-1 can easily spread to the latter’s lymphocytes.”

And the description in a French report of treatment process within these injection clinics illuminates one reason iatrogenic spread happened: “The principles of mass production and time and motion study should be applied to ensure the maximum speed and efficiency in getting through, say, 250 injections in a morning. The man actually giving the injection should merely have to turn around in order to hand over his used syringe and take a freshly charged one. As he turns back again, a freshly iodined buttock, and the appropriate dose, should present themselves before him.”

Also ironic is that one of the medications used by French medical personnel to treat trypanosomiasis was pentamidine. This same medication had a noticed upshot in use in 1980–1981 Los Angeles to treat gay men with Pneumocystis jiroveci—an opportunistic infection that symbolizes the cognizant beginning of our AIDS epidemic and the subsequent discovery of HIV. This was some 50 years after HIV first began to infect humans.

The Origins of AIDS is ambitious and well written, but the abundance of data can be overwhelming at times—although humor is scattered throughout to keep the interested reader going. One surprising omission: scarring and tattoos (knife and needle sharing) weren’t mentioned, while all other possible avenues of transmission were discussed—including female circumcision and intravenous drug use.

Nonetheless, The Origins of AIDS is a fascinating and important read that tells how it came to be that over 60 million global citizens are either now infected or have died of HIV. The book also cautions us about ignorance and unintended consequences of our actions—socially, politically, and medically. The fire, as the song says, goes on and on and on and on. . . .