AIDS: 30 Years

Thirty years ago Sunday, a brief report in the Morbidity and Mortality Weekly Report described cases of a rare form of pneumonia called Pneumocystis carinii in five young Los Angeles men, "all active homosexuals." The cases were noteworthy because the men had previously been healthy, though their particular pneumonia had only been seen in people with severely depressed immune systems.

Within a month, a second report had identified 54 young gay men with a rare cancer known as Kaposi's sarcoma, another disease that had been almost unknown in young men. And by the following summer, the mysterious disease underlying these reports had a name: acquired immune deficiency syndrome, or AIDS.

AIDS was a murderous, mysterious delinquent that emerged seemingly out of nowhere. Transmitted primarily through sexual activity and blood, it mowed down whole communities of young gay men, tore through a generation of intravenous drug users and made orphans of millions of the world's children.

In the 30 years since its first recognition, AIDS has killed nearly 30 million people worldwide, including more than 615,000 in the United States. Today, an additional 34 million people — including nearly 1.2 million in the U.S. — are living with the virus that causes the disease, human immunodeficiency virus, or HIV. This year, 1.8 million of them will die, including about 17,000 in this country.

The identification of HIV in 1983 brought the promise of a quick fix for the problem, a vaccine that would block transmission. Sadly, that promise has not materialized. The shifty virus mutates so rapidly and has so many ways of entering the white blood cells that are its primary target that vaccine researchers have had only limited success.

The best results so far were from a 2009 trial in Thailand that reduced new HIV infections by a modest 26%. The results hinted that a vaccine might eventually be possible, but suggested that researchers still had a long way to go to produce one that is useful.

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