| Chapter 1: | Introduction |
|
|
hairy leukoplakia, pulmonary tuberculosis, herpes zoster, and fungal nail infections. These conditions may also be manifested in the final stage of the disease. Stage 4 is the final stage of HIV progression, at which point an individual is diagnosed with AIDS. The immune system at this stage is so weak—with a CD4 cell count of 200 or less—that it can no longer fight infectious illnesses. Stage 4 is manifested with severe opportunistic infections and cancers, such as pneumocystis carinii pneumonia (PCP), Kaposi’s sarcoma, lymphoma, extrapulmonary tuberculosis, HIV wasting syndrome, esophageal candidiasis, invasive cervical carcinoma, central nervous system toxoplasmosis, and chronic isosporiasis, to name only a few. Several of these illnesses might be manifested at once or individually. Without treatment, HIV/AIDS leads to death. As illustrated further on, it was the manifestation of some of these listed opportunistic illnesses that led to the initial discovery of AIDS.
Discovery of HIV
AIDS was first diagnosed in the United States in 1981 among five homosexual men in San Francisco and New York who portrayed manifestations of PCP and Kaposi’s sarcoma (Bongaarts, 1996; FanninGottlieb, &Weisman, 1982; WebMD, 2008). PCP is caused by a fungus. Symptoms of PCP include a dry cough, fever, difficulty breathing, shortness of breath, weight loss, and night sweats. Kaposi’s sarcoma is a type of cancer resulting in patches of tissue grown under the skin that look like mosquito bites. Overtime, tumors often develop in the mouth, nose, and gastrointestinal tract, affecting internal organs such as the stomach, liver, and lungs (Harden, 1992). PCP, Kaposi’s sarcoma, and many other opportunistic illnesses are rare among healthy individuals but common among individuals with weakened immune systems, especially the elderly, premature children, malnourished individuals, and bone marrow or organ transplant recipients (Aliouat-Denis, 2008). Therefore, the discovery of these two conditions among population groups generally expected to be healthy was a mystery, and it raised public health concerns. Uncertainty about the new illness that led to manifestation of these health conditions