Tale of two viruses 

Ebola has made headlines, but is HIV/AIDS still around?

click to enlarge Scanning electron micrograph of HIV-1 budding from cultured lymphocyte. - CYNTHIA GOLDSMITH, CENTERS FOR DISEASE CONTROL AND PREVENTION
  • Scanning electron micrograph of HIV-1 budding from cultured lymphocyte.
  • Cynthia Goldsmith, Centers for Disease Control and Prevention

Following the images of the Ebola outbreak that was first reported in March, it isn’t difficult to imagine rows and rows of hospital beds of patients cared for by healthcare workers dressed head-to-toe in protective gear.

The international media has offered countless glimpses of the roughly 16,000 reported patients worldwide, including nearly 6,000 who have died, mostly in countries on the west coast of Africa: Liberia, Sierra Leone, and Guinea, according to November 23, 2014, statistics from the Centers for Disease Control and Prevention. While people around the globe, including Hoosiers, commemorated World AIDS Day on December 1, they may have recalled a similar sight that was common in the news 30 years ago.

Also around that time, on December 17, 1984, a 13-year-old named Ryan White was diagnosed with AIDS in Indiana, due to a tainted blood transfusion. Following White’s death in 1990 at 18, the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act was passed. The Ryan White HIV/AIDS Program continues to fund services to an estimated 536,000 people each year living with HIV and AIDS in the United States.

People are less likely to talk about HIV/AIDS because those who’ve been diagnosed are living longer and more treatments are available with fewer side effects than the first drug, AZT. However, according to amfAR, The Foundation for AIDS Research, 1.1 million people in the United States are living with HIV/AIDS, and almost one in five people are unaware they are infected. Approximately 50,000 new infections have occurred every year in recent years, men who have sex with men are the most likely to be infected, especially young African-American men who have sex with men, but women make up about 20 percent of new cases.

Worldwide, there are 35 million people living with HIV/AIDS, and every day more than 5,700 people contract HIV, according to statistics compiled by amfAR. However, that seems to be all but forgotten when the media focuses on news of Ebola, including four cases and one death for patients diagnosed in the U.S., as of November 23.

click to enlarge Marion County Public Health Director  Dr. Virginia Caine encourages anyone who may be a t risk to be tested for HIV. - PHOTO SUBMITTED
  • Marion County Public Health Director Dr. Virginia Caine encourages anyone who may be a t risk to be tested for HIV.
  • photo submitted

Dr. Virginia Caine, an infectious disease specialist and director of the Marion County Public Health Department, says this Ebola outbreak is worse than others because it occurred in an urban setting with a dense population as opposed to past outbreaks in more rural areas.

Further, “the political strife that has been going on in these countries [Liberia, Sierra Leone, Guinea] has decimated their healthcare delivery infrastructures,” says Dr. Caine. “They don’t have enough gowns, and they might not even have soap or gloves. Another problem is the fear and mistrust from some of the residents in those countries. They hear about people going to the hospital who still die, and that people are being quarantined if they’ve been exposed to friends and relatives with Ebola. It’s very scary to some of these residents. Some of them have gone into hiding, even when some of them were symptomatic, and refused to get healthcare.” It’s more likely for an American to die in a plane crash (1 in 11 million) than contracting Ebola in the U.S., says Dr. Caine.

But if it is found in Indianapolis, “All of our hospitals and infectious disease consultants have been preparing in case an Ebola patient comes into an emergency room,” says Dr. Caine. “How to isolate that patient, how to wear the protective gowns, and how to take necessary precautions to make sure there isn’t a risk to any other people in that hospital. We have some of the best infectious disease doctors in the country, and I feel really good about the process here.”

She also encourages Indiana residents to get flu shots.

“We’ve had people call and say, ‘my muscles are aching, I have a fever, sore throat, nausea or diarrhea or vomiting, and I’m concerned I have Ebola, but I may have the flu,’” she says. “It’s easier to concentrate on another disease if they’ve had a flu vaccine. When it comes to treatment, time is of the essence for Ebola patients.” While Ebola and HIV have some things in common, including the spread of the viruses by bodily fluids and even a similar method of infecting healthy cells, an otherwise healthy person with HIV is unlikely to know until he or she gets tested, something Dr. Caine and other medical professionals encourage.

According to the Indiana State Department of Health, the number of persons diagnosed as living with HIV/AIDS (PLWHA) in the state of Indiana continues to increase every year. In 2012, the number increased from 10,279 in 2011 to 10,746 at the end of 2012. By the end of 2013, the number increased again to a total of 11,087 PLWHA. In Marion County alone, as of December 31, 2013, there were 4,582 PLWHA, plus another 853 in the donut counties. Those numbers do not include those PLWHA who haven’t been tested.

From 1981 to December 31, 2013, 6,206 people have died in Indiana after being diagnosed with HIV or AIDS, compared to 6,070 as of December 31, 2012. While Indianapolis-area HIV/AIDS awareness community members tend to agree that much has changed in the last 30 years, there is still work to be done.

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