The Pandemic We don’t Want to Recognize.

THE PANDEMIC WE DON’T WANT TO RECOGNIZE

 It was caused by a virus.  Still is.  Two, actually, both species of the Genus Lentivirus.  And it is a “retrovirus.”  Tricky in its ability to fool a host cell.  Your cell.  Here’s how.

When the virus passes into a human cell, it releases its genetic material within.  In this case, RNA [Ribonucleic Acid].  When that sneaky strand slips inside the cell’s cytoplasm, it uses an accompanying enzyme [reverse transcriptase]to copy itself into a complimentary DNA [Deoxyribonucleic Acid] strand.

That is backward to the way we generally do our genetic business, and our cells are tricked into taking up these new DNA strands as though they were obviously one of our own.  Then the cell does what is natural.  It reads the new genetic information, copies the virus, and sends out instructions to the cell’s ribosomal factories to produce multiple copies of the proteins encoded by it.

Your own cellular machinery then assembles many copies of the monster’s structure, which turn on you to explode out of your cells and kill your ability to resist infection.  The result is pretty terrible.

So what do they look like, these terrible tiny things?  The virus is  generally spherical, with a fatty [lipid] envelope squeezed out around it from your cell membrane as it breaks free.  Inside that envelope, the copied RNA is protected by proteins with sugar chains [glycoproteins] produced by you from one of the viral genes’ instructions.

The entire viral gene code is composed of two strands of RNA with about ten thousand nitrogenous bases, three of which, together, form the underlying unit of genetic information [the codon].  How many actual genes are thusly carried?  Maybe nine.  It doesn’t take many, it seems, to conquer your system.

How does it kill you?  By infecting the immune cells you would otherwise use to fight it.  In this case, the helper T-cells.  White blood cells.  Ingenious.  Attack the guards and go straight at them.  And without your natural defense system, all the other disease vectors of nature rush in to infect your body [even the common cold virus, which you are now helpless to thwart], weakening you until you succumb to such terrors as fungal pneumonia [Pneumocystis pneumonia(PCP)]; Tuberculosis [a leading cause of death in these cases]; Toxoplasmosis [Toxoplasma gondii, a parasite related to cats]; Fungal Meningitis [Cryptococcal]; Herpes [Cytomegalovirus]; Oral Thrush [Candidiasis, a yeast]; Lymphoma [cancer of white blood cells]; Kaposi’s Sarcoma [blood vessel tumors]; and organ failure.

Worldwide, more than 30 million people have died of this disease since 1980.  Many more are currently infected and still living today, many with treatment.  Yet in 2019, more than 500,000 people still died from the virus.  About one million people in the United States are infected, with 38,000 new infections in 2018 and about 6,000 deaths.

There is no cure for this viral infection.  But there are treatments for its disease.  Medical research has stepped quickly forward, producing a “cocktail” of drugs to combat the infection and its consequence.  Drugs that disrupt viral reproduction [nucleoside reverse transcriptase inhibitors (NRTI)]; additional viral reproduction blockers [protease inhibitors (PI)]; cell membrane receptors [fusion inhibitors]; drugs that slow viral reproduction [highly active antiretroviral therapy (HAART)]; transcriptase blockers [non-nucleoside reverse transcriptase inhibitors (NNRTI)]; and copy inhibitors [chain termination].

As a result, longer life and better health are now possible for those with the illness.  Yet the human toll of this Human Immunodeficiency Virus [HIV], and its resulting Acquired Immunodeficiency Syndrome [AIDS], has devastated our worldwide human population.  We should learn more of its underlying science, and not avert our eyes because we don’t want to see it.

The federal government has recently spurred the development and distribution of vaccines necessary to combat the explosion of our current viral pandemic, Covid-19.  The fastest development of vaccines in history.  But that effort had its own history, previous to the appearance of Covid-19, so that the mechanism of vaccine production was already underway when Covid-19 appeared.

Here is why.  After decades of effort, we still do not have a vaccine for HIV.  This is partly due to the rapidly changing structure of the viral envelope that a vaccine targets.  But it is also due to the incapacitation of the white blood cells by the virus when it attacks.  The same white blood cells that a vaccine would otherwise promote as the body’s defense.

A terrible situation.  But more than $75 billion has been invested in the United States, since 1982, to overcome these obstacles and produce an AIDS vaccine.  So when the call went out to develop a Covid-19 vaccine, many companies were already geared up and ready.

For example, researchers had been modeling HIV spike proteins on that virus’ envelope.  They had recently applied those techniques to a Coronavirus called Middle East Respiratory Syndrome (MERS), which surfaced in the Arabian Peninsula in 2012.  They were using messenger RNA to reproduce the spike protein.  So they were quickly able to transfer their efforts to code for a Covid-19 spike protein.  The process is similar to that which was used to develop the Moderna Covid-19 vaccine.  This was the vaccine administered to my family by the Shelbyville Pharmacy.

A different approach was unsuccessfully developed by Merck & Company to address HIV involved using the common cold virus [Adenovirus] to transfer antigen-creating genes [antigens are foreign compounds that create an immune response] into the body.  Later researchers adapted different carrier viruses and focused on the Covid-19 virus.  This research simulated the development of a different vaccine by AstraZeneca.  And Johnson and Johnson Company found, and inactivated, a rare human cold virus [Ad26], and studied it for potential use in developing a vaccine for HIV, Zika, and Ebola epidemics.  This research was available for use in the development of a vaccine for Covid-19.

HIV research has had other benefits in Covid-19 treatment.  Remdesivir, a viral replication blocker, can aid in recovery from a Covid-19 infection.  Similarly, HIV research led to the discovery of potent antibodies in infected blood.  This has assisted in the development of “Monoclonal Antibodies” for Covid-19 treatment [used by President Donald Trump during his Covid-19 infection].

HIV and AIDS originally manifested in the gay community during the 1980s.  Some believed the disease to be the result of a dangerous lifestyle choice.  It was even condemned and described as a punishment from God by some prominent religious leaders.

Then AIDS attacked the heterosexual population and became the scourge of Africa.  It became the most prominent health outreach of President George W. Bush in 2003.  Called the President’s Emergency Plan for AIDS Relief [PEPFAR], the program has spent $90 billion in over fifty countries for treatment, prevention, and research.  The largest single global outreach for health in history!

And we continue to benefit from the effort to conquer HIV in our fight against Covid-19.  In 1984, Anthony S. Fauci was appointed as the Director of the National Institute of Allergy and Infectious Diseases in the United States.  He has been on the front line of AIDS research ever since, and has recently been appointed the Chief Medical Advisor to President Joseph Biden.  Here is what he says.  “Everything we do with every other pathogen spins off of things we’ve learned with HIV.”

We need to continue learning as we fight off these continually attacking pandemic diseases. Continue to understand the science and gear up our defenses.  And then maybe we can utilize what we’ve learned in our fight against Covid-19, and finally deliver a vaccine for HIV!

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