Chapter 22 Chapter 21 The AIDS Virus Revealed

The significance of understanding the origin of AIDS lies in the ability to grasp the law of the spread of this epidemic.It didn't take long for things to become clear.Central and East Africa are the epicentres of infection.Most of those infected are city dwellers.Later, an unknown simian immunodeficiency virus was discovered, which has similarities with AIDS virus.Although no symptoms similar to AIDS have ever appeared in apes, many people still can't wait to grasp this point, thinking that AIDS is transmitted from monkeys to humans.Ever since, the issue of the source of human infection has been concluded.However, from an epidemiological point of view, this assumption is not well founded.Monkeys live in jungles.AIDS is prevalent in cities.We can go as far as we can to pursue the monkey who is the culprit of the accident, but we are afraid that this method will lead astray and go too far from the topic.Therefore, the real answer has to be found.

Research continues.It became clear to everyone involved in the research that the virus was not spreading very efficiently.The route of transmission must be sexual contact or blood contact, such as transfusion of infected blood.Drug users share needles, or abuse unclean needles and the like.From this, what conclusions can we draw?Since the launch of the Xida project, a question has been hovering in my mind.Now we have to come back to this question.However, I should change it slightly to adjust my thinking and broaden my horizons. I might as well change the question of asking how long the AIDS virus has existed to: Before the early 1980s, the AIDS virus was invisible to people and silently. How long has it been hidden and dormant? In the 1960s, I have seen many cases of various types of infections.But I've never seen anything like AIDS.In retrospect only cases of tuberculosis resembled those of AIDS patients in rural Africa.Say, like the rest of Africa, has changed profoundly and rapidly since then.The biggest change is large-scale urbanization.

As a result, millions of people on the land of Africa flocked from the countryside to the cities in search of work.As for the situation in rural Africa, at least where I have worked, gender relations, for example, are not the same as young women in cities like Kinshasa.Open phenomena such as unscrupulous promiscuity and interbreeding in cities are absolutely unacceptable, especially in remote rural areas.The constraints of rural society are extremely strong.Anything out of the ordinary will have serious consequences.Moreover, polygamy is common in African rural areas, and women who give up marriage immediately lose their freedom.Social institutions limit the existence of disordered sexual relations.Correspondingly, the spread of AIDS has been reduced to a minimum. According to this situation, the transmission rate of AIDS itself is not high, and the incubation period is relatively long. Although it has spread, the degree and scope of spread are very limited. case of illness.What's more, since it is not a common disease at the initial stage of the disease, it will not attract many people, and it is easy to be misdiagnosed or ignored. These areas are short of doctors and medicines, let alone suitable and necessary medical diagnosis facilities.I know too much backcountry places like Say's to have any medicine to talk about.Therefore, it can be considered that AIDS was quietly spreading in rural Africa under such circumstances.

I would suggest an experiment, perhaps called a longitudinal study, to see if this hypothesis holds water.First specify a period of study, and compare the infection rate in rural Africa step by step.At this moment, I remembered that when we were investigating the Ebola virus outbreak in 1976, we had collected 600 blood samples from the area around Yambuku and handed them to the Center for Disease Control for safekeeping. I know we What to do next. I approached the person in charge of the AIDS virus laboratory of the Center for Disease Control and asked them to use a batch of blood samples collected in 1976 to test for AIDS virus antibodies.It was much more difficult to do such a test then than it is now.Equipment in this area cannot be bought on the market, and the reagents have to be processed and produced by the laboratory itself.Besides, the final test is called radioimmunoprecipitation, which is extremely difficult to do, takes as long as its name, and is more cumbersome than the much simpler Western blot method.Later, it was simply switched to the latter method, which was to find antibodies against a specific virus protein in the blood.I waited for weeks for the results of all six hundred blood samples.

The radioimmunoprecipitation method tests the serum function of the patient.See if the serum can precipitate certain types of proteins in the virus.Viruses are labeled with radioactive markers.Comes with a radioactive tracer.The strength of the radioactive signal is directly proportional to the amount of antibody in the tested serum.The advantage of this test is its high sensitivity and specific results. We await the results.It can be described as beyond expectation.I'd wager that HIV could be found, but the numbers are pretty low.How low is it, I hope it's not only one in 600.At least I'll stand a chance of finding HIV.In order to be able to make a reasonable estimate of the prevalence of AIDS in the remote north of Say in 1876, I needed good evidence.

Finally, the AIDS laboratory called me and said that all the tests had been completed. A series of tests in the enzyme chain immunoabsorbent assay to look for antibodies to the virus.This time, I waited for the confirmation of various tests of radioimmunoprecipitation method, and found 5 AIDS virus antibodies in 600 blood samples.That is to say, during 1976, among the residents living in the Yambuku area, there were 0.Eight percent of people are infected with HIV.According to Paris Claude.Francois of Bernard Hospital.A 1986 study by Buren︱Wezinett confirmed that in 1976, 0.0.Eight percent of the antibody ratio, that is to say, nine out of every thousand people are infected.This conclusion is very similar to our situation in Say AIDS.Of course, we are not stopping there. We are going to the Centers for Disease Control to see if we can isolate the AIDS virus from these five blood samples.Most viruses cannot survive outside the human body.HIV is no exception.As long as they are taken out of the body, they often die in the blood sample, ranging from a few minutes to a few hours.In order to ensure their survival, the process of collecting blood samples and subsequent preservation measures must be extremely careful.When Yambuku first conducted his research, we didn't pay attention.In dealing with the AIDS virus, the most desirable method is to take and preserve blood cells from the patient's whole blood.It is a pity that a batch of blood samples in Yambuku did not preserve blood cells, but only serum.

These blood samples were sent across the ocean to Atlanta, with great care along the way.Shipped on dry ice.The temperature of dry ice is kept at a few degrees below zero Celsius.However, we cannot escape the fact that it has been a long decade.Ten years is too long to keep the virus alive.In particular, all corresponding conditions are far from ideal, and the titer rate is relatively low.We also know that the five recipients who developed antibodies were alive and well at the time of the blood collection, and were survivors of the Ebola outbreak.None of the five showed any symptoms of an AIDS-like disease, at least not then.

A young woman was tasked with the notoriously difficult task of extracting the virus from five blood samples.That's Jane from the AIDS virus room.Getschel.She is tall and thin, about thirty-five or sixteen years old, and she is indeed from a professional background.Started as a medical technician and earned a Ph.D. at the University of North Carolina.Her dissertation was completed in our laboratory, and after her Ph.D. she joined the Center for Disease Control's New Diseases Laboratory.This time, I offered her another new opportunity.As always, she puts herself into work with the same enthusiasm and energy that she always takes on projects.

Jane was assisted in her work by a stocky technician in the laboratory.All I know is his name is Donald.The two set up their own tissue culture system and began to raise that tiny bit of precious serum in it.In order to find out whether the virus may be found in the five blood samples, the first step he needs to do is to cultivate lymphocytes from fresh blood, that is, to separate cells from lymphoid tissue.The so-called lymphoid tissue refers to lymph nodes, spleen, tonsils, etc., which are all vital components of the human immune system.As long as the virus is exposed, the lymphocytes must stand out and respond unambiguously.The condition required by the test is that the amount of lymphocytes must be sufficient.So Jane and Donald first had to grow and multiply the lymphocytes, mixing it with the suspected virus in the blood sample.It is easy to say, but it is time-consuming and troublesome to do it.Arrange and organize one set after another.And to be an expert and experienced, you have to rely on a high degree of professionalism.Even if you have all these, you still have to try your luck.Day after day, Jane and Donald replenished the culture medium.What should be changed, what should be added.It is all due to the proliferation and growth of lymphocytes in this part of the fluid.Then there is the timing test.To see if reverse enzyme appears.This kind of enzymatic enzyme is tantamount to the visiting card of AIDS virus.As soon as you see it, you know another one is coming.It is through this enzyme that ribonucleic acid can be copied into deoxyribonucleic acid.This is the most normal genetic material of the AIDS virus, and the replication of DNA by ribonucleic acid does not belong to the behavior of somatic cells.This is why, under normal circumstances, enzymes are not found in body tissues or fluids.If enzymes are present, then a virus (such as the AIDS virus) must be mixed in with this part of the mix.Although this is the case in theory, no one can be sure what will happen.It is certain that we need to put a long line. It is still unknown whether there are big fish that can be caught.Besides, the amount of blood left is so small that it looks like it can only be done again.We had successfully isolated multiple viruses from blood samples collected from patients at Mamanamo Hospital in 1983, and that was the first year.This time in Say, we believe that the possibility of isolating the virus still exists.But no one has ever isolated a virus as old as this long.

So and so, after several setbacks.Time and time again, blood samples disappeared in fresh cell culture medium.Finally, a blood sample showed signs of increased anti-recording activities.Jane and Donald suppressed their excitement for the time being, and once again put the blood sample into the fresh human lymphocyte culture system for further observation.Sure enough, the breeding was successful!In every fraction of the fresh cells, reverse transcriptase surged.That is to say, we have caught the ancestor of AIDS virus.And it was captured alive! The virus extracted by Jane and Donald became the prototype strain of AIDS virus, which can be used to study the evolutionary history of the virus.Because there are many different forms of the AIDS virus, the emergence of prototype strains has undoubtedly provided help for many scientists in clarifying the relationship between AIDS viruses isolated at different times and spaces.Some scientists have further established a genetic information sequence for this prototype virus strain.Some scientists have further explored how much and which changes have occurred in the descendants of each line of this prototype virus strain over time based on the sequence.In simple terms, we have thus figured out the sequence, time interval, and relationship between the various variants of the virus, and have an accurate means of judging and distinguishing them. Summarizing these research results, Draw a genealogy that might be called a pedigree map.After the genealogy of the virus was clarified, the apparent differences between the AIDS virus and the virus infected by monkeys became clear at a glance.Perhaps the simian immunodeficiency virus and the virus that acquired acquired immunodeficiency (ie AIDS) in humans once came from the same source, but the genetic history of the two proves that they parted ways a long, long time ago.Whether this kind of virus was first seen in monkeys and then infected humans, or from humans to monkeys, we may never be able to solve this mystery.What we can be sure of is that this kind of infectious relationship between the two cannot happen in recent years.

We also hope that our virus extraction work will benefit and save lives today.So we are happy to provide research results to the Salk Institute (Solk Institute) for the development of vaccines against AIDS.Unfortunately, vaccines produced by the Salk Institute or elsewhere have so far been ineffective. Although we isolated the virus in the lab, the extent to which the virus multiplied in African populations remains a mystery.AIDS is good at disguising, and there are too many disguises, not only pretending to be like tuberculosis, but also like many other diseases.It is even difficult to find out the extent and scope of the AIDS epidemic.To cure the sick and save the sick, we must first find out the number of sick people, and this is what puts us in a predicament at present. The situation developed very quickly.Our survey in Sai in 1983, together with another survey carried out in Rwanda at the same time, confirmed that the AIDS virus is rampant in the whole of Central Africa.At this time, the head of the infectious disease department of the World Health Organization was the Egyptian Fahari.Assad.This person is full of drive and enthusiasm.I first met him in 1979 on my way to Sudan.Our conundrum falls squarely within his purview.After a lot of phone calls and letters, I managed to convince him that it was really necessary for the World Health Organization to sponsor and implement a corresponding project.The problem lies with his immediate boss Halfdan.Dr. Mahler.This person is difficult to persuade, he just cannot understand the importance of the current situation.Later, when he figured it out, he was very supportive. In early 1985, I started working on AIDS in the Central African Republic.Central Africa shares borders with Say and Sudan and has a population of about 2.4 million.I was in this country in 1976 when I tracked down the Ebola virus.At that time, I tried to enter from its border with the northern border of Say, but failed.This time I took a different route, passing through Bangui, the capital of the country.I can only assume that the tree barriers that blocked the passage in 1976 have been removed, and the old ferries that are not working have been replaced. The main accomplice in this trip was Alan, the director of the Pasteur Institute in Bangui.Georges.The Institut Pasteur of France has a network of laboratories in most of the former French colonies.This laboratory is one of its networks. Alan has typical French hair with dry leaf color, is energetic and enthusiastic, and his lifelong wish is to do what he does well.He loves to eat, so he cooks good dishes, and he is a very expert wine critic, specializing in good wine; with an oxygen tank on his back and a mask, he is a diver who can compete with anyone .He has been working in Africa and is currently in Gabon.His specialties were AIDS and viral hemorrhagic fevers, two of our mutual passions. In the early spring of 1996, some patients were infected with Ebola virus from a dead chimpanzee, and Alan was responsible for isolating the virus.As soon as Alan took over the work, he recognized the epidemic and immediately took action. He did not need to wait and see, and contained the epidemic.In the course of our investigation, we quickly realized that the HIV virus had reached the Central African Republic.In April 1985, we were together in Bangui.I asked Alain if he would host an African AIDS conference in the Central African Republic, hosted by the World Health Organization.After he expressed his in-principle agreement, I sent a letter to Fahari in Geneva.Assad sent a fax proposing a working conference on AIDS in October 1985.That said, a month before another meeting already scheduled in Europe, Fahari has no objection.In order to broaden the scope of participation in the conference, we decided to invite representatives from sixteen African countries in addition to participants from Europe and the United States. We intend to make the conference a forum to spread information about AIDS research and to Non-African scientists hear the truth about life in Africa under the shadow of AIDS.Many people in the world (including scientific workers) do not know the reality of foreign lands and lack geographical knowledge.Letting everyone understand the situation of the epidemic can only help the development of the situation and not harm it.The Western scientists who came to Africa have various and strange imaginations about Africa, and the Central African Republic can open their eyes to see the outside world because of this. This is another aspect.The Central African Republic can be said to be extremely backward.Even within Africa, it is one of the poorest countries.Before 1979, it has been in the let.Bader.Under the tyrannical rule of Emperor Bokassa.The coronation of His Majesty the Emperor cost tens of millions of dollars at a time.Following the example of Napoleon, he proclaimed himself emperor and declared his country an empire.Before being deposed and expelled from the country, he scavenged the country's already barren lands, murdered his opponents, and even ate them alive.Africa is notorious for its multi-faceted tyrants, and Bokassa is the leader of all evils. From the looks of it, Sheila.Mitchell was just a lovely little woman.I partnered with her and continued to investigate among various groups of people in Bangui. Located on the banks of the Ubangi River, Bangui is both a major port and a commercial center with a population of 340,000.One of the key groups of our investigation is the so-called free women. Women like Sayinama and his accomplices I mentioned earlier are all homeless and helpless prostitutes.These prostitutes who liberated themselves live in groups at the outer circle of the city wall in Bangui, and they can be recognized at a glance.When we approached them, they heard that we guaranteed confidentiality and would never quote their names in the investigation report, so they expressed their willingness to cooperate. The places where they sell their bodies are pitiful, for example, the dilapidated body of a German Volkswagen pickup, with a few cardboard cushions, and a few rags on the window, it becomes a small piece that outsiders don’t ask of privacy.Thanks to a local doctor who checks them regularly, all the ones we investigated are among them.So it's much easier when we educate them, remind them, warn them of the risks they're taking.It is also easier for us to follow the traces and further clarify the layers of infection.As early as 1985, 40% of these prostitutes were HIV carriers.For this number, we think it is too small, and I am afraid that it is only a small part of the whole. In the midsummer of that year, Fahari approached several people to discuss who would lead a key AIDS prevention project in Geneva.The focus of prevention and control is on developing countries.I nominate Jonathan.Man.Since the launch of the Sida project, he has opened up the situation in Say and has a lot of momentum.I thought there was no one more suitable than him.During the Bangui meeting in October, Fahari had the opportunity to meet with Jonathan and listen to Jonathan's opinions face to face.As I expected, the two were very speculative when they saw each other.But when Fahari asked him if he would like to start a World Health Organization AIDS project, Jonathan did not immediately agree, but only expressed his willingness to help Fahari give some ideas for this new organization.Later, Jonathan came out and took charge of the preparation and leadership of the World Health Organization's global AIDS project.The impact of this work in the following five or six years can be said to be unmatched by other similar projects in developing countries to deal with AIDS. Fahari had a short life and died suddenly and young two years later.This project became his greatest bequest to the World Health Organization. During this period, the debate among peers was in full swing, or the definition of Bangui mentioned above.Now the World Health Organization has used it as the textual basis for judging AIDS cases.The comprehensive article based on the representatives' many years of clinical experience defined AIDS and was unanimously approved.Practice has proved that this definition is effective, and it is a reliable tool for judging the extent of AIDS epidemic in Africa, especially in areas without experimental conditions.The main content of this definition, such as persistent fever for one month or more, sudden weight loss, loss of more than 10%, protracted diarrhea, etc., there are also some secondary symptoms, such as tuberculosis. Some features, such as continuous and recurrent herpes virus infection. Among the scientists who attended this groundbreaking conference, some were authorities and prominent figures in AIDS research in Africa and Europe.It so happened that there were two Francois, and both were from Paris.One is Barry.François of Sinosi, and the other François.Bren.Vecinet.In the field of AIDS research, Barre of the Pasteur Institute.Sinosi.Francois deservedly is the key figure.Her popularity is justified.She is Luke.Staff in Professor Montavine's laboratory.In 1983, he became the first scientist in the world to isolate the AIDS virus.At that time, the media hype was hot, advertisements and reports were not distinguished, and the business of discovering the AIDS virus was overwhelming, but it overwhelmed the significance of her academic contribution.I learned afterwards that she really contributed a lot, and the achievement came from her almost obsessive research quality and her indomitable perseverance.She later became the recipient of the prestigious King Faisal Prize in Medical Sciences.François is still immersed in her HIV research, with a particular emphasis on developing countries. The second François, surnamed Brun.That of Vecinet was the co-author of the famous paper of the first François mentioned above.This paper was written to isolate the content of the AIDS virus.Bren.Vezinet lived up to his name, and through his own efforts, he became a leading figure among AIDS researchers.She also contributed to the reexamination of stored blood samples in the 1976 Ebola virus investigation.She concluded that Sudan's infection rate in 1979 was almost equal to Say's 1976 figure. This François almost inadvertently caused a great tragedy during the Bangui meeting.If the catastrophe does happen, AIDS research will have to go back ten years.At that meeting, during the break, the host organized a helicopter outing to the countryside, and the two Francos traveled together.Twenty minutes after take-off, Brunn was sitting on the pilot's side.Vezinet inadvertently bumped the joystick controlling the propeller, causing the propeller to stall.The helicopter suddenly plummeted.Fortunately, the pilot responded quickly and stabilized the plane before the plane lost altitude completely.When the plane stopped and the scientists stepped on the hard ground, they were still trembling with lingering fear.These scientists are dedicated and can take the risk of accidental infection in the laboratory in peace, but they cannot be reconciled to having their plane crashed and buried in the wilds of the Central African Republic. Returning to Atlanta from the Central African Republic, the origins of the AIDS epidemic were still on my mind.But at least now there is an important piece of unique information, that is, in 1976 the prevalence of HIV infection among the rural population in northern Say was less than 1%.Also, we got the virus from a villager.What we still don't know is what happened to the same group of people in the past few years.If our current assumptions are correct, infection rates in rural areas should remain the same even as urban populations increase significantly.We analyzed that in those remote rural areas, the spread of the virus is similar to this level.It can't be too many, and it can't be cut off, so that there will be no major outbreaks and floods.Our concern is to implement this hypothesis, so that we can further understand where the HIV virus has been living for these years.We also have another idea that needs to be proved through experiments, so that we can further clarify whether the reason for the rampant AIDS virus is the continuous development of urbanization, rural population migration, changes in lifestyle, especially problems related to sexual behavior and so on.It seemed that someone must be sent to Say to investigate.So, Kevin.Here comes De Kock.