25 Anos de Sida: história de uma pandemia: em memória de José Luís Champalimaud

Abstract

Twenty five years after the report of the first cases of HIV/AIDS we can consider that the evolution of this pandemic registered several successes but also significant failures. During the first 15 years of the pandemic, etiologic agent was identified, diagnostic tests were developed and the first antiretrovirals were available. During this period we could verify that the use of zidovudine had a prophylactic effect on the vertical transmission and that some drugs could prevent several opportunistic infections. However, the morbidity and the mortality associated to the infection continued to be very significant and AIDS was considered a fatal disease. Only in 1996 with the development of HAART (highly active antiretroviral therapy) AIDS became a chronic disease. The use of protease inhibitors and, later, of non-nucleoside reverse transcriptase inhibitors, the development of resistance assays and the capacity to quantify the viral load and of dosing the plasmatic concentration of the antiretrovirals, were important tools to change the course of this infection. Nevertheless, in 2007, HIV continues to resist to the efforts to find a cure or a vaccine and HIV continues to spread particularly in the poorest countries of the World and infected until now 65 millions of persons of which 25 millions died.