In the autumn of 1980, the immunologist and doctor Michael Gottlieb of the University of California, Los Angeles noticed that five of his patients had the same strange disease. This is a fungal pneumonia caused by the otherwise harmless “Pneumocystis carinii”. The patient’s mouth is slimy because of oral overdose of Candida.

The T lymphocyte counts of the 5 patients were extremely low, and they were all homosexuals.

The June 5, 1981 Weekly Morbidity and Mortality Journal published a short article “Pneumocystis pneumonia, Los Angeles.” Gottlieb reports: This disease has many culprits and the cause is unknown.

The evil spirit, AIDS, which killed 40 million people around the world, appeared for the first time; and its source was still shrouded in fog over 20 years later. The stigma that was previously given to the infected by public opinion has not yet been washed away.


Is he patient number zero?

One month later, the Weekly Morbidity and Mortality Report published another report in New York: Rare Kaposi ’s sarcoma was found in gay men In the case of Klebsiella pneumonia, 8 people died. At the same time, Miami reported on 20 Haitian immigrants with Pneumococcal pneumonia, oral candidiasis and Kaposi’s sarcoma, and 10 people died.

The medical community believes that a new disease has emerged, which is immunodeficiency and is related to homosexuality (Although Haitian immigrants claim to be heterosexual, they are suspected of lying by doctors) In September 1982, the Weekly Morbidity and Mortality Report called it acquired immunodeficiency syndrome AIDS.

The US Centers for Disease Control and Prevention (CDC) surveyed 40 homosexuals nationwide and drew a relationship diagram. At the center of the graph is a circle, which intersects with the other 8 circles; “0” is written on the circle, and he connects the entire network. This is the “Patient Zero” that was later written in countless bestsellers: Gaitan Dugas.

Dugas is a handsome, unruly Canadian flight suit flying through major cities in North America. He estimated that he might have 2,500 partners. Dugas died of AIDS in March 1984, and the CDC investigation report came out. The public believed for a while that “patient zero” was found. The investigation report believes that the route of pathogen transmission is similar to hepatitis B virus.

Published in the May 1983 issue of ScienceListed the HIV found by two independent teams. A year later, there will be an independent report. The three sources were unified and named HIV in 1986.

But “Patient Zero” can’t solve the doubts, the virus will not be born out of nothing. How do Haitian patients who have nothing to do with Dugas explain?

It did n’t take long to realize that Dugas was not a patient zero. Gret Lasker, who died in 1977, was a Danish surgeon who had worked in Zaire and also died of AIDS symptoms. HIV-1 was detected in her blood sample in 1986. That is to say: Dugas, Haitian immigrants, Danish doctors are not the source, but the middle chain.


Stigmatization can’t stop the spread

Today, AIDS is no longer a terminal illness, and it is also “desensitized” in many countries. But when it first appeared, AIDS was like a protagonist in a horror movie, terrifying the public. The patient was stigmatized.

The emotional vocabulary of the media vocabulary is strong-“New Plague”, “Super Cancer” and “Demon”. American society talks about Aise.

HIV infection spreads to all groups in the society, but the media initially reported it as “gay-related immunodeficiency” and also used the term “gay cancer”.

In the last years of his life, Dugas gradually declined, but his private life became more vertical, seemingly in retaliation. In San Francisco ’s public baths, he often turned on the lights to reveal the location of the lesions and told strangers who had just had a relationship: “I have gay cancer. I ’m dying and you ’re about to die.”

Many people claim that “AIDS is a punishment for the sexual liberation movement”. By discriminating against AIDS, many people openly hate homosexuality and sexual liberation. The anti-AIDS propaganda emphasizes dealing with partner loyalty and labeling HIV-infected people with promiscuity in disguise. It is unfair to closely link a certain group with a virus. One is the lack of respect, and the other is the distortion of the perception of the virus.

In the late 1980s, Susan Sontag wrote “AIDS and Its Metaphors”, criticizing the demonization of AIDS by society. Susan Sontag said that disease symbolizes personality defects and moral flaws: “The most frightening disease is not loss of life, but loss of personality.”

Many Patients are not only afraidAIDS is more afraid of discrimination. Discrimination makes people afraid of testing, making AIDS investigation difficult. Some carriers who have tested positive also try not to go to treatment.

In the 1990s, American scholars said that AIDS discrimination has made HIV-infected people ashamed and guilty and refused treatment, thus causing a wider infection.

The enlightenment of the plagues again and again is: society is easy to fall into irrationality because of disasters, and the people need simple explanations of disasters. Homosexuals became scapegoats in the 1980s. The plague is a natural disaster, and discrimination is a human disaster.

Virus tracing is a rational and difficult process, and discrimination and shirk responsibility are meaningless.


Identified the origin and species of origin

In the summer of 1980, a veterinarian Phyllis Cargill discovered that some captive Asian macaques Died of a mysterious immune disorder. Proved in 1985: Monkeys have HIV relatives, named SIV (simian immunodeficiency virus). SIV was subsequently found on the African green monkey. This is a wide range of grassland monkeys, including several major categories. About half of the African green monkeys in the field and various research centers carry SIV, but they do not get sick. This shows that the virus may have lived peacefully with African green monkeys for millions of years.

Since Karji found a virus between HIV and SIV from the blood sample of a sex worker in Senegal, it can be determined that people are infected with more than HIV-like viruses One kind.

Then Kaji and others found another HIV virus, but it is different from the US version-HIV-1 is a global plague, HIV-2 is only one in West Africa An endemic disease that is relatively unscathed. The source of HIV-2 was quickly identified, from the African smoked mangabey.

HIV-1 is divided into 3 families, and HIV-2 is divided into 9 families. The 12 families are very different, which means that independent beast-to-human incidents have occurred at least 12 times.

People are particularly concerned about how HIV-1 came about. In the late 1980s, the Marina Pitts team discovered that several chimpanzees also carry the SIV virus, which is closer to HIV-1. Suggesting that chimpanzees may be the source.

In 1998, HIV-1 was found in human tissue preserved in Leopoldville, the capital of Congo in 1959. It was soon discovered that HIV-1 was also found in another human sample in the same city in 1960. The common ancestor of the two samples can be traced back to around 1908.

Scientists went to the tropical rain forest to find the source. In 2000, scientists first found SIV antibodies from chimpanzees in Tanzania. Subsequently, the virus closest to HIV-1 was found in the orangutan in southeastern Cameroon.

The virus on an orangutan numbered LB7 is so similar to HIV-1 that scientists are shocked and delighted when the computer displays the results: “These results It ’s not made up, it ’s so beautiful! “

In July 2006, Science published this conclusion: the source of HIV-1 is southeast Cameroon Rainforest.


Unfinished traceability, unfinished discrimination

Since 1980, early suspected cases have been found, with different true and false. For example, a British man who died in 1959 had symptoms similar to AIDS; his organization detected HIV-1 in 1990. However, the review after a few years considered that the sample was contaminated.

A best-selling book in the 1990s said that from 1957 to 1960, the Congolese polio vaccine may have been the source of the plague because the vaccine used chimpanzee kidneys. But this view has also been rejected by science.

Even if the evidence seems sufficient, virus tracing is still error-prone.

The following theory of the origin of AIDS may be closest to the facts:

SIV has long existed in apes and monkeys. Hundreds of years ago, a monkey-eating chimpanzee mixed the red-crowned white-tailed monkey’s SIV and the large white-nosed red-tailed monkey’s SIV-two distant relatives discharged a new virus, which is more deadly than the chimpanzee’s adapted SIV This is the predecessor of HIV-1.

A few hundred years ago, in the rain forest on the upper Congo River, a hunter killed a chimpanzee and his wound hit the blood of the orangutan. The virus is transmitted topeople. Through shipping trade, the virus spread to the lower Congo River, spreading in the emerging city of Leopoldville and spreading across Africa. Congo promoted injection medicine in the 1920s; lack of sterile needles may have increased infection.

HIV-1 continues to differentiate. Thousands of Haitian staff dispatched to Congo by UNESCO in 1960 may have brought the virus back to Haiti.

Based on the virus detected in hundreds of blood samples in Haiti, an HIV carrier quickly spread the virus around 1966, probably through the local developed blood sales industry. The virus spreads worldwide with blood products.

Some studies suggest that in 1966, an American teenager contracted AIDS through homosexual sex. There is also evidence that at the latest in 1969, HIV infected Americans through Haitian blood products. Before Michael Gottlieb discovered AIDS, it had been quietly popular in the United States for more than a decade.

Behind AIDS is the inevitable risk of global communication. There are no races, no national boundaries, and no group can be exempted. Discrimination does not help to overcome the plague, it only harms the patients.

According to UN statistics in 2018, 29.6 million to 40.8 million people have died of AIDS, and 37.9 million people have HIV. The United Nations AIDS Program (UNAIDS) pointed out that until today, humiliation and discrimination against patients still exist in many parts of the world.

(Original title: HIV: a stigmatized virus that has been traced back for 30 years)