William H. Schneider - The Histories of HIVs: The Emergence of the Multiple Viruses That Caused the AIDS Epidemics

THE HISTORIES OF HIVS

PERSPECTIVES ON GLOBAL HEALTH

Series editor: James L. A. Webb, Jr.

The History of Blood Transfusion in Sub-Saharan Africa, by William H. Schneider

Global Health in Africa: Historical Perspectives on Disease Control, edited by Tamara Giles-Vernick and James L. A. Webb, Jr.

Preaching Prevention: Born-Again Christianity and the Moral Politics of AIDS in Uganda, by Lydia Boyd

The Riddle of Malnutrition: The Long Arc of Biomedical and Public Health Interventions in Uganda, by Jennifer Tappan

The Histories of HIVs: The Emergence of the Multiple Viruses That Caused the AIDS Epidemics, edited by William H. Schneider

THE HISTORIES OF HIVS

The Emergence of the Multiple Viruses That Caused the AIDS Epidemics

Edited by William H. Schneider, PhD

Ohio University Press

Athens

Ohio University Press, Athens, Ohio 45701

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Library of Congress Cataloging-in-Publication Data

Names: Schneider, William H. (William Howard), 1945editor.

Title: The histories of HIVs : the emergence of the multiple viruses that caused the AIDS epidemics / edited by William H. Schneider.

Other titles: Perspectives on global health.

Description: Athens : Ohio University Press, 2021. | Series: Perspectives on global health | Includes bibliographical references and index.

Identifiers: LCCN 2021004955 (print) | LCCN 2021004956 (ebook) | ISBN 9780821424582 (hardcover) | ISBN 9780821447444 (pdf)

Subjects: LCSH: HIV (Viruses)History. | HIV (Viruses)AfricaHistory. | HIV infectionsHistory.

Classification: LCC QR414.6.H58 H54 2021 (print) | LCC QR414.6.H58 (ebook) | DDC 616.97/9201096dc23

LC record available at https://lccn.loc.gov/2021004955

LC ebook record available at https://lccn.loc.gov/2021004956

CONTENTS

FRANOIS SIMON

WILLIAM H. SCHNEIDER

WILLIAM H. SCHNEIDER

PRESTON A. MARX

ERNEST M. DRUCKER

TAMARA GILES-VERNICK AND STEPHANIE RUPP

DIDIER GONDOLA AND AMANDINE LAURO

GUILLAUME LACHENAL

JORGE VARANDA

WILLIAM H. SCHNEIDER

ILLUSTRATIONS

Figures

Tables

PREFACE

It has been over a century since the human immunodeficiency viruses (HIVs) have infected the human population as the result of their emergence through several interspecies transmissions from nonhuman primates naturally infected by simian immunodeficiency viruses (SIVs). So far, more than forty species of African monkeys and great apes have been found to be naturally infected by SIVs, but there is little or no disease in the simian hosts. In recent decades, at least thirteen cross-species passages have been discovered from simians to humans. These viral passages to the human population have produced quite different results, ranging from several tens of millions infected to a few rare cases of a single patient. The polymorphisms of the two types of HIV and their epidemiological differences are good indicators of the difficulties encountered by the simian viruses in adapting to our species, in spite of the genetic similitudes between humans and great apes. The adaptation of a virus to a new host cannot be achieved only by overcoming the immune defenses of the host. They must also persist, depending on the epidemiological conditions, especially demographic ones, which must also be favorable for the adapted virus to become widespread.

At present, two types of HIVs have been reported with different origins and numerous subgroups classified for each. The HIV-1 types were the result of transmissions between great apes and humans; the HIV-2s are the product of transmissions from West African monkeys to humans. There are four HIV-1 groups, very unequal in the number of infections they have produced, but very useful for comparison by researchers studying them. Both their origins and clinical presentations are different. Group M (for main and responsible for the pandemic) and group N (for non-M non-O) are the result of chance transmissions from chimpanzees of Central Africa. Group O (outlier) and the latest group P (putative) come from SIV-infected gorillas. For HIV-2, there have been nine groups reported so far, all originating from sooty mangabey monkeys. These HIV-2s appear to be less adapted for infecting humans, inasmuch as although they inevitably lead to immunosuppression, the time is usually longer than is the case with HIV-1 infections.

In the past centuries, there have probably been multiple other viral interspecies transmissions between simian viruses and the human populations in Africa. But none produced an epidemic widespread enough even to be reported by the local populations and colonial doctors who watched closely for such developments. The recent emergence of so many HIV strains in such a short time therefore strongly suggests a common explanation. It cannot be the case of an isolated passage of the virus to a single case index, but, rather, recent and ongoing new conditions affecting the two species participating in the cross-species transmission, thus resulting in a successful infection of humans. It was thus only in the twentieth century that a favorable set of circumstances existed for the epidemic explosion of these viruses that changed not only the history of medicine but also our society.

Since the recognition of AIDS and the discovery of HIV, numerous questions have been raised by specialists and the general public. Most of them can be summarized as follows: Why did these HIVs emerge in human populations in the twentieth century in an extremely short time, given how long the simian viruses have existed in primates? How and why have some HIVs infected so many people worldwide while other strains have remained isolated in Africa? What can be learned from the differences between viruses and their epidemiology? Why are some HIVs less pathogenic than others?

Several studies have attempted to respond to some of these fundamental questions raised by this world-changing pandemic. This volume offers the most complete overview of the origins of the HIV viruses and their relationship to ancestral simian viruses. But the great value of the current volume is to combine African history, including colonial medicine and anthropology, with the basic sciences of virology and immunology to examine these questions. Among the findings of this novel approach are the unintended consequences of new medical interventions that became available in Africa after the First World War, such as injections and blood transfusions. Although greatly beneficial to the health of Africans, these medical procedures also favored the adaptation of the simian viruses to humans. These viruses probably emerged first in populations living in rural areas before expanding secondarily to cities like Leopoldville and others thanks to successive mutations and recombination between different strains. Then the adaptation to humans of these cross-species transmitted viruses was generally favored by direct passage via unsterile syringes and transfusion. The human-adapted viruses further took advantage of the troubles and disturbances in the rapid urbanization of the 1960s to create one of the worst pandemics in human history.