The world erupted that day because Magic Johnson was so beloved. At that point in time, many believed that HIV naturally led to AIDS, which automatically meant a death sentence. The fact that so prominent and loved a personality as Magic Johnson was a victim was stunning news.
Fortunately, Magic Johnson is still alive. Advances in HIV treatments saved his life, and today he is healthy and living a relatively normal life with his wife, children and thriving business interests. That long-ago press conference, while not forgotten, is no longer viewed as the final chapter in his career, and Johnson even came back to play basketball and coach the Lakers for a time.
Living with HIV
Today, HIV is no longer regarded as a death sentence. While people can and do die from HIV infections, it no longer is automatic, and most HIV-infected people manage to live well with the disease and die of natural causes at a normal life expectancy.
But unlike many viruses, the human body cannot shed HIV. Once acquired, the patient will have HIV for life. There is still no cure for HIV or AIDS, but research continues.
Meanwhile, HIV is managed by antiretroviral therapy, or ART. It lowers the chance of infecting others and extends the lives of people already infected. Its introduction in the mid-1990s was a godsend because many early HIV cases progressed to AIDS and death within a few years.
HIV infects immune system cells called CD4 cells, or T-cells. HIV works to destroy those cells, lowering the overall immune system to the point where infections and diseases run rampant, and HIV infection turns into AIDS. The AIDS diagnosis comes when T-cells drop below a count of 200.
Statistics
More than 1 million people in the United States older than age 13 are estimated to be infected with HIV, with nearly 11 percent of them unaware of their infection, according to statistics from the Centers for Disease Control and Prevention. The majority of the afflicted are bisexual and gay men who have sex with other men, with black men being the largest group.
Unfortunately, despite massive education efforts, the total number of people with HIV infections is increasing, even though annual numbers remain relatively stable. There are an estimated 50,000 new infections each year, with more than 25,000 people developing AIDS. There have been close to 1.2 million people in the United States diagnosed with AIDS since the infection was first discovered. An estimated 658,000 people with an AIDS diagnosis have died in the United States. However, not all of them necessarily died from AIDS and may have passed away from unrelated causes, accidents or suicide.
The Origins of HIV
It's believed that HIV originated in Africa via animal-to-human transmission when hunters would seek "bush meat," or that of chimpanzees, to eat.
HIV/AIDS surged in the 1980s among gay men and intravenous drug users, primarily, and was largely ignored for several years until it affected other segments of the population, including heterosexual people and children. It is now known that bodily fluids such as semen and blood transmit the virus, which made it difficult to cross oceans when jet travel was not common.
Stages of HIV
There are several stages of HIV infection, during which transmission is possible. The acute stage arrives within two to four weeks after the initial infection, when the patient has flu-like symptoms. This is technically called the acute retroviral syndrome (ARS) or primary HIV infection. Large numbers of HIV are being produced at this time, as the virus uses CD4 cells to replicate itself while destroying the CD4 cells. This is the most infectious stage because of the large amount of HIV in the body.
At some point, the afflicted’s immune system will begin to fight back, decreasing the amount of virus and increasing CD4 count. However, it is unlikely to return to previous T-cell levels.
At this point, the patient reaches the clinical latency level. HIV is still active but is not reproducing very fast, and the patient may not exhibit symptoms. If treatment is started, symptoms may not manifest, but even people who are not being treated can stay in this period for up to a decade before the CD4 cell count begins to drop.
The final phase is the AIDS infection onset. This is when the CD4 cell count decreases to less than 200 cells per cubic millimeter of blood (displayed as 200 cells/mm3). At this point, the immune system is badly damaged, and infections occur easily. Opportunistic diseases like infection-related cancers also may emerge. Without treatment, this phase has a projected survival rate of three years, but if an opportunistic disease emerges, that period can decrease to one year.
Treatment
Treating the opportunistic and rare infections that depressed immune systems could not fight was the first line of defense against HIV/AIDS in the early days of the epidemic. They largely did not work, and early victims died swiftly and cruelly.
When the antiretroviral AZT came along in 1987, it was treated as a magic bullet to slow the disease's progression and to prevent mother-to-child transmission. However, patients can become resistant to AZT, and it loses efficacy, not to mention has fairly significant side effects.
People still died of AIDS at an alarming rate until 1996, when the first protease inhibitors were discovered to be successful in preventing AIDS-related deaths. The CDC reports that the "cocktail," as it was called, reduced AIDS deaths in the U.S. from 50,000 to 18,000 within two years.
Today, AIDS deaths continue to plummet as strict adherence to antiretroviral regimens prolong life and make HIV a chronic, manageable disease instead of a death sentence. Just one pill a day, compared with dozens, can keep viral loads – the measurement of the number of virus particles in bodily fluids – at nearly zero, making HIV undetectable in many patients, including Magic Johnson, and more recently, Charlie Sheen.
People who live with HIV/AIDS are even free to pursue physical relationships with HIV-negative partners, thanks to the advances in PrEP, or pre-exposure prophylaxis. People at high risk of contracting the virus may consult their health care providers about the benefits of a regimen of HIV drugs, designed to lower chances of being infected. With partners whose viral loads are nearly zero, those who take PrEP as directed cut their chances of contracting the virus by up to 90 percent, according to the CDC.
Antiretroviral treatment has worked, and HIV-infected people are now less prone to infecting others and living normal lives. That underlines the need for early testing. The earlier treatment begins, the greater the expectation that it will work and prolong life.