An ordinary meeting of the Society took place at the Royal Southampton Yacht Cub on 2nd November 2016. The President was in the chair. Dr Keightley introduced the speaker Dr Liz Foley who spoke to the title: ‘The Story of HIV: Paradise lost; Paradise Regained. Dr Foley said that it is now 35 years since 5 young gay men were diagnosed with Pneumocystis pneumonia, a rare disease rarely seen in young people. There followed many reports of Kaposi’s sarcoma and a new condition named AIDS was described. Three years later the HTLV3 virus was isolated from from a lymph node.
In 1985 the famous film star Rock Hudson died of AIDS and there were cases of it being spread by human blood and tissue products. Mass hysteria was the consequence with it being imagined generally that the virus could be caught by just being near someone who was possibly HIV positive. Ryan White, a 15year old haemophiliac, was excluded from school and gays were unable to rent property. The hysteria was only quelled when the late Princess Diana was televised shaking the hand of an HIV patient with AIDS. This was a turning point.
Dr Foley described the natural history of the illness. By 1989 it was known that the CD4 count dropped and the virus replicated in the blood stream. It would then take up to 8 years before the onset of AIDS. It takes about 4 weeks for seroconversion to take place. The first drug, AZT, became available in 1987. By1996 a highly active anti-retroviral therapy scheme was introduced using 3 drugs synergistically, each working on a different part of the HIV life cycle. As a result the incidence of AIDS has dropped significantly. Guidelines suggest starting therapy at diagnosis but this is not funded by the NHS. Treatment will be required for the rest of the patient’s life. The situation is now that treated HIV patients now live longer than non HIV patients Dr Foley said. However 17% of patients with HIV are not diagnosed and are unaware of it.
In pregnancy 98% of mothers opt for an HIV test. AZT is given to mothers at any stage of pregnancy with the result that the transmission rate is now down to less than half a per cent, where it was formerly 34 per cent. As HIV is also transmitted in mother’s milk breast feeding is not recommended. In Africa the solution is to continue with AZT until weaning.
Treatment as prevention is also effective and protects others from being infected. Pre-exposure treatment is now being promoted. Risk factors and counselling were also discussed.
The President thanked Dr Foley for a most interesting presentation and the meeting proceeded to the Treasurer’s annual report. The details are reported elsewhere. Dr Phillip Carter, seconded by Dr John Dracass, proposed the accounts be accepted which was carried unanimously