Fortunately, waves of major diseases rise and fall. This is most immediately apparent with COVID-19, which at its peak in 2021 caused over 2.5 million hospitalizations in the U.S. (and an associated 450,000 deaths) but by 2023 contributed to “only” about 900,000 hospitalizations and 75,000 deaths.
Although the numbers in the U.S. continue to decline, the World Health Organization (WHO) still considers COVID-19 to be a pandemic, given its ongoing strength in other parts of the world. Both WHO and the U.S. federal government ended their declarations of a public emergency in May 2023 – but that is hardly the same as saying the coronavirus is a thing of the past.
You may be surprised to learn that the same is true of the HIV virus, which can cause AIDS. First recognized as a new disease in 1981, AIDS is still considered to be a pandemic by WHO, and with good cause. New cases are on the decline, but that does not mean it has been defeated. During the past 40-plus years, most people have become more aware of the potential pitfalls of unprotected sex, and needle-sharing. Even so, we still see people living with HIV, as do hospitals across the country and throughout the world.
One invaluable tool against the HIV virus has been Pre-exposure prophylaxis (PrEP), a general term for using medications to prevent the spread of disease in people who have not yet been exposed to it, and Post-exposure prophylaxis (PEP), which reduces the risk of someone exposed to HIV from having the virus infect them. It is not, however, 100% effective, and is meant to be taken only in emergency situations. PrEP has been the preferred treatment – and a highly successful public health approach – for the last few years.
Chimeric antigen receptor (CAR) technology also shows promise with HIV, having already been established as a viable treatment for many types of cancer, including leukemia. The therapy involves collecting a patient’s T cells and re-engineering them in a lab to produce proteins that are then reintroduced into the patient’s body. These CAR-T cells then seek out and eliminate cancer cells.
Even with these and other methods to prevent and treat the virus, however, the disease has not gone away. According to the Joint United Nations Programme on HIV and AIDS (UNAIDS), there were about 39 million people worldwide with HIV in 2022: 37.5 million adults, and 1.5 million children under the age of 15.
Lack of awareness, as well as socioeconomic disparities here and abroad, are commonly cited reasons for the disease’s continuing threat; untreated adults may pass the virus to their partners and children, continuing the cycle.
Nevertheless, UNAIDS reports that an estimated 1.3 million individuals worldwide acquired HIV in 2022 – a 38% decline in new HIV infections since 2010, and a 59% decrease since 1995’s peak. The group has targeted 2030 as when it believes HIV/AIDS’ pandemic status can end, depending on cooperation from governmental and other leaders throughout the world.
It is definitely a hopeful goal, one that UNAIDS announced last summer that it believes is still achievable. In the meantime, let us all remain vigilant against this and other viruses by supporting behaviors that reduce risk for ourselves and others.
More information about HIV and AIDS can be found here.
Dr. Gary Zeitlin is an attending physician and Chief of the Infectious Disease Division at White Plains Hospital. To make an appointment, call 914-948-0500.