Term Paper on "AIDS and HIV"

Term Paper 20 pages (6090 words) Sources: 10 Style: APA

[EXCERPT] . . . .

HIV and AIDS

Gallo, R. & Montagnier, L. (2003 Dec 11). The discovery of HIV as the cause of AIDS. The New England Journal of Medicine, 349(24). Retrieved November 17, 2006, from ProQuest database.

Gallo and Montagnier's (2003) article is a qualitative review of the research and history that led to the discovery of human immunodeficiency virus (HIV) as the cause of acquired immune deficiency syndrome (AIDS). The purpose of the article was to demonstrate how this discovery followed the typical twisting path of scientific research, comprised of "a mix of good and bad ideas, good and bad luck." The methodology was a qualitative review of research that both authors were heavily involved in.

The tale of scientific discovery begins in the late 1970s when many thought that industrialized nations were beyond the reach of epidemic diseases. Prevailing thought concluded that there was no such thing as a retrovirus that infected human beings. The authors, however, both worked for laboratories who continued the search for just such a retrovirus.

Their search paid off when they discovered human T-cell leukemia virus types 1 and 2. Many causes were considered at the time, however the authors realized that "(f)irst, the various manifestations of AIDS were unified by a biologic marker: a decrease in the levels of a specific subgroup of T cells that harbored the CD4 surface antigen. CD4 and other CDs had been identified only a few years earlier with the use of specific monoclonal antibodies, thanks to the work of Milstein and Kohler" (Gallo & Montagnier, 2003). As such the authors began a search for an HTLV-like virus in patients with AIDS.

The authors conclude that there are a variety of lessons that can be learned for the early intense period of research and note that great modesty is required for science. Basic research was critical for providing the technical and conceptual tools that lead to the discovery of HIV as the cause of AIDS. This was facilitated by the work of numerous researcher. And, although discovering the cause of an infectious disease, like AIDS, is an important step in medical research, allowing for development therapies and strategies for the elimination of transmission of the disease, it does not guarantee a cure (Gallo & Montagnier, 2003).

Critical Analysis of the Article:

This article was a comprehensive, yet brief, qualitative presentation of the early history of AIDS research and the discovery of HIV as the cause of AIDS.

It summed up the authors' personal experiences with the scientific discovery that led to this identification. Of particular interest was the notation that both authors had been working against prevailing thought at the time regarding retroviruses. It was this dedication to looking beyond the traditionally accepted that would ultimately lead to the new knowledge that it was indeed HIV that causes AIDS.

In addition to looking outside of the box, the process of scientific discovery was a twisting, turning path. It took both bad and good ideas, as Gallo & Montaganier (2003) note, as well as bad and good luck to eventually make the discovery possible. This demonstration of the struggle to come to new scientific knowledge was incredibly useful to fully appreciate the trials and tribulations that were experienced. Oftentimes scientific discovery is taken for granted as it seems advancement comes at leaps and bounds.

Future directions in research for this article would include the investigation of the pathway that has led to the various treatments offered. In addition, it would be interesting to learn more about other examples of collaborative processes that have yielded such significant results. Lastly, future research could provide a qualitative comprehensive literature review of all of the research, supportive and contradictory, that led to the discovery of HIV as the cause of AIDS, as opposed to this abbreviated, but thorough work.

Sabin, C., Pasi, J., Phillips, A., Lilley, P., Bofill, M., Lee, C., & Duesberg, P. (27 Jan 1996). Comparison of immunodeficiency and AIDS defining conditions in HIV negative and HIV positive men with haemophilia A. British Medical Journal, 312(7025). Retrieved November 17, 2006, from InfoTrac database.

Summary of the Article:

Sabin et al.'s (1996) article is a research findings report comparing the defining immunodeficiency and AIDS conditions in HIV negative and HIV positive hemophiliac males. Quantitative research was conducted on 263 hemophiliac males, over a six-year period. One hundred eleven of the subjects had become infected with HIV after treatment with contaminated factor VIII concentrate. One hundred fifty-two men remained HIV negative when infected batches of factor HIV started to be used, after regular testing.

The HIV positive patients were switched to monoclonally purified factor VIII concentrate which preserved the immune system of the patients. Since only the HIV positive patients received this treatment, the researchers focused on CD4 lyrnphocyte counts and clinical events that occurred before the end of 1990, when all received only intermediate purity factor VIII.

HIV positive patients were matched to HIV negative patients in two stages. Firstly, each HIV positive patient was matched for his median yearly usage of concentrate to an HIV negative patient whose usage was closest to and within 5% of that of the HIV positive patient. Secondly, the mean yearly amounts of concentrate received were compared in cases and controls and considered a good match if they were within at most 30-000 units. All matching was blind to patient outcome. Matching on the basis of both median and mean usage ensured that patients were treated similarly in terms of the number of years of treatment with concentrate and the overall amount of concentrate received. As most patients with severe haemophilia -- and therefore the highest users of clotting factor concentrate -- were seropositive to HIV, only a few matches could be identified. However, the patients who could be matched in this manner were comparable in their usage of concentrate. (...) Paired comparisons between HIV negative and HIV positive patients were tested for significance with McNemar's test for the development of AIDS and the sign rank test for the mean CD4 count during follow up. (Sabin et al., 1996).

It was concluded that HIV infection led to progressive immune deterioration and AIDS irrespective of clotting factor usage.

Critical Analysis of the Article:

The article concisely described the testing performed as a comparison of immunodeficiency and AIDS defining conditions in HIV negative and HIV positive hemophiliac men. However, more information could have been presented regarding the contaminated factor VIII concentrate. As it was presented, it was very confusing. No background information was given regarding this important factor. Therefore more information that would clarify this even would have added value to the report.

The authors' conclusion that HIV infection led to progressive immune deterioration and AIDS irrespective of clotting factor usage is rebutted at the end. It is this contrary information that enhances the usefulness of this research report and help with the clarification process noted above. In the rebuttal, it is noted that hemophilia specific AIDS may be explained non-infectiously via the long-term use of immunosuppressive foreign proteins containing contaminating commercial factor VIII and zidovudine. This rebuttal further goes on to note that Sabin et al. "reject the foreign protein-zidovudine hypothesis. However, their data and those of others actually support the hypothesis" (cited in Sabin et al., 1996). This clearly demonstrates an inaccuracy in the researchers' work and the need for continued research.

Their own findings that most severe hemophiliac patients, and therefore highest users of clotting factor concentrate, were seropositive to HIV, which would support the foreign protein hypothesis. As the rebuttal notes, "An appropriate test of the foreign protein hypothesis would compare HIV positive patients with HIV negative patients matched for the lifetime dosage of factor VIII" (cited in Sabin et al., 1996). In this way, the pathogenicity of the foreign protein zidovudine can be investigated.

Mitchell, C., DeLange, N., Moletsane, R., Stuart, J., & Buthelezi, T. (2005 July). Giving a face to HIV and AIDS on the uses of photo-voice by teachers and community health care workers working with youth in rural South Africa. Qualitative Research in Psychology, 2(3). Retrieved November 17, 2006, from ProQuest database.

Summary of the Article:

Mitchell et al.'s (2005) article discusses the teachers and community health workers, in rural South Africa, that work with youth and HIV and AIDS. The goal of the paper was to determine how university researchers could "draw on the voices of the people who most crucially must be heard in debates about curriculum and care in addressing HIV and AIDS, and how can the research itself do more than just draw on the voices, but make sure that those voices are heard?" Both teachers and community health care workers have a significant amount to contribute to the challenges and solutions regarding working with young people. The goal of the paper was to determine how visual methodologies, particularly photo-voice, could assist in this work.

The first phase of the study involved working with health care workers, over the course of four sessions. The first session… READ MORE

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