Pathophysiology of HIV and strategies to eliminate AIDS as a public health threat

Abstract

Since its discovery, it is estimated that human immunodeficiency virus (HIV) has infected more than 80 million people and caused more than 36 million deaths. At the end of 2020, an estimated 37.7 million people were living with HIV/Acquired immunodeficiency syndrome (AIDS), with 1.5 million new cases during this year and 680,000 associated deaths.The virus was described as a new retrovirus in 1983, but its origins date back to the first years of the 20th century, as a spillover event from monkeys to humans in Democratic Republic of Congo, to become pandemic in the 1980s, after significant social and economic changes in the world. Extraordinary efforts led to important advances in virology, immunology and pathophysiology, and therapeutics that changed the paradigm of HIV management.Today, HIV infection is a chronic treatable condition, with a life expectancy similar to general population. Treated individuals cannot transmit HIV and the dissemination of this knowledge should also reduce stigma and discrimination. New research is intensively looking for a cure and preventable vaccines, while in the meantime, and long-acting option of treatment is the focus for treatment strategies.However, current tools could eliminate HIV-AIDS as a public health threat, if we could be able to engage communities in expanding testing, implementing combined prevention for individuals at risk of HIV exposure, and providing optimal treatment to all positive cases.