Who Are at Risk?
WHERE did the AIDS virus come from? The prevailing opinion in European and American medical circles is that its origin is Central Africa. The African green monkey carries a similar virus, and it is thought that the virus found its way into humans through their close contact with infected monkeys.
But AIDS victims were first identified in the United States. How was the virus supposed to have reached them? By way of Haiti, according to popular opinion. Many Haitians visited Africa during a cultural exchange program in the mid-1970’s. Later, it is said, homosexuals, infected while vacationing in Haiti, carried AIDS to New York.
Such theories, however, are strongly opposed by Africans, who call them “a propaganda campaign.” Dr. V. A. Orinda, the editor of an African medical publication, suggests that tourists from around the world introduced AIDS to Africa. Admittedly, no one knows for sure where the AIDS virus came from.
In any case, this killer disease lurked in the United States for several years, silent, deadly, multiplying prolifically. After finally being recognized only a few years ago, it quickly became a world health disaster.
Those at Risk
AIDS is spread by the exchange of body fluids, particularly blood and semen. Thus anyone who has sexual relations with a person infected with the AIDS virus is at risk. The type of sexual practices of homosexuals make them particularly susceptible. Indeed, over 70 percent of AIDS victims in the United States are male homosexuals, causing some to call AIDS a gay disease.
Then, in 1982, there was an AIDS victim who was not a homosexual. He was an intravenous drug abuser. By sharing unsterilized needles, drug abusers were injecting themselves not only with drugs but also with the AIDS virus from the blood of their associates. Intravenous drug users soon became a second high-risk group for AIDS.
Does this mean that those bitten by mosquitoes carrying blood from an AIDS-infected person are at risk? There is no proof that AIDS is transmitted in this way. “Health care workers with contaminated needle-sticks get more blood than a mosquito could transmit,” notes Dr. Harold Jaffe, a leader in AIDS research. “But,” he adds, “I don’t think you can say it’s impossible.”
Besides homosexuals and drug abusers, another group that began to come down with AIDS was hemophiliacs—persons who tend to bleed easily. They are commonly treated with a concentrate known as Factor VIII, made from blood plasma that is pooled from up to 5,000 different donors. The British medical journal The Lancet said that “in countries that use factor VIII concentrate from the USA the incidence is likely to increase.” Thus, it said, the percentage of German hemophiliacs reportedly having antibodies to the AIDS virus grew from zero in 1980 to 53 percent in 1984!
But the AIDS virus has also been found in urine, saliva, and tears. Can the disease be contracted through the exchange of these body fluids? There is no proof that anyone has contracted AIDS in this way, and prevailing medical opinion is that transmission by such fluids is unlikely. However, a Washington, D.C., neurologist, Dr. Richard Restak, says: “If the virus exists in these fluids, the better part of wisdom dictates that we assume the possibility that it can also be transmitted by these routes.”
The National Catholic Reporter last November said that the prevalence of AIDS has caused concern about sharing the common wine cup at Communion. When inquiry about the practice was made of the U.S. Centers for Disease Control in Atlanta, Georgia, acting director Dr. Donald R. Hopkins said that there was no evidence that AIDS could be transmitted this way. However, he added that the lack of evidence “should not imply that there is no risk.”
Since AIDS can possibly be contracted by close contact with AIDS sufferers, is it any wonder people are concerned? Yet, parents are often given assurances that their children will not be infected with AIDS by fellow students. As evidence, it is claimed that AIDS victims have not passed the disease on to family members even though they kiss, eat with the same utensils, and share the same toilet facilities. However, New York writer William F. Buckley, Jr., sympathizes with parents’ concerns, observing:
“When [the well-known AIDS victim] Rock Hudson was discharged, all the nurses who attended to him—and this was in a modern hospital, not at a witch doctor’s hut—were made to burn their dresses. The patient was fed on paper and plastic plates, with plastic forks and spoons—which were destroyed.” Why such precautions if hospital personnel did not believe that there was some risk of infection?
On the other hand, AIDS unquestionably can be transmitted by receiving the blood of an infected person. Even blood donors carrying the AIDS virus, but who as yet do not themselves have symptoms, can pass AIDS on to others.
Dr. Arthur Ammann reported that an infant in San Francisco who had been given several blood transfusions just after birth later developed AIDS. One of the donors, who was well at the time, did not become ill with AIDS until seven months after donation. Both the donor and the infant receiving his blood died.
Four premature Australian infants developed AIDS after transfusion from a common donor who was later found to carry AIDS antibodies. Three of the four died within seven months.
A boy in the state of Georgia, United States, died of AIDS five and a half years after receiving a single blood transfusion from a homosexual who had no symptoms but whose blood later tested positive to AIDS antibodies. Sadly, doctors at the Medical College of Georgia report: “The donor’s blood has been given to many recipients since our patient’s transfusion.”—The New England Journal of Medicine, May 9, 1985, page 1256.
One study reported that nearly 40 percent of patients “with transfusion-associated AIDS . . . were 60 years of age or older” and “had most often received their transfusions in association with surgical procedures, often coronary-bypass surgery.”—The New England Journal of Medicine, January 12, 1984.
This raises the important question: Isn’t there some sure way of keeping the AIDS virus out of transfused blood?
A Reliable Blood Test?
With the isolation of the virus that causes AIDS, it became possible to develop a blood test to tell at least whether a person had at one time been exposed to AIDS and had developed antibodies. Thus, a more rigorous program of screening blood donors became possible.
The press and many medical people seemed to feel that the problem had thus been solved. For example, Newsweek of August 12, 1985, spoke of this test as “ensuring, in the view of most experts, that AIDS will no longer be spread through the nation’s blood supply.”
But the U.S. Public Health Service’s revised guidelines to be given to persons in “high risk” categories do not say that. Instead, they say: “The test will not detect all people who may be carriers of the virus because not everyone who is infected with the virus will have antibodies. . . . There is a possibility that antibodies for the virus may not be detected when your blood is tested even though you may have been infected. If that were to happen, the blood would be used to treat patients who would then be at risk for infection by HTLV-III and for AIDS.”
The U.S. Food and Drug Administration’s magazine FDA Consumer for May 1985 said that “a negative antibody test result does not guarantee that a person is free from the virus. . . . This is because antibodies may not have developed yet if exposure to the virus was recent.”
Dr. Myron Essex, chairman of the department of cancer biology at the Harvard School of Public Health, was quoted by The New York Times as saying: “It’s extremely unlikely that the test is picking up more than 90 percent [of the infected blood], and my best guess is it’s 75 to 80 percent. I’d be shocked if it’s any better than that.”
Not only does the test fail to catch all virus-contaminated blood but, as Time magazine commented, “The blood test is too expensive for many countries to carry out on a large scale.”
A Newsweek poll reported that 21 percent of those interviewed said that they or persons they knew were refusing elective surgery that requires transfusion. Perhaps more people will now search out doctors who have developed the more careful methods that are used by specialists in the growing field of bloodless surgery.
[Picture on page 5]
Can a patient be sure that the blood he receives is free of the AIDS virus?
H. Armstrong Roberts