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August 6, 2008

The Past, Present, and Future of AIDS

Author Affiliations

Author Affiliation: President Emerita, Josiah Macy, Jr Foundation, Falls Church, Virginia.

JAMA. 2008;300(5):581-583. doi:10.1001/jama.300.5.581

Once upon a time, there was a world without AIDS—it seems so long ago. In the past 3 decades since first recognition of the new virus and syndrome, millions of lives have been lost or thwarted by debilitating illness or by orphanhood, and there is a sure promise of many millions of damaged lives to come. Looking back, it is astonishing how much progress has been made. What had been a devastating lethal disease caused by the new human retrovirus human immunodeficiency virus 1 (HIV-1) yielded to intense efforts to devise therapies that prolonged the lives of young people in their prime. With the advent of highly active antiretroviral therapies (HAART) in 1996,1 it was tempting to hope that science was close to vanquishing the new foe: AIDS had been converted into a manageable chronic disease.