In this continuing series of blog posts, the Editor-in-Chief of Virology, Michael Emerman, recommends books chosen for their descriptions of the roles of viruses and viral disease in the broader contexts of human health, society and history.
Here’s part 3 with two books about HIV/AIDS.
And the Band Played On: Politics, People, and the AIDS Epidemic – Randy Shilts
Publication Date: 1987
And the Band Played On is a powerful journalistic chronicle of the AIDS epidemic in major US cities in the 1980s starting with the recognition of patients with strange opportunistic infections and ending soon after HIV/AIDS finally became part of major media coverage after Rock Hudson flew to Paris to be treated. The book is a litany of failures of both individuals and institutions to act in ways that would have limited or slowed the spread of the epidemic. I read this book twice. The first time, in late 1988 when I was a postdoc at the Pasteur Institute studying HIV, I found it be both moving in its desperation, and inspiring at being part of the community of HIV researchers trying to make an impact. My recent reading 25 years later is more complicated. We know so many things now about HIV/AIDS that we did not know then (for example, the high levels of virus in early infection which impacts virus transmission, the understanding of drug resistance which complicates treatment, nearly anything about HIV pathogenesis, the extreme difficulty of HIV vaccines, etc.), that, despite the author’s justifiable anger that the lack of action took many lives, the epidemic would still have continued to climb even if research had started more quickly in 1983-85, and effective treatment would still not be available for some time to come. Moreover, the scope of the global epidemic is scarcely mentioned in the book as the author keeps track of deaths in thousands, when in the global toll is really measured in millions. Finally, the book’s caricature of everyone as either a devil or a saint is too simplistic. Nonetheless, the book should definitely be required reading for any virologist working on HIV as it helps understand what the early desperate days of the AIDS epidemic were like, and will surely provide motivation and inspiration for research to end it.
The Origins of AIDS – Jacques Pepin
Publication Date: 2011
The Origins of AIDS is my second favorite HIV/AIDS book. Jacque Pepin describes a very well-reasoned hypothesis for how HIV-1 was amplified from its initial cross-species transmissions from chimpanzees. The heart of the theory is that colonial policies amplified the virus in central Africa initially due to reuse of needles during mass inoculation campaigns against sleeping sickness, and subsequently yaws and other tropical diseases. HIV was then further amplified due to transmissions from female sex workers in larger central African cities crowded with male-dominated populations forced to labor on railroad construction projects. The arguments are properly couched in speculation and probabilities and supported by incidence data of infectious diseases, needles used, and population distributions. In my opinion this is the best argument to date for how HIV emerged from local infections due to bush meat hunting to the major pandemic of our time. It also explains how four separate infections of HIV-1 (group M, N, O, and P) and well as HIV-2 all date to cross-species transmissions into humans around the start of the 20th century. This is definitely a book to be read together with And the Band Played On which takes up the narrative from where this one leaves off at the introduction of HIV-1 to North America.
Do you have any favorites that should go on the Virologist’s Bookshelf? Feel free submit them in a comment!