Zika Virus and HIV/AIDS

The first documented cases of HIV/AIDS in the United States bewildered physicians as they presented an unusual disease spectrum. Two young men were diagnosed with Kaposi sarcoma and Pneumocystis carinii pneumonia, which was inexplicable at that time, as these health outcomes were rare among their age, race/ethnicity, and individuals not living in nursing homes. Subsequently, it was found that after infection with HIV, individuals were asymptomatic up to 4 weeks and if symptoms developed, they appeared as a simple type of flu. The progression and global proliferation of the HIV pandemic is mirrored by the spread of Zika virus (ZikaV). Humans were probably first infected with HIV in the Kinshasa region in the 1940s and ZikaV was first detected in humans in the Zika forest in the 1950s. Aedes aegypti and Aedes albopictus mosquitoes transmit ZikaV, an arbovirus, as well as other related arboviruses. In addition to mosquito transmission, ZikaV transmission occurs through sexual risk and blood transfusions. The latter two risk factors were prominent modes of transmission during the early stages of HIV/AIDS epidemic and sexual transmission risk remains prominent. In addition, injection drug use is a risk factor to become HIV infected. For HIV, blood transfusion risk was reduced after appropriate testing of blood supplies. Unlike HIV, ZikaV does not produce significant symptoms that require medical attention among four-fifths of infected individuals. Indeed, initially considered a relatively benign virus, the unexpected emergence of ZikaV in the Americas since 2015, and continuing as a virulent and pathological virus for children and adults, created a sense of fear and distress. These emotional responses parallel the HIV/AIDS epidemic. Clinicians, epidemiologists, and other scientists are currently increasingly laboring to discern the full spectrum of risk, relative to vector and population behaviors, and as with HIV, to develop vaccines and chemotherapy against ZikaV. NIH and Walter Reed ZikaV vaccines are on the way.