Hammett Theodore M, Bronson Roderick T
Theodore M. Hammett is with Abt Associates, Cambridge, MA. Roderick T. Bronson is with Harvard Medical School, Boston, MA.
Am J Public Health. 2016 Jun;106(6):1015-22. doi: 10.2105/AJPH.2016.303085. Epub 2016 Apr 14.
AIDS was recognized in humans in 1981 and a simian form was described in the years 1983 to 1985. However, beginning in the late 1960s, outbreaks of opportunistic infections of AIDS were seen in monkeys in the United States. This apparent syndrome went unrecognized at the time. We have assembled those early cases in monkeys and offer reasons why they did not result in earlier recognition of simian or human AIDS, including weaknesses in understanding disease mechanisms, absence of evidence of human retroviruses, and a climate of opinion that devalued investigation of infectious disease and immunologic origins of disease. The "epistemological obstacle" explains important elements of this history in that misconceptions blocked understanding of the dependent relationship among viral infection, immunodeficiency, and opportunistic diseases. Had clearer understanding of the evidence from monkeys allowed human AIDS to be recognized earlier, life-saving prevention and treatment interventions might have been implemented sooner.
艾滋病于1981年在人类中被确认,1983年至1985年期间描述了一种猿类形式。然而,从20世纪60年代末开始,美国的猴子中出现了艾滋病机会性感染的爆发。当时这种明显的综合征未被识别。我们汇集了那些早期的猴子病例,并阐述了它们没有导致猿类或人类艾滋病更早被识别的原因,包括在理解疾病机制方面的不足、缺乏人类逆转录病毒的证据,以及一种贬低对传染病和疾病免疫起源调查的舆论氛围。“认识论障碍”解释了这段历史的重要因素,即误解阻碍了对病毒感染、免疫缺陷和机会性疾病之间依存关系的理解。如果对来自猴子的证据有更清晰的理解能使人类艾滋病更早被识别,那么可能早就实施了挽救生命的预防和治疗干预措施。