Advertisement

Globalizzazione in medicina: l’emergenza HIV

  • Luca Ceccherini-Nelli
Chapter
  • 149 Downloads

Estratto

L’ottimismo generato dalle migliori condizioni di vita (cibo e acqua più sani, migliori sistemi di raccolta rifiuti e di discarica, nuove conoscenze nella biologia e nella medicina capaci di consentire lo sviluppo e l’uso diffuso di vaccini, la produzione di antinfettivi e di antiparassitari più sicuri ed efficaci) che avevano portato nel mondo occidentale all’allungamento dell’aspettativa di vita da una media di 46,5 anni nel 1950 a 65 anni nel 2002 (51 anni per i redditi bassi, 78 per gli alti), negli anni Ottanta si era già esaurito per l’emergenza di agenti infettivi “nuovi” (non riconosciuti prima) e per la riemergenza di altri già noti, a causa sia di fattori determinati dall’agente infettante stesso, quali l’acquisizione della capacità di salto di specie o la formazione di varianti farmacoresistenti, che di fattori determinati dall’ospite, quali: 1) manovre invasive iatrogene responsabili di infezioni ospedaliere; 2) cambiamenti climatici capaci di favorire il diffondersi di parassiti vettori di infezione e alterazioni degli ecosistemi (con prevalenza incontrollata di predatori o di prede); 3) esplosione demografica con ripercussioni importanti sulle tecnologie industriali di produzione alimentare, sullo sviluppo economico-urbanistico tumultuoso, sulle migrazioni di rifugiati; 4) promiscuità sessuale e turismo sessuale; 5) tossicodipendenza, e infine 6) spostamenti delle persone e delle merci che sono sempre stati fonte di diffusione degli agenti infettivi, ma che avevano raggiunto livelli di quantità e frequenza impensabili precedentemente [1] (vedi anche i Capitoli pubblicati altrove in questo volume).

Bibliografia

  1. 1.
    World Health Organization (2003) World Health Report 2003-Shaping the Future. Geneva: World Health OrganizationGoogle Scholar
  2. 2.
    Hahn BH, Shaw GM, DeCock KM e coll (2000) AIDS as a zoonosis: scientific and public health implications. Science 287:607–614CrossRefGoogle Scholar
  3. 3.
    Gallo RC, Montagner L (2003) The discovery of HIV as the cause of AIDS. N Engl J Med 349:2283–2285CrossRefGoogle Scholar
  4. 4.
    Zhu T, Korber BT, Nahmias AJ e coll (1998) An African HIV-1 sequence from 1959 and implications for the origin of the epidemic. Nature 391:594–597CrossRefGoogle Scholar
  5. 5.
    Wensing AM, Van de Vijver DA e coll, SPREAD Programme (2005) Prevalence of drug-resistant HIV-1 variants in untreated individuals in Europe: implications for clinical management. J Infect Dis 192:958–966CrossRefGoogle Scholar
  6. 6.
    Wei X, Ghosh SK, Taylor ME e coll (1995) Viral dynamics in human immunodeficiency virus type 1 infection. Nature 373:117–122CrossRefGoogle Scholar
  7. 7.
    Grossman Z, Meier-Schellersheim M, Paul WE e coll (2006) Pathogenesis of HIV infection: what the virus spares is as important as what it destroys. Nat Med 12:289–295CrossRefGoogle Scholar
  8. 8.
    Walker BD, Korber BT (2001) Immune control of HIV: the obstacles of HLA and viral diversity. Nat Immunol 2:473–475CrossRefGoogle Scholar
  9. 9.
    Ahr B, Robert-Hebmann V, Devaux C e coll (2004) Apoptosis of uninfected cells induced by HIV envelope glycoproteins. Retrovirology 23:1–12Google Scholar
  10. 10.
    De Clercq E (2005) Antiviral drug discovery and development: where chemistry meets with biomedicine. Antiviral Res 67:56–75CrossRefGoogle Scholar
  11. 11.
    Sallie R (2005) Replicative homeostasis: a fundamental mechanism mediating selective viral replication and escape mutation. Virol J 2:1–14CrossRefGoogle Scholar
  12. 12.
    Sallie R (2005) Replicative homeostasis II: influence of polymerase fidelity on RNA virus quasispecies biology: implications for immune recognition, viral autoimmunity and other “virus receptor” diseases. Virol J 22:1–20Google Scholar
  13. 13.
    Sánchez MS, Grant RM, Porco TC e coll (2006) HIV Drug-resistant Strains as Epidemiologic Sentinels Emerging Infectious Diseases. Emerging Inf Dis 12:191–197Google Scholar
  14. 14.
    Thomson MM, Najera R (2005) Molecular epidemiology of HIV-1 variants in the global AIDS pandemic: an update. AIDS Rev 7:210–224Google Scholar
  15. 15.
    Holte SE, Melvin AJ, Mullins JI e coll (2006) Density-dependent decay in HIV-1 dynamics. J Acquir Immune Defic Syndr 41:266–327CrossRefGoogle Scholar
  16. 16.
    3° IAS Conference on AIDS Pathogenesis and Treatment (2005) Rio de Janeiro, BrazilGoogle Scholar
  17. 17.
    Malta M, Petersen ML, Clair S, Freitas e coll (2005) Adherence to antiretroviral therapy: a qualitative study with physicians from Rio de Janeiro, Brazil. Cad Saude Publica 21:1424–32CrossRefGoogle Scholar
  18. 18.
    Anderson RM, May RM, Boily MC e coll (1991) The spread of HIV-1 in Africa: Sexual contact patterns and the predicted demographic impact of AIDS. Nature 352:581–589CrossRefGoogle Scholar
  19. 19.
    UNAIDS and WHO. AIDS Epidemic Update (2001) GenevaGoogle Scholar
  20. 20.
    National Intelligence Council (2002) The Next Wave of HIV/AIDS: Nigeria, Ethiopia, Russia, India, and China Washington DCGoogle Scholar
  21. 21.
    The World Health Organization strategy (2003) The WHO and UNAIDS global initiative to provide antiretroviral therapy to 3 million people with HIV/AIDS by the end of 2005, GenevaGoogle Scholar
  22. 22.
    www.noiperlafrica.orgGoogle Scholar
  23. 23.
    Graziano KL, Tempest B (2002) Hantavirus pulmonary syndrome: a zebra worth knowing. Am Fam Physician 66:1015–1020 ReviewGoogle Scholar
  24. 24.
    Coimbra TLM, Nassar ES, Burattini MN e coll (2004) New arenavirus isolated in Brasil. Lancet 343:391–392CrossRefGoogle Scholar
  25. 25.
    Murray K, Selleck P, Hooper P e coll (1995) A morbillivirus that caused fatal disease in horses and humans. Science 268:94–97CrossRefGoogle Scholar
  26. 26.
    Chua KB (2003) Nipah virus outbreak in Malaysia. J Clin Virol 26:265–275CrossRefGoogle Scholar
  27. 27.
    Barozzi P, Luppi M, Facchetti F e coll (2003) Post-transplant Kaposi sarcoma originates from the seeding of donor-derived progenitors. Nat Med 9:554–561 Erratum in (2003) Nat Med 9:975CrossRefGoogle Scholar
  28. 28.
    Webby RJ, Webster RG (2003) Are we ready for pandemic influenza? Science 302:1519–1522CrossRefGoogle Scholar
  29. 29.
    Beigel JH, Farrar J, Han AM e coll (2005) Writing Committee of the World Health Organization (WHO) Consultation on Human Influenza A/H5. Avian influenza A (H5N1) infection in humans. N Engl J Med 353:1374–85. Review. Erratum in (2006): N Engl J Med 354:884CrossRefGoogle Scholar
  30. 30.
    Van den Hoogen BG, De Jong JC, Groen J e coll (2001) A newly discovered human pneumovirus isolated from young children with respiratory tract disease. Nat Med 7:719–724CrossRefGoogle Scholar
  31. 31.
    World Health Organization (2003) Cumulative number of reported cases of severe acute respiratory syndrome (SARS) GenevaGoogle Scholar
  32. 32.
    Reed KD, Melski JW, Graham MB e coll (2004) The detection of monkeypox in humans in the western hemisphere. N Engl J Med 350:342–350CrossRefGoogle Scholar
  33. 33.
    Allela L, Bourry O, Pouillot R (2005) Ebola Virus Antibody Prevalence in Dogs and Human Risk. Emerg Infect Dis 11:385–390Google Scholar
  34. 34.
    Sanbonmatsu-Gámez S, Pérez-Ruiz M, Collao X e coll (2005) Toscana Virus in Spain. Emerg Infect Dis 11:1701–1708Google Scholar
  35. 35.
    Iwamoto M, Jernigan DB, Guasch A e coll (2003) Transmission of West Nile virus from an organ donor to four transplant recipients. N Engl J Med 348:2196–2203CrossRefGoogle Scholar
  36. 36.
    Gubler DJ (2002) Epidemic dengue/dengue hemorrhagic fever as a public health, social, and economic problem in the 21st century. Trends Microbiol 10:100–103CrossRefGoogle Scholar
  37. 37.
    Chastel C (2005) Chikungunya virus: its recent spread to the southern Indian Ocean and Reunion Island. Bull Acad Natl Med 189:1827–1835Google Scholar
  38. 38.
    Allander T, Tammi MT, Eriksson M e coll (2005) Cloning of a human parvovirus by molecular screening of respiratory tract samples. Proc Natl Acad Sci USA 102:12891–12896 Erratum in: (2005) Proc Natl Acad Sci USA 102:15712CrossRefGoogle Scholar
  39. 39.
    Smolinski MS, Hamburg MA, Lederberg J (eds) for the Committee on Emerging Microbial Threats to Health in the 21st Century, Board on Global Health, Institute of Medicine (2003) Microbial Threats to Health: Emergence, Detection, and Response. National Academy Press, Washington, DCGoogle Scholar

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • Luca Ceccherini-Nelli
    • 1
  1. 1.Dipartimento di Patologia Sperimentale BMIEUniversità di PisaPisa

Personalised recommendations