The Mysterious REAL Origin of HIV

I can remember back to a time long, long ago in middle school when I had no idea what HIV was. And yet the understanding that my peers and I had was that HIV came about because a man copulated with a monkey or an ape of some kind. And it was used as an insult to say that someone at school had HIV because it implied that you were having slept with animals. Well, I and I'm sure many of you have never gotten a clear understanding exactly where HIV came from and how it seemingly overnight became this violently deadly virus. Today, I hope to get some clarity on this topic. Hi everyone, Ra Dazzi here and I'm really looking forward to having this conversation with our special guest Michael Keegan to discuss the origins of HIV and the history of the pandemic. But first, a brief introduction. With over three decades in the pharmaceutical field, Mike Keegan has built a career of curiosity at the intersection of clinical science, translational research, and patient impact. He began in 1995 as a pharmacy technician, preparing chemotherapy treatments, grounding his understanding of patient care. Alongside his early career, he pursued academic study, earning both a BSc and MSE in psychology. Michael later transitioned into medical affairs within HIV at Glaco Smith Klein before moving on into clinical research at Viv Healthcare. During this time, he completed a PhD at Imperial College London, focusing on the neurological impact of HIV. Three years ago, he joined Viv's translational research and cure team, where he worked with this team to design the organization's first clinical study exploring HIV cure and remission strategies. In addition to his industry work, Michael is an honorary research fellow at Imperial College London and has a strong interest in the history of HIV and AIDS. He regularly lectures across the UK, sharing both scientific insight and historical perspective on the evolution of the epidemic. Um, I'll underscore also that Michael is joining us today as an expert in the field and while he works for Avivve Healthcare, he's not here representing the company in any official capacity and I in turn have not been paid nor given any payment in kind for hosting this interview. Michael, thank you so much for agreeing to share your incredible wealth and knowledge with us today. How are you? >> Hi Raith. No, really nice to meet you. Doing very well, thank you. Really pleased to be here and uh talking to you about this. Yeah, I've been looking. >> Um, so before we dive in, I would love to know what it is exactly about the history of HIV that grabbed your attention. >> Yeah. Well, I mean, like you in in your introduction just now, I mean, I I was seven when when HIV was, you know, first characterized in 1981. And you go through school thinking, "Oh, it's something to do with monkeys and someone's, you know, having sex with monkeys." And of course, that level of ignorance is is dangerous. And and wherever you don't fill a gap with with proven knowledge, there's the ability for for um you know, prejudice to to set up a narrative. And so for me it's really important to to study these things particularly in a disease area that carries so much stigma with it to to just say right actually we know way better than that now and so we can fill in those gaps with with evidence and with scientific sort of integrity and so for me that that was the driving factor for this and also it's an incredibly interesting story about humans human behavior both good and bad you know in terms of where it came from and and and and how we ended up where we are today over a hundred years after it it transferred into the human population. So that yeah that's me. [laughter] >> That's great. Uh well let's begin where the world first noticed that something was wrong. um what were the first unusual cases that popped up in 1981 that alerted clinicians to what we now call HIV and AIDS? >> Yeah. So, so there was a group a small group of clinicians on in the west coast um of America s California and they described some cases uh five cases of what's called PCP so pumacyus corini pneumonia and it's a type of um pneumonia that is caused by a fungus and it's not normally something that you would see in someone with a competent immune system and so you might have previously seen it in people with genetic sign sort of genetic ab abnormality for their immune system or going through profound chemotherapy. And but this showed up in in a group of five young um gay men who come into clinic both with this PCP and then with a couple of other illnesses like CMV and so on and um oral candidasis like thrush and and so that really kicked things off to say maybe this isn't normal. And then um about a month later another 26 cases were reported from New York all describing a similar kind of condition or um a type of cancer called carposi saroma um which is caused by a human herpes virus which again is not something that you'd normally see in people who you know whose immune systems were doing well. Um and so that really kicked off that kind of uh that that that concern that maybe there was some new cell mediated issue going on. Um and over I think it was about the next 18 months the CDC um had about 541 cases reported to them of something similar and around 40% of whom had actually died. Um and and it wasn't until sort of that year that you know the the the reports of the first sort of uh uh sort of uh scientific reports from the Pastor Institute and from from the US teams reported a new virus that was thought to be associated with those. So that's yeah that's that was kind of our first indication that something new was was was happening out there. And what what was discovered in the US and then found in Europe that led early observations to look toward central Africa as a potential origin of HIV? >> Yeah. So, so obviously one of the first things you want to do is try and find out where it came from to give you some more information about what to expect. Um and I think around 50% of the cases at least in Europe that were showing up there early on in those early sort of um 1980s and early to mid 1980s were had all come from central Africa. So either um they were people who had lived in central central Africa and moved to Europe and they were being diagnosed or there were people that had spent time out there um whether they were you know medics or work or or you know those kind of things. Um and so it we started having a look in those areas and actually most of those cases came from Zire and so Zire's had a few different names over the years. It was the Belgian Congo um way back um over 100 years ago became Zire and is now known as the Democratic Republic of Congo. Um so so that was where people started to look. So then they set up some um observational field reports and bits and pieces from from around Kinshasa which was the the capital of the of Zera still today I believe. um started to have a look at those and you could take samples from from people from from around that period of time or even stored samples from a few years earlier during the 70s and you could see the slow uptick in numbers of of HIV once we had sort of reliable testing but actually from a an analysis of around 6,000 samples from other areas in Africa that it wasn't seen and so we really we were starting to hone down on the area where it was most prevalent and been sort of coming for some time. Um there were a few interesting cases that stand out like the Norwegian sailor. Um so he was a guy who had um stopped off near central Africa during the 1960s, come home, got married, had a child, and then all three of of of the families and mom, dad, and the daughter died in 1976 mysteriously from a unknown, you know, sort of disease. >> Oh wow. Um and so then samples were stored for those and then they analyzed those samples retrospectively and found out that those were you know um due to HIV as well. Um so yeah there's a few there's a there's quite a few cases like that that you can then start placing them into a particular geographical region. I mean it's pretty incredible that folks had the foresight to store samples of these medical cases. >> Yes. Yeah. And actually they would write them up as well. So they would write up that they were you know um things that you would not expect to see like the PCP and like the carposi saroma but you can't find another reason. So they would write those cases up and then hopefully at some point come back. I mean the best thing to do you know as researchers and and medical staff is to try and publish that stuff and that's what happened in 1981 but that we've had a few opportunities over the years which we've missed to be able to bring it to the world's attention a bit sooner. >> Yeah. So what so what were the earliest confirmed cases of HIV and why were these so important for dating the origins of HIV? >> Yeah. So there were a couple of very old samples. So, the Pastor Institute had been operating in the Belgian Congo for a long time. Um, right back to at least the 1910s, I believe. Um, and and so they would store some samples there. I think the earliest one that was ever found was from 1959 and I think it was lymph tissue sample and then a blood sample from 1960 and then a later sample from 1966. and analyzing them. HIV was found to be in those samples. But then you can use um uh a particular procedure called a molecular clock analysis where you start to see how much they deviated from each other. I'm not an expert on this part of it. That that's I'll have to leave that to my other scientists to understand, but you can actually start to give you a rough estimate of when it might have had an originator kind of virus. Um, and so the dating on that from the first two samples and then the the sec the third one that came in narrowed it down to somewhere between 1895 and the 1920s was where we first thought it would come in, you know, uh, come into the human population. And so that was that was kind of the the data to suggest that. Yeah. >> And are the samples being limited to the I think you said early 60s. >> Uh, yeah. Yeah. from 1959 to 1966. >> Okay. Is that due to just like technological reasons like having refrigeration? >> I I would assume so. Yes. Um they they did have a number of uh sexual health clinics in and hospitals in Sier um that had been looking after people for decades. Um and I imagine they they kept those samples in deep freeze at that point. Um you have to be uh careful with with keeping samples for so long because depending on how you keep them they degrade but these seem to be you know they they found viral sort of DNA in them. >> Yeah. So what do we know about immuno deficiency viruses in primates and how did it give rise to HIV1 and HIV2 and can you kind of differentiate those two for folks who aren't really familiar? >> Yeah, absolutely. So um one of the first things that we saw when people were actively now looking a case study tends to make you go hang on a sec what's this? Oh, I've seen cases like this. Right? So it sparks off those thought processes. And there was uh I think there was some immuno deficiency cases found in a US colony of of captive macaks which are a type of primate used for for research. Um and then people started testing some of the primates in central Africa and actually found that there are a number of what we call simeon immuno deficiency viruses throughout those species. each one would have their own versions. Um when we finally narrowed things down to chimpanzees, um there was a particular um uh species of chimpanzeee that that had an immuno deficiency virus that was very very similar to HIV1. So there's five types of chimpanzeee. The bonobos are although no the paniscus are one and I think and then there's there's four species of troglodites and it was one found in southern Cameroon that had the most similar virus to HIV1 and so people started having a look at that they had a look at other primates so the suti manga bay monkey had a similar virus to HIV2 and so they are very similar viruses structurally I think they share around 40 to 50% of of the DNA kind of uh uh chains sort of similarity there but they operate slightly differently in humans. So with HIV1 um you tend to to contract it. You might have an initial poorly you know kind of feeling with fever and so on and then it will go kind of quiet usually for up to around 10 years while it's it's attacking the immune system and bringing your immune cell counts low. we call them CD4 cell counts. Um type of white blood cell. Um the HIV2 is quite different. I my understanding and I don't know much about HIV2 I have to be honest is that they have much lower viral loads initially and a much longer time period before you start to feel the effects of it. Um they are treated more or less in the same way with a there are a couple of key differences in how you might might might use the drugs. um or rather your choice of drugs but but they are quite different but the one that really is the one that we we tackle as the pandemic is HIV1. HIV2 is limited mostly to central Africa. There's a few cases in in each country but there's not as many and it tends to be dying off because it it it doesn't spread through sex quite so well. it's much better to spread through sort of injecting uh you know sort of medical practices and so on and because of the improvement in those we don't see as many cases but they are still out there. I'm curious does HIV um affect um primates the way it does humans? Like do they start to have this degradation of their immune system and then to something like AIDS? >> Yeah. So, so they do they tend to tolerate their own species specific viruses much better. They don't seem to my understanding is that they don't seem to react quite so much to those versus how we react to it. However, if you were to give them a cross species virus, they would tend to get sick quite quickly. Um, and so, so, so there does appear to be a difference there. Um, >> yeah. Interesting. >> Not the expert on the the non-human primate stuff quite so much. >> Yeah. >> Okay. So a little bit to the controversial idea, many theories exist about how SIV or the Simeon immuno virus first crossed into humans. What were some of the early theories about how the virus entered the human population? >> Yeah. And some of this might sound like science fiction as we go through they get weirder and weirder. It's like weird science. >> Uh yes. First one actually which makes a lot of sense was there was some thought that it was caused by um a contamination of an oral polio vaccine and there was a book called the river which went into this in quite a lot of detail. So there's a specific vaccine called chat which have been developed and when you're making some of these vaccines sometimes you use animal cells to to grow viral proteins and so on. And so one of the theories was that they'd used chimpanzee cells within the chat vaccine back in I think it was the 60s um and that they had brought in the HIV into that and then people had ingested it and and contracted HIV that way. Um so this one's a bit more normal because that is plausible. But when we went back to have a look, they were using a a small monkey species that um uh did not have an immuno deficiency virus similar to HIV1. Um in fact, no chimpanzees have been used in that and actually there were some huge clinical trials testing that outside of the Congo. So in Poland, I think about 9 million people got it and it didn't show up in Poland initially. And so um people just to be safe went back and tested some old batches that were in the Wister Institute and in one of the UK institutes um and found no evidence of chimpanzeee cells and no evidence of of the immuno deficiency virus there. And so that's one of the ones that we can kind of rule out. Um there this is where it gets a little bit weirder though. There was um uh I think he was a a Belgian scientist from around the early 1900s called Jerome Rodane who who worked at the Pastor Institute. Um and he used to do experiments where he would give human blood to primates and then in some instances gave primates human blood. And quite often he was trying to look to see if you could transfer primate versions of diseases to humans. And so he was looking at things like TB and you know malaria and those kinds of things. Um and so that was you know that's a little off. It's not something get through you know the ethics today that work for quite a few decades. Um and so so people went back to have a look at that and actually he wasn't using chimpanzees again. Um they were using other monkeys mostly sourced from east east Asia where this you know didn't come from and uh and so that was kind of proven to be false but you know he continued that right up into until his death when in in the late 40s. So that was a little odd. Um and and one of my favorite weird ones is um a Russian surgeon called Serge Voronov. And in the early 1900s, he worked for the local Kadiv, like the royal royal family in Egypt. And he observed that the um Unix who worked uh there had short lifespans. And so Unix obviously had their testes removed. and he hypothesized that aging of the testes or degradation of them caused a reduction in male hormones and then that caused the aging process. So when he he got home in sort of 1910, he started doing these experiments where he would take baboon testes and implant them into humans to see if the hormones that they were giving off would give the humans like a boost of some kind. And so I mean >> Well, yeah. right? [laughter] Thoseized and died off. And so he then started using very thin slices of of these testes in humans to grafting it to the human testicles instead. >> Um and and whilst that may have done something for a couple of weeks, those eventually died off as well. Um and again, >> it it was shown that actually he didn't use chimpanzees, he used different different other primates as well. and and so that one was ultimately um disproven, but he died very rich from a lot of of older men, very rich men who would pay for this procedure over the next few decades. So there's some weird and wonderful bits out there and there stuff that you wouldn't normally find. And I have to say a lot comes from a book by Professor Jack Pepin who was an epidemiologist and infectious disease physician who's put a lot of this work together. say it's well worth a read that book. [sighs] But uh yeah, so the actual the actual one that stuck for a long time and it's only really the last couple of years where it's been challenged a little bit in terms of some of it is the cut hunter hypothesis. So this is where they had the railroads that the Belgians and French governments and and the Belgian king had installed in the Congo following colonization, you know, colonialism from from the Europeans where they press gang all the local people to build these railroads so they could extract ivory and then rubber during the industrial revolution out of of the Belgium and French Congos as they were called at the time. Um, and the cut hunter hypothesis was that teams of hunters from those work camps working on the railroads would go out into the bush, hunt a monkey or a chimpanzeee, kill them, butcher them at the sight of the kill, bring them back to the camp to eat. And if they had any cuts on themselves from working through the brush or taking the animal down, then then that blood from the butchering process could get into those cuts transfer, which is a totally legit, you know, kind of uh of way of doing it. It's called zunosis, where a virus transfers from one species to to another. >> I imagine that was hand-to-hand combat. >> Yeah. Right. It sounds like it, right? So, so that was actually one of the things that people commented on. So, the local congalles people didn't have rifles that were sufficient to take down a chimpanzee. They were not that powerful. And so, that that was cast into doubt. And then there were a few other factors that made us pause. One of them being it was illegal to hunt chimps. I mean, you're not going to stop poachers, but it was illegal to hunt chimps. There were huge fines in the Congo at the time to to you know for doing so. But there were also and probably much more potent cultural taboss which meant that people um associated some of these primates with ancestors, you know, either spiritually or reincarnations of their people and those kind of things that would have prevented them from doing it. And so, excuse me. Um, when you combine all of those factors, it seems unlikely that that was the the way it happened. Also, the main the other main reason is that the species of chimp, the shrinefery species that existed in the Belgian Congo and still exist there are not the species of chimp that carried the virus. The actual chimp species that that carried it were from um about 800 miles north in southern Cameroon. And there's a whole bunch of rivers in between and chimps are worse swimmers than I am. And so they don't, you know, to migrate 800 miles through those rivers that it just probably wouldn't have happened. And so we started or or rather Prof. Pepin started looking at some other um reasons as to why this might have happened. And there was a at the time there was a large um uh set of uh Belgian and French troops in in southern Cameroon in around 1914 to 1916 and they they have documented uh bits where there were starving they took to eating bush meats and they did have rifles that could take down a chimpanzee. So the idea now the most prominent theory is that th those troops killed the monkey. it transferred during the butchering process the blood and the virus into those and then what they did was they did a big loop down the uh west coast of Africa through the Congo and then back up. So where they they'd come through there and at the time there was another disease sweeping through the work camps in the Congo called African tripanosmiasis which is called sleeping sickness. And so the French and the Belgian medics were using huge quantities of injected arsenic based medicines to treat that. And so it's thought that the troops coincided with some of those treatments receive treatment themselves. They didn't have sterilization processes for those needles. That was then passed to the local people where over the next few decades where they were treated for this disease. It then amplified the number of cases. Um and so there are some data supporting that too in terms of the number of cases slowly increasing over time. Um and so that's where we think that comes from um initially and so that's kind of rewritten our understanding of that hunter hypothesis a bit. Um there one one other thing to add actually which was was back to to publishing is there was a chap called um Dr. Leon Pales who was a French medic, young French medic who at the end of the 20s, 1920s, he got posted in um in the French Congo and he had started performing autopsies on workers who died on a stretch of the the um the railroad called Maybe which was the stretch where most people died. It was quite treacherous uh to work on that stretch. And so he autopsied around 50 cases of people who had come who whose bodies have been brought in and they were massively wasted in terms of weight. So you'd have an adult male who would weigh about 35 kilos 30 35 kilos and we know that HIV causes that wasting when you're not able to treat it. Um, in I think 24 of those cases, he found evidence of tuberculosis, which also causes it. It's like it's sort of an uptick in the metabolism. Once you've got the virus or a disease, you you start to shed weight because you're spending all your resources repairing the damage that the disease is doing. >> Um, and but 26 of those cases, he couldn't find another reason for this wasting. And he also noticed some atrophy of the brain and that they also had enlarged lymph nodes. All of which are consistent with an AIDS like condition. And whilst we don't have any of the samples left from that time to be able to definitively test, it's possible that he was describing the first 26 cases of AIDS back in I think what 1931 I think that was. So 50 years before we found it. Um, and so just another push for any researchers listening is to publish your case studies because it it means we might be able to tackle these things a bit quicker. >> Yeah. And I think it's fascinating. I love the the fact that a lot of these theories were I mean in my view plausible ideas. They seemed rational and may make sense at at first blush. And I can see like looking at today's environment and our culture um how people come to these conclusions that seem logical but at the end of the day if the evidence isn't there to support it then it doesn't matter but it's easy to run away with an idea I guess is what I'm saying because it looks like it sense. >> Yeah, totally agree. Yeah. And they they like you say they seem plausible. they're logical and then when you look at them in detail you can then start to go right there's either definitive or you know less definitive to say maybe let's cast some doubt on that one and unfortunately I think with with the stigma pieces that you you know some prejudices can fill in those spaces and make way worse than they actually are >> you know um so you know get getting back to that it's it's a case of trying to get this story out there about how it started so that it doesn't stigmatize groups of people. You know, one being gay and bisexual men from the 70s and 80s, the other being here some African people, are they eating or having sex with monkeys? No, they're not. You know, actually, our best guess is it was colonialism again that's causing this problem. Yeah. So I'm curious as something that was relatively obscure in central Africa to the like traumatic epidemic that we're so familiar with. What conditions allowed for the amplification in the number of cases of HIV? How did this explosion just suddenly happen? >> Yeah. No, that's a really good point because actually it's reasonably difficult to to pass the virus on, you know, um and so this was over a long period of time. The um the the railroads was really the kickoff. They were dispensing industrial levels of this arcenic to treat sleeping sickness. So if you so what people what this group would do and it started with Eugene Jamat using Jamott's doctrine which was we go to a work camp we take a sample from lymph nodes from everyone at the work camp and everyone that we can see this this um uh this uh protozoa this this um African trap trapanmas I never say that one properly in that we treat them for 12 weeks with an injection every week and we'll leave the medicines here you don't have a sterilizing process. There's 300 people in this camp. Half of them are taking the drug. You share the needles around, right? And so that would even in a couple of cases would amplify um over time. And then this just became an industrial process for the next few decades. They were using these these things. Um they they were using it in sex clinics. So for for they opened a couple of clinics in the late 20s and early 30s uh for for sexual health. And so people would come in and and people who were sex workers or or just anyone else, you know, to to be able to work, they would have to have their card stamped and and have this treatment. Um and what we see over time is rising case numbers in terms of the number of cases of carposi saroma in that region for a long time and that bubbled away. um uh for quite a while. And it wasn't until 1960 where the Congolese people uh pushed the Belgian government out of of what became known as the Democratic Republic of Congo. um that you had an influx of new people and so there was an infrastructure collapse in the in the country and so the UN and the WHO sent in somewhere between 5 and 7,000 medics and teachers and people to keep the infrastructure alive um and those people a lot of them came from Haiti and so those people came to work there for a number of years during the sort of mid late60s some of them would have had relationships with local congalles people. And um what we now know is that a particularly rare form of HIV, cuz there's lots of different subtypes um traveled back from the Congo at the end of the 60s to Haiti. And the reason that it showed up was during that time there was a new blood bank being set up in Porter Prince in Haiti. Um and it was being set up by um uh Luckname James Cameron who was the former head of the Tontoton Maku for for Papa Dr. Valier's regime and he got funding from an American um investor called Joseph B. Gorenstein and they set up Hemo Caribbean and actually Lucker James Camron became known as the uh the vampire of the Caribbean um because they were taking blood from people and so they would take blood from hundreds of people every day. There was no true sterilization process for the blood extraction um machines that they used and they would take the bits that they want and infuse the rest back into into the donor. And so for around 18 months, this this um blood bank had somehow got possibly only one person with HIV um uh in to to to donate and we think it's probably only one person cuz it's subtype B and it's very rare in Central Africa to find that subtype. Um and so that set up shop in in that that blood bank and then that blood was flowing into the US because they would buy most of their blood from from developing nations and around 20% of their blood supply came from Haiti and so that would be used for things like you know blood transfusions during pregnancy or road traffic accidents and those kinds of things. Um and so it it was only around 18 months later that President Nixon ordered um a review of the blood sort of services where US got its blood from that they did an audit of the hemocaribbean blood bank and found that found out about its practices without knowing about HIV. Um and so they shut it down and it stopped. But by that point, you know, that had kind of arrived in America. And then we had a few kind of um social kind of changes at that time. One was the hippie movement where there's lots of free ship sexual partners and uh and IV drug use. But also, you know, men, gay men had just acquired the right to congregate in public spaces and so they were not going to give that right up. And so the the bath house kind of phenomenon arose too where you had a lot of people you know sharing partners. Um and then add on the additional effects of US sex tourism to Haiti and then to Europe and so on you start to get this buildup of the number of cases over time. And if you think that the that HIV normally has a a roughly average 10year period between the point where you acquire it to the point where you start to become sick um you know your your your immune system collapses that's about 10 year window. So if it that started in the late 60s early 70s then it' be towards the end of the 70s early 80s that you'd start seeing a lot of those cases come through which is what we saw in the US and what was ultimately published and I think the reason that it was picked up better in the US despite being in Africa for for for decades is health surveillance system that the US had at the time. >> So people you know had the opportunity to publish those findings. >> Yeah. >> Okay. So there could have been, you know, a lot of people with experiencing transmission and and dying, but because they weren't really surveilling like we do in the US, no one was really paying attention. >> That that is my understanding of it. If they did that, you know, trying to get the lab equipment and those kind of things >> into it as well. But that's my understanding and I could be wrong. I'm very happy to be corrected. [laughter] And just the irony of of a lot of what was going on like being monitoring and and checking in on sexual health was like the point of transmission for a lot of people it seems >> right you're actually trying to do the right thing right know you're trying to take care of yourself and the pe your partners and so on and then that you know the medical route ultimately being the root that causes the problem and it it wasn't just for HIV it was for hepatitis B and hepatitis C as well. We saw a big uptick in what we call medical hepatitis cases as when again we didn't know what was causing it but we knew that there was an issue. Um and so it wasn't just HIV. Um there there were a number of other other uh viruses that were amplified over that period of time as well probably much more so. Um >> because they spread a bit easier. And you mentioned this 10-year sort of incubation period. What because a lot of people have said like talking about theories and stuff how like it seemed like in the 80s one day someone was um experiencing HIV symptoms and then all of a sudden they were dying like so quickly. >> Yeah. >> Was there a change in the virus itself or is this just because the symptoms weren't showing up for so much long after or both? It's a great question. I actually don't know about whether the virus settled down over time. That's something I'd need to check. Um but certainly >> when when I say there's a roughly 10 year that's the median, right? So there's always going to be outliers. And actually what we now know is that there are some um genetic alilles that people have that protect them allow them as the virus evolves inside the body. >> You want your immune system to evolve at least as fast as that to tackle it. >> And so some people have genetic alles like HLAB 5701 and a few others that allow them to respond very quickly to changes in the virus. Whereas there are some people that have the opposite where they they they are quite slow to to adapt. Their immune system is quite slow to adapt to those changes as the virus evolves. And so the virus is able to do more damage before you can then stop that version of it. And so um you know some people may progress from the point of acquiring HIV to to AIDS where their immune system starts to collapse um and they start to acquire those other illnesses which you'd normally be able to fend off within a few years and some people can go for 20 30 years without you know without that. And so there's quite a lot of variation within you know human populations as to what they can tolerate and what they can't. Um I think probably what we saw in the 80s was when people became ill with some of those diseases they had already had the virus for a number of years and you can't tell usually you you can't tell that you've got it. Um so so by the time they did become ill and then pass away um it was because their immune system had already had a reasonable amount of damage done to it and the illness that they then caught cuz they couldn't fight it off did a lot more damage for them. >> Yeah. Yeah. I mean my own experience just to support your point is about three years give or take from you know acquiring HIV to getting an AIDS diagnosis. So for me it was very fast. >> That's very fast. Yeah. Yeah. Priy >> I'm sorry. Yeah. >> Could HIV have been found earlier than 1981? >> Yeah. So so I think that goes back to my point around Leon Pales. You know in 1931 he had probably characterized the first number of cases from the autopsies. Um, and so if he'd published that work rather than leaving notes at the Pastor Institute, then it's entirely possible that people would have been on the lookout for it and been able to put some level of programming to say, "Right, we think this is happening. Here's some mitigation that you can put in." And so it might not have amplified the way that it had. Um and there were a number of chances for that over over time. But given the stretch of the health care resources in in the sort of Belgian Congo and Zire and so on for at those times, it's it's difficult to say. I mean, most people were just there trying to get medicine and treat people, right? >> Yeah. So, um I think I think the the program actually was so industrialized because it was tied to an industrial program. I you know we have railroads to maintain or build and maintain so we can get you know resources out from the country back to Europe. So therefore, we're actually going to invest, but they didn't invest enough. And actually, a lot of those early sexual health clinics um particularly in the French Congo, but also the Belgian Congo, um were mostly just for Europeans or for people who local Congolese people who were useful to the regime and it was only that they started to expand those later on. Um, and so maybe the damage had already been done by that point, but without samples, you know, it's difficult to to track that properly. >> It's fascinating that this was possible due to this like grand convergence of all these factors and situations, wartime movement and cultural changes, sexual liberation, tourism, medical practices, like all these things just made this ticking time bomb happen. I feel like I because I'm visualizing all the things as you're as you're talking about it. I'm like this would like make such an incredible film if it hasn't been done already. >> Right. Exactly. >> It's like this ominous slowm moving freight train of death about to happen. >> Yeah. No, I totally agree. And and you know we myself and Laura Waters from who used to be the chair of the >> Laura. >> Yeah. She's great. Um, we we had discussed trying to put together a documentary on this and then a podcast and and fortunately I'm finally getting to speak to you. So, uh, yeah, >> I'm not a let me out much. [laughter] >> Well, I I encourage that pursuit to dive into it even deeper. It would be very cool. >> Yeah, it would be great if we could get get something together for that. >> And like what a what a fantastic educational tool that would be too. >> Yeah. >> Storytelling. >> Yeah, absolutely. No, I totally agree. I mean, we can get stuff on to Netflix for for all sorts of things. >> I know they made a few movies like that. Um, I think regarding COVID that was this had this like sus continuous like suspense of like the things that happened, the confluence of events that led to >> Yes. Yeah. Yeah. Yeah. It's all those kind of threads that this sort of mystery >> Yeah. that that come together. But uh yeah, if you if you're interested, I I will send you the slides, but also >> Yeah. >> Jack Pepin's book, The Origins of AIDS, addition to because that includes the the cut soldier hypothesis. >> Um well worth a read. >> Yeah. >> Okay, cool. Yeah, I would love to see that. >> Um and I I noticed now that you're doing work in HIV cure research as well. >> I am. Yes. Yeah, I um have been working with the company um to to look essentially at whether we can reduce what we call the viral reservoir, the the the cells that have the virus stuck in them that are producing virus or or even asleep. See if we can reduce that amount, reduce the output that it's giving and and also try and train the immune system to control it by itself. And actually there's some data out there from other >> uh groups that are already doing stuff like this um demonstrating that that you can to some degree uh put people into a level of remission at least. I think we're a way off yet from what we would call a sterilizing cure where you can just completely eradicate the body of the virus because the the difficulty is it's not really the the mature viruses. We can get rid of those. it plants its DNA code inside your DNA in some of your tea cells, your white blood cells. And so trying to extract that when that cell's not doing anything, you can't even identify the cell because it's not making anything that we can see. And so, so yeah, so what we're trying to do is is put in place some some bits where the body is already ready to pounce on it as soon as that that starts to make new virus and and emerge. So what we're trying to do is train the immune system to be able to be ready for when that that virus emerges. So before it can even infect another cell, can we get rid of it, destroy it, or or destroy the cell that's making it? Um, and so, uh, that's our current kind of of of strategies that we have. Um, so I think we're a way off. Um, but we might be able to put people in some level of remission. So, we're waiting for those. >> Yeah. >> I saw a fascinating uh, Instagram reel this morning. It's this guy and all he does is study slime mold and he was saying how um slime mold is actually just a single cell organism but it just has tens of thousands of nuclei and so as it grows into this big organism organel and he was talking about retroviruses specifically and how it's able to just squash all retroviruses because when a cell is infected nor nor it's like trained to produce more of the virus and eventually it exhausts and dies. That's what normally happens. But in in the slime mold, all the other cells, it's essentially put it on life support and provide it everything it needs to keep living so it doesn't get exhausted until the point where it can evolve to the point where it can squash the virus. And then it transmits that information on how to squash the virus to all the other nuclei so that the whole thing becomes immune to the virus moving forward. And it's been able to do this for how thousands of years to the point where it's like resistant to all viruses or retro viruses I should say. It's just mindblowing. >> Yeah. Well, I need to have a look at that and uh yeah, see if we can exploit that in some way. >> Yeah. Like how they all rally around the cells that need it. >> It's so crazy >> without having an immune system. It's like what? >> Yeah. Yeah. >> As we understand it anyway. >> Yeah. Yeah. I know that honestly the complexity of biology is is insane. >> It's so cool. >> Need to have a look at that. Definitely. >> Yeah. >> Well, I would love um in the future too to have you on some for some cure related um conversations as well if you're open to that. >> I I I definitely would be um my boss um as well is is uh would be a great person to speak to as well. >> Okay, cool. >> Um yeah, he'd he'd be great. Um, I'd need to speak to Ben and and chaps about what we can and can't say because we can't promote >> kind of things. Yeah. >> So, for for explaining a bit about how things work and and you know what kind of mechanisms we're trying to train into things interesting filled in sort of general. >> Yeah. >> And I meant to ask you, do you prefer to go by Michael or Mike? >> Uh, Mike's fine. Michael's my given name, but everyone calls me Mike. I used to get for obvious reasons. [laughter] >> I love your look, by the way. You have such a cool look. >> I'm just an old grunge fan for, you know, [laughter] >> I sort of had look since I was 20. And with with with the birds in the background and your look and then this like esoteric talk about the history of HIV, I'm just thinking like Hogwarts of uh >> I literally watched Harry Potter for the first time. >> My wife made me sit down and watch all of them. I thoroughly enjoyed it. But yeah. >> Yeah. Awesome. >> Hogwarts. Oh, I will take that. [laughter] Yeah. Fantastic. Well, Mike, thank you so much for taking the time to sit with me today. I'm so glad we were able to do this. >> Everyone at home, please comment below your thoughts, comments, and questions. I know you're going to have many, and I'm happy to follow up anytime. Don't forget to like, subscribe, hit that bell so you get a notification every time a new video comes out. And please share this with anyone who might find value in this content. Those are the best ways that you can help support me and my channel. Until next time.