By Wang Hairong

Prepared for the Worst Emergence of a new AIDS-like immune disorder is no cause for alarm

By Wang Hairong

A disease that can cause AIDS-like symptoms recently has aroused public concern.

“So far, there has been no reported case of adult-onset immunodefciency on the Chinese mainland,” said Deng Haihua, a spokesman for the Ministry of Health, at a press conference in Beijing on September 11.

Despite this, Deng said that the Chinese Center for Disease Control and Prevention is already equipped with related techniques and equipment, and will strengthen monitoring over the disease.

The disease was discovered by scientists from the United States, China’s Taiwan and Thailand, who published their findings in theNew England Journal of Medicineon August 23.

Like AIDS, the disease impairs people’s immune system, weakening their ability to fight off infection; yet, unlike AIDS, it does not seem to be contagious, and no virus has been found in patients, said the scientists.

Although the disease causes acquired immune deficiency syndrome like AIDS, it damages a different part of the immune system.

While HIV destroys germ-fghting T-cells, the new disease produces antibodies that block interferon-gamma, a molecule crucial to normal immune functioning, leaving people vulnerable to viruses, germs, fungal infections and parasites.

In an interview with China National Radio in early September, Wu Zunyou, Director of the Chinese Center for Disease Control and Prevention, did not rule out the existence of cases of adult-onset immunodefciency on the Chinese mainland. He said that perhaps they have not caught the attention of medical doctors.

Disease control departments on the Chinese mainland have already started to make technical preparations to identify the disease, according to Wu.

“If an immunodeficient patient tests negative for HIV, doctors can consider measuring the level of the antibodies that block interferon-gamma to determine whether the patient has the AIDS-like disease,” he said.

Unknown causes

The disease is said to usually afflict Asian adults around age 50. According to the Associated Press, the frst case of the AIDS-like disease was reported in 2004. More than 200 cases have been confirmed, most of which are in Thailand and China’s Taiwan, and some in the Asian community in the United States.

The cause of the disease is still unknown. Scientists suspect genetic and environmental factors are to blame. The disease does not appear to be hereditary.

“It’s still possible that an infection of some sort could trigger the disease, even though the disease itself doesn’t seem to spread from person to person,” Dennis Maki, an infectious disease specialist at the University of Wisconsin in Madison, told theAssociated Press.

(Left) FRONT LINE: An institute for AIDS/STD control and prevention in Chaoyang District, Beijing, is equipped to identify cases of adult-onset immunodefciency

“In the case of the recently reported AIDS-like disease, patients’ immune deficiency was proven with clinical and laboratory evidence, whereas

HIV-negative AIDS is exclusively self-diagnosed.”

—Wu Zunyou, Director of the Chinese Center for Disease Control and Prevention

A number of factors have been known to lead to immunodefciency, including genetic defects, cancer, radiotherapy, chemotherapy, and mental illness, according to Zeng Guang, Chief Epidemiologist with the Chinese Center for Disease Control and Prevention.

Zeng said that immunodeficiency is not something new, and for many years, a large number of immunodefciency sufferers showing various symptoms have seen doctors.“Only that now, as science and technology develop, people have gained new understanding of this type of disease,” he said.

Zeng suggests not labeling the disease as “bizarre” or “AIDS-like”, saying a casual defnition may mislead people into believing that the disease is an epidemic, and cause unnecessary confusion.

“There is no need to panic over adultonset immunodeficiency and it is also too early to conclude that such immunodefciency occurs only among Asian people,” Zeng said.

THOROUGHEXAMINATION: Staff members at a blood center in Zhuzhou, Central China’s Hunan Province, conduct HIV tests on blood samples

Wu also said that understanding a new disease is a gradual process. “When AIDS was frst reported in 1981, its cause was also unknown, but doctors noticed that homosexuals, drug addicts, and patients who had received blood transfusions were susceptible to the disease, and hence suspected the disease was transmitted through blood and sexual intercourse. It wasn’t until years later that doctors were able to confirm HIV as a contagious disease,” he explained.

Not HIV paranoia

In China, groups of people reportedly suffer from HIV-negative AIDS. Such people claim to display symptoms very similar with those of AIDS, such as swollen lymph nodes, subcutaneous bleeding, joint pain, fatigue, night sweating and loss of weight, yet they test negative for HIV. Medical experts dismiss the phenomenon as mass hysteria.

After learning about the newly reported AIDS-like disease, there has been concern whether it is the same as the so-called HIV-negative AIDS.

Wu said that the two are completely different. “In the case of the recently reported AIDS-like disease, patients’ immune defciency was proven with clinical and laboratory evidence, whereas HIV-negative AIDS is exclusively self-diagnosed,” he said.

According to Xinhua News Agency, the Ministry of Health of China first received reports of HIV-negative AIDS in June 2009. Wu estimated that there are hundreds of people who claim to suffer from the disorder.

TheBeijing Timesrecently reported a case about Sun Li, a man who reportedly suffers from HIV-negative AIDS. Sun noticed symptoms in August 2010. Soon, his wife and son also complained about such symptoms.

Since Sun once had unprotected sex, he suspected that he might have contracted AIDS. He went for an HIV test, but tested negative. Sun and his family had undergone many medical examinations, which all indicate that nothing was wrong with them.

Later, Sun and 59 other self-proclaimed sufferers of HIV-negative AIDS were reexamined by Zeng, and again, the results of their HIV tests were negative.

The Ministry of Health said in May 2011 that no new or unknown viruses had been found among people claiming to suffer from HIV-negative AIDS, and the cause of their AIDS-like symptoms had yet to be determined.

From March to May 2011, sufferers of the “disorder” went to Guangzhou in southern Guangdong Province to receive examination by epidemiologist Zhong Nanshan. Zhong found that these people are ill to different degrees, and their illnesses were caused by known rather than unknown viruses.

Of all the 60 people tested for six common pathogens including the Epstein-Barr virus (EBV), 48 were found infected. Thirtythree people, including Sun, were found to be EBV positive.

EBV can be transmitted through saliva, and that may explain why Sun’s wife and son also showed symptoms, Zhong said.

Zhong said that these pathogens can invade white blood cells and affect the immune system, causing subjectively similar symptoms.

Twelve people in the group also voluntarily received psychological tests, and seven showed abnormalities: Five had hypochondriasis, one had anxiety and one was slightly depressed.

Most of the HIV-negative AIDS patients were found to suffer from psychological AIDS phobia or other mental stress, according to Zeng. The symptoms of some HIV-negative AIDS patients relieved or even disappeared after their psychological problems were addressed.

Zeng told Xinhua News Agency although it might be possible that some HIV-negative AIDS patients may well be those caught with adult-onset immunodeficiency, there is no need to panic because the disease is not contagious.

wanghairong@bjreview.com