When Arthur Ashe and Magic Johnson were told they had HIV, the diagnosis was a death sentence. At the time – Ashe in 1988 and Johnson in 1991 – no treatment could stop the virus from ravaging the immune system. Ashe succumbed to AIDS in 1993. Johnson survived. The difference is in the date they were infected.
Ashe allegedly contracted the virus in 1983 and began to be treated five years later, when he already had symptoms of AIDS – in his case, a paralysis in his right arm that turned out to be due to a toxoplasma infection. There was then a single antiretroviral drug against HIV, AZT (or zidovudine), which had been approved in 1987. It extended the life expectancy of patients, but only for a while. HIV soon became resistant to the drug and continued its inexorable advance. Ashe lived with HIV for ten years, a typical period for those who contracted the infection in the 1980s.
Johnson was diagnosed before he had AIDS symptoms, when his immune system was still able to keep toxoplasma and other opportunistic infections at bay. It was as a result of a medical examination in the NBA preseason. He probably had been infected shortly before, since he had not tested positive in previous tests.
The prognosis was grim. A legion of doctors and scientists had spent years searching without success for a way to stop HIV. New drugs arrived that acted in a similar way to AZT, inhibiting the same enzyme of the virus (reverse transcriptase). It was not enough. HIV always became resistant to treatment.
Later came the protease inhibitors, which acted on another enzyme of the virus. It was thought that by combining drugs that attack it from different sides, the life of patients could be prolonged. For those with HIV, hope was slim. Until then the virus had eluded all attempts to control it.
And then, in July 1996, at a historic conference in Vancouver, combination treatments were shown to reduce the amount of virus in the blood to undetectable levels. With those results, HIV ceased to be a deadly virus for the majority of those affected.
For those who survived until 1996 like Magic Johnson, the combination treatments were the salvation. Arthur Ashe did not make it to shore.