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Epidemiologic and clinical aspects of the acquired immune deficiency syndrome.

The acquired immune deficiency syndrome is a disease that severely compromises the cellular immune system of the host resulting in multiple life-threatening opportunistic infections and rare malignancies. Since 1981 when the disease was first recognized over 5000 cases have been reported in the United States and approximately 2000 cases have been reported in Europe the Caribbean and Africa. Most of the cases have been identified in homosexual men intravenous drug abusers hemophiliacs Haitians and blood transfusion recipients. From epidemiologic and etiologic studies the disease appears to be transmitted by a retrovirus referred to as HTLV-3/LAV which can be transmitted by intimate sexual contact or through blood products. This virus now recovered from large numbers of AIDS patients causes cytolysis of T-helper lymphocytes the primary target of AIDS patients that results in overwhelming immunosuppression opportunistic infections and Kaposis sarcoma. From clinical and serologic studies there now appears to be a wide spectrum of illness associated with infection by this virus the most prominent of which is AIDS and a lymphadenopathy syndrome. While some opportunistic infections are amenable to treatment the disease thus far appears to be irreversible resulting in a fatality rateof nearly 100% over a 2- to 3-year period. (authors)