The Epidemiology of AIDS: Current Status and Future Prospects

Abstract

The reported incidence of acquired immune deficiency syndrome (AIDS) continues to increase in countries throughout the world. On the basis of a polynomial model for extrapolation, the cumulative number of cases diagnosed and reported since 1981 in the United States is expected to double during the next year with over 12,000 additional cases projected to be diagnosed by July 1986. The annual incidence rates for single (never-married) men in Manhattan and San Francisco, intravenous drug users in New York City and New Jersey, and persons with hemophilia A ranged from 261 to 350 per 100,000 population during 1984. For single men aged 25 to 44 years in Manhattan and San Francisco, AIDS was the leading cause of premature mortality in 1984 as measured by years of potential life lost. Infection with HTLV-III/LAV is considerably more common than reported AIDS in high-risk populations and can persist at least for several years, so the presence of specific antibody should be considered presumptive evidence of current infection. The screening of donated blood and plasma for antibody to HTLV-III/LAV and use of safer clotting factor concentrates should greatly reduce HTLV-III/LAV transmission through blood and blood products. Most HTLV-III/LAV infections occur through sexual transmission, use of contaminated needles, and as a result of infected mothers passing the virus to newborns. Continued research commitment is needed to develop an HTLV-III/LAV vaccine and therapy for this infection. In the interim, widespread community efforts are needed to minimize transmission.

Knowledge and attitudes of AIDS health care providers before and after education programs

“…It has been shown frequently that smoking is associated with natural menopause (1)(2)(3)(4)(5)(6). Other studies have found smoking to be associated with the inability to become pregnant (6), lowered estrogen levels in the luteal phase (7), and alterations in the levels of gonadotropins and other hormones that may affect ovarian function (8).…”

“…As THE NUMBER OF PERSONS WITH acquired immunodeficiency syndrome (AIDS) increases, most of the nation's health care workers will need to learn how to care for people with AIDS and how to avoid exposure to the AIDS virus, which is named the human immunodeficiency virus (HIV) (1,2). The evidence suggests that many providers are uneasy about the idea of caring for someone with AIDS (3,4).…”

Some Highlights of Animal Virus Research in 1985

“…Here we summarize work on AIDS retrovirus, and do not treat epidemiology or public health aspects, beyond noting the following. First, in 1985 the cumulative total of reported AIDS cases passed 104 in the U.S.A. and 103 in western Europe; the disease is thus now of major public health concern (Curran et al, 1985). Second, systems to test for the presence of serum antibodies to AIDS retrovirus have now come into widespread use, most significantly in screening of blood donated for transfusion.…”

Historical reflections on cell culture engineering

“…In fact, one senior regulator of the time confided to the author (years afterwards) that when he first heard the author describe the results of characterization of the CHO cells expressing tPA (basically, CHO cells are tumorigenic in nude mice and express retrovirus-like particles), he feared that the desire to investigate these products in humans would rekindle the spirited debates of 1954-1975 on the use of CCLs to prepare biologicals for human use. The then-recent discovery of human immunodeficiency virus (HIV) and its transmission to recipients of blood and plasma products and their derivatives (Curran et al, 1985) fueled concern in the regulatory community over the possibility of iatrogenic transmission of pathogenic viruses, especially retroviruses. There was also theoreticallybased concern in a few ex-US regulatory agencies over the possibility of transmissible spongiform encephalopathies (TSEs) as a potential contaminant of medical products based on earlier studies of ovine scrapie and human kuru.…”