Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
THE EPIDEMIOLOGY AND NATURAL HISTORY OF HUMAN IMMUNODEFICIENCY VIRUS
AIDS: Etiology, Diagnosis, Treatment, and Prevention. Second Edition. DeVita VT Jr et al, eds. Philadelphia, Lippincott, p. 33-60, 1988.. Unique Identifier : AIDSLINE ICDB/89650899 Goedert JJ; Blattner WA; Environmental Epidemiology Branch, NCI, Bethesda, MD
Abstract:
HIV is a sexual and blood-borne pathogen that infects and, in most persons, gradually destroys a critical component of immunity, the population of helper-inducer lymphocytes identified by the CD4+ (T4+) surface epitope. Because CD4+ cells coordinate the entire cellular immune response, HIV infections can have myriad manifestations, ranging from subclinical laboratory abnormalities to the opportunistic infections and malignancies that define AIDS. In tracking the natural history of HIV infection, time is a critical, and sometimes overlooked, parameter of the epidemiology. This oversight has contributed to erroneous suggestions that most persons infected with HIV will remain asymptomatic or that homosexual men have a higher incidence of AIDS following HIV than do other individuals. The modes of transmission of AIDS, its natural history, various subclinical and clinical manifestations, and the implications for the course of the epidemic and the prevention of the disease are discussed. Topics described include the definition of HIV infection, AIDS, and AIDS-related complex (ARC), the epidemiology of AIDS in North America, South and Central America, Europe, Middle and Far East, and Australia and Oceania, the prevalence of HIV in the United States, the risk factors for HIV infection, and the possible mechanisms of transmission. AIDS incidence, factors predicting or modifying AIDS risk, staging systems for HIV disease, sublethal conditions related to HIV, HIV disease in children, cancers in AIDS, HIV-2 and other retroviruses, and possible intervention strategies also are considered. The prospects for successful control of HIV and AIDS are unknown. Particularly in the developing nations of the world, much will depend on the development of safe and effective vaccines or chemotherapies that prevent viral replication, release, or attachment to receptors. However, even with the arrival of such modalities, factors that influence sexual activities and other personal behaviors are likely to have major effects on the worldwide prevalence and incidence of human retroviruses, AIDS, and their associated conditions. (263 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY/TRANSMISSION AIDS-Related Complex/EPIDEMIOLOGY Comparative Study Cross-Cultural Comparison Cross-Sectional Studies *Disease Outbreaks Human HIV/*PATHOGENICITY HIV Antibodies/ANALYSIS HIV Seropositivity/EPIDEMIOLOGY Risk Factors United States MONOGRAPH REVIEW REVIEW, ACADEMIC
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Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
