Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
THE EPIDEMIOLOGY OF AIDS
HIV Detection by Genetic Engineering Methods. Luciw PA and Steimer KS, eds. New York, Marcel Dekker, p. 15-40, 1989.. Unique Identifier : AIDSLINE ICDB/90660253 Carlson JR; Univ. of California at Davis, Davis, CA
Abstract:
The early epidemiologic evidence suggested that AIDS was caused by an infectious agent. Cytomegalovirus was considered initially because it is often detected in AIDS patients and is associated with mild immunosuppression. Retroviruses also were suspected because animal models had demonstrated that this group of viruses can cause immunosuppression. Ultimately, the virus that had been termed human T-lymphotropic virus type-III and AIDS-associated virus, but now is called HIV, was confirmed as the causative agent. Since then, a new virus called HIV-2 (formerly LAV-2) has been isolated from people with AIDS in West Africa. The relationship between HIV-1 and HIV-2 is not clear; HIV-2 appears to be more closely related to simian immunodeficiency virus. Methods for epidemiologic studies are summarized and several aspects of the AIDS epidemic are reviewed, including natural history of HIV infection, blood-borne transmission (iv drug users, hemophiliac/coagulation disorders, transfusion recipients, and health care professionals), sexual transmission (homosexual/bisexual and heterosexual), perinatal transmission, and other possible modes of transmission (insect bites and casual contact). Research in retrovirology has provided a working knowledge of the etiology and pathogenesis of HIV infection and AIDS. The development of clinical virology and serology methods has helped investigators to begin to define the scope of the AIDS epidemic, to characterize study populations to determine the natural history of the infection, and to prevent HIV transmission by HIV-contaminated blood and blood products. HIV serologic assays are now the major epidemiologic tool to monitor the national and international spread of HIV and to watch for the 'bridging' of HIV out of known risk groups. More sensitive and specific assays need to be developed so that virus-positive, antibody-negative persons can be detected, neonatal diagnosis can be improved, and testing low-prevalence populations (eg, blood donors) will be practical. Molecular genetic approaches may offer advantages in the development of future HIV serologic assays. At present, public health education appears to be the most important tool for the prevention of the infection, but future strategies will involve antiviral drugs and vaccines. Molecular retrovirology research will provide answers about the appropriate targets for specific drug action. (174 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY/TRANSMISSION Adult AIDS Serodiagnosis/METHODS Cross-Sectional Studies Female Human HIV Seroprevalence HIV-1/*ISOLATION & PURIF HIV-2/*ISOLATION & PURIF Incidence Infant, Newborn Male Opportunistic Infections/EPIDEMIOLOGY Pregnancy Risk Factors United States/EPIDEMIOLOGY MONOGRAPH 900530
M9051021
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Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.
