MMWR Weekly, December 12, 1986 / 35(49);757-60,765-6
As of December 8, 1986, physicians and health departments in the United States had reported 28,098 patients (27,704 adults and 394 children) meeting the acquired immunodeficiency syndrome (AIDS) case definition for national reportin) (1-3). Of these patients, 15,757 (56% of adults and 61% of children) are known to have died, including over 79% of those patients diagnosed before January 1985. Since the initial reports of AIDS in early 1981 (4-5), the number of cases reported for each 6-month period continues to increase.
In June 1986, two sexually active women in Minnesota were found to have antibody to human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV).* Both belonged to social/sexual clubs whose stated purpose was to provide their members (primarily couples) with opportunities for social and sexual contacts.** Each of the two seropositive women reported having sexual contact with a number of other persons from these clubs, including two men who were bisexual.
As of September 15, 1986, a total of 238 cases of hemophilia-associated acquired immunodeficiency syndrome (AIDS) have been reported to CDC through state health departments, hemophilia treatment centers (HTCs), and physicians. Of the 238 patients, 212 (89%) had hemophilia A (coagulation factor VIII deficiency); 16 (7%), hemophilia B (factor IX deficiency); seven (3%), von Willebrand's disease; two, an acquired inhibitor (antibody) to factor VIII; and one, a factor V deficiency. All but seven (3%) of the patients were male.
MMWR Weekly, October 24, 1986 / 35(42);655-8,663-6
In the period June 1, 1981-September 8, 1986, physicians and health departments in the United States notified CDC of 24,576 patients meeting the AIDS case definition for national reporting (1-3). Of these, 6,192 (25%) were black and 3,488 (14%) were Hispanic, whereas these groups represent only 12% and 6%, respectively, of the U.S. population (4). The proportion of cases by racial/ethnic group has remained relatively constant over time (Figure 2), but the number of reported cases of AIDS among persons of all racial and ethnic backgrounds continues to rise (Figure 3).
From July 1982 through September 15, 1986, 79 persons meeting the surveillance case definition for acquired immunodeficiency syndrome (AIDS) were reported from western Palm Beach County, Florida. These patients were residents of the towns of Belle Glade (62 case-patients), Pahokee (seven case-patients), and South Bay (10 case-patients) at the time of onset of their illnesses. The number of cases is shown by year of diagnosis in Figure 1.
MMWR Weekly, September 26, 1986 / 35(38);595-8,603-6
This document is intended to summarize available information and to assist health-care providers in developing policies for the immunization of children infected with human T-lymphotropic virus type III/lymphadenopathy- associated virus (HTLV-III/LAV), * the virus that causes acquired immunodeficiency syndrome (AIDS). These policies may vary depending upon the prevalence of HTLV-III/LAV infection and the incidence of vaccine-preventable diseases in the community, individual assessment of a child's health status, and the risks and benefits of immunization in a particular situation.
In 1985, 1,425 tuberculosis cases were reported in Florida, an increase of almost 7% over the 1,335 cases reported in 1984. Concern about a possible association between human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV)* infection and increased tuberculosis morbidity (1,2) led to an evaluation of data on acquired immunodeficiency syndrome (AIDS) and tuberculosis.
In 1985, the number of new tuberculosis cases reported to CDC was essentially the same as that reported in 1984 (1). In contrast, the average annual decline in morbidity during the past 32 years has been 5%. The failure of tuberculosis morbidity to decline as expected in 1985 is probably related to the occurrence of tuberculosis among persons with acquired immunodeficiency syndrome (AIDS) or human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV/LAV) * infection.
From October 1, 1985, through March 31, 1986, as part of medical evaluation of individuals volunteering for military service, the U.S. Department of Defense tested 308,076 recruit applicants for serologic evidence of infection with human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV), the etiologic retrovirus of acquired immunodeficiency syndrome (AIDS).* Blood samples were obtained at 71 Military Entrance Processing Stations. The screened population consisted predominately of young adults in their late teens (54%) and early twenties (33% were 20-25 years old).
In November 1985, a blood donor at a Colorado blood-collection center was found to be seropositive for human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV)* antibody by both the enzyme-linked immunosorbent assay (ELISA) and Western blot methods. He had previously donated at the center in April and August 1985, when he had been seronegative by ELISA. Both recipients from the August donation, one of whom had no other risk factors for acquisition of HTLV-III/LAV, were subsequently found to be seropositive.
Patients with end-stage renal disease who are undergoing maintenance dialysis and who have manifestations of human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV)* infection, including acquired immunodeficiency syndrome (AIDS), or who are positive for antibody to HTLV-III/LAV can be dialyzed in hospital-based or free-standing dialysis units using conventional infection-control precautions. Standard blood and body fluid precautions and disinfection and sterilization strategies routinely practiced in dialysis centers are adequate to prevent transmission of HTLV-III/LAV.
Persons infected with the etiologic retrovirus of acquired immunodefi- ciency syndrome (AIDS) (1-4) * may present with a variety of manifestations ranging from asymptomatic infection to severe immunodeficiency and life- threatening secondary infectious diseases or cancers. The rapid growth of knowledge about human T-lymphotropic virus type III/lymphadenopathy- associated virus (HTLV-III/LAV) has resulted in an increasing need for a system of classifying patients within this spectrum of clinical and laboratory findings attributable to HTLV-III/LAV infection (5-7).
On March 2, 1985, an enzyme-linked immunosorbant assay (ELISA) test to detect antibodies to human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) was licensed by the U.S. Food and Drug Administration to screen blood and plasma collected for transfusion or manufactured into other products. Since it was recognized that many individuals in groups at high risk for AIDS might want testing to determine their antibody status, federal funds for alternate testing sites were made available so that HTLV-III/LAV antibody tests could be obtained free of charge outside the blood-bank setting.
On November 15, 1985, "Recommendations for Preventing Transmission of Infection with Human T-Lymphotropic Virus Type III/Lymphadenopathy-Associated Virus in the Workplace," was published (1). That document gave particular emphasis to health-care settings and indicated that formulation of further specific recommendations for preventing human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) transmission applicable to health-care workers (HCWs) who perform invasive procedures was in progress.
Immune globulins produced by plasma fractionation methods approved for use in the United States have not been implicated in the transmission of infectious agents. Nevertheless, because immune globulins manufactured before 1985 were derived from plasma of human donors who were not screened for antibody to human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV), CDC and the U.S. Food and Drug Administration (FDA) have received inquiries concerning the safety of immune globulin (IG), hepatitis B immune globulin (HBIG), and intravenous immune globulin (IVIG).
Recently, the National Institute of Justice (NIJ) of the U.S. Department of Justice, and the American Correctional Association (ACA) jointly sponsored the development of a report on the incidence of acquired immunodeficiency syndrome (AIDS) in correctional facilities, the issues and options facing correctional administrators in formulating policy responses to the problem, and the rationales advanced for various policy choices (1). The report was based, in part, on a questionnaire mailed to all 50 state correctional departments, the Federal Bureau of Prisons, and 37 large city and county jail systems. Following are key findings of the report.
Human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV), the virus that causes acquired immunodeficiency syndrome (AIDS), is transmitted through sexual contact, parenteral exposure to infected blood or blood components, and perinatally from mother to fetus or neonate. In the United States, over 73% of adult AIDS patients are homosexual or bisexual men; 11% of these males also had a history of intravenous (IV) drug abuse. Seventeen percent of all adult AIDS patients were heterosexual men or women who abused IV drugs (1,2). The prevalence of HTLV-III/LAV antibody is high in certain risk groups in the United States (3,4).
CDC has received a report from state and local health officials of a child with transfusion-associated infection caused by human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV), the virus that causes acquired immunodeficiency syndrome (AIDS). The child's mother appears to have been infected with HTLV-III/LAV while providing nursing care that involved extensive unprotected exposure to the child's blood and body secretions and excretions.
As of September 30, 1985, 1,573 cases of acquired immunodeficiency syndrome (AIDS) were reported to the World Health Organization (WHO) European Collaborating Centre on AIDS by the 21 countries corresponding with the Centre (Table 1). The new cases represent an average increase of 27 cases per week. Of the 1,573 patients, 792 are reported to have died (case-fatality rate: 50%) (Table 2, Figure 1).
Between June 1, 1981, and January 13, 1986, physicians and health departments in the United States notified CDC of 16,458 patients (16,227 adults and 231 children) meeting the acquired immunodeficiency syndrome (AIDS) case definition for national reporting (1-3). Of these, 8,361 (51% of the adults and 59% of the children) are reported to have died, including 71% of patients diagnosed before July 1984. The number of cases reported each 6-month period continues to increase (Figure 1), although not exponentially, as evidenced by the lengthening case-doubling times (Table 1).
This information is designed to support, not replace, the relationship that exists between you and your doctor.