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The Epidemiology of the Human Immunodeficiency Virus Infection

Published online by Cambridge University Press:  28 April 2021

Nancy Mueller
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Extract

It is nearly six years since the first evidence of the AIDS epidemic was seen, with the report of five cases of Pneumocystis carinii pneumonia diagnosed in young, otherwise healthy homosexual men in Los Angeles. The report was surprising, for although P. carinii is a common human commensal, the pneumonia essentially occurs only in the presence of severe immune suppression. Similar reports quickly followed from New York City and San Francisco, with the additional observation that Kaposi's sarcoma—a malignancy usually seen only in elderly men in this country—was also occurring epidemically among young homosexual men.

Since then, the epidemic has evolved at a relentless pace to a reported 32,000 cases in the United States by March 1987. The epidemic has sparked a massive multidisciplinary scientific effort, resulting in the successful identification of the causal agent—the human immunodeficiency virus (HIV)—within two years from the first report and producing a commercially available antibody test within four years.

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Article
Information
Law, Medicine and Healthcare , Volume 14 , Issue 5-6 , December 1986 , pp. 250 - 258
Copyright
Copyright © American Society of Law, Medicine and Ethics 1986

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References

Centers for Disease Control (henceforth “CDC”), Pneumocystis pneumonia—Los Angeles, Morbidity and Mortality Weekly Report (henceforth “MMWR”) 1981, 30: 250–52.Google Scholar
Benenson, AS, ed., Control of communicable diseases in man, 14th ed., Washington, D.C.: American Public Health Association, 1985: 295–96.Google Scholar
CDC, Kaposi's sarcoma and pneumocystis pneumonia among homosexual men—New York City and California, MMWR 1981, 30: 305–8; CDC, Follow-up on Kaposi's sarcoma and pneumocystis pneumonia, MMWR 1981, 30: 409-10.Google Scholar
Benenson, , supra note 2, pp. 2-5; CDC, Revision of the case definition of acquired immunodeficiency syndrome for national reporting—United States, MMWR 1985, 34:373–75.Google Scholar
CDC, Weekly Surveillance Report—United States AIDS Program, November 3, 1986.Google Scholar
CDC, Update: Acquired immunodeficiency syndrome—United States, MMWR 1986, 35: 17–21; CDC, Weekly Surveillance Report—United States AIDS Program, October 6, 1986.Google Scholar
CDC, Weekly Surveillance Report—United States AIDS Program, October 6, 1986.Google Scholar
CDC, Acquired immunodeficiency syndrome (AIDS) among blacks and Hispanics—United States, MMWR 1986, 35:655–66.Google Scholar
Goedert, JJ, Blattner, WA, The epidemiology of AIDS and related conditions, in DeVita, VT Jr., Hellman, S, Rosenberg, SA, eds., AIDS: Etiology, diagnosis, treatment and prevention, Philadelphia: Lippincott, 1985: 1–30; Jaffe, HW et al., AIDS in a cohort of homosexual men: A six year follow-up study, Annals of Internal Medicine 1985,103: 210-14.Google Scholar
Winkelstein, W et al., Reduction in AIDS virus transmission: Seroconversion in San Francisco, 1982-85, paper presented at the International Conference on AIDS (ICA), Paris, June 1986.Google Scholar
Goedert, JJ et al., Three-year incidence of AIDS in five cohorts of HTLV-III-infected risk group members, Science 1986, 231: 992–95; Marmor, M et al., HTLV-III seropositivity and its relationship to disease in a prospective study of homosexual men, paper presented at the International Conference on Acquired Immunodeficiency Syndrome (IC), Atlanta, Georgia, April 1985; Stevens, CE et al., Human T-cell lymphotropic virus type III infection in a cohort of homosexual men in New York City, Journal of the American Medical Association 1986, 255: 2167-72.Google ScholarPubMed
Detels, R et al., Predictions of AIDS in young homosexual men, paper presented at ICA, Paris, 1986.Google Scholar
Goedert, et al., supra note 11.Google Scholar
Mayer, KH et al., Natural history of HTLV-III/LAV infection in asymptomatic male homosexuals in Boston, paper presented at ICA, Paris, 1986.Google Scholar
Rinaldo, C et al., Association of HTLV-III with risk factors for AIDS in gay men from a low incidence area, paper presented at IC, Atlanta, 1985.Google Scholar
Weiss, S et al., Screening test for HTLV-III (AIDS) agent antibodies, Journal of the American Medical Association 1985, 253: 221–25; Cohen, H et al., Behavioral risk factors for HTLV-III/LAV seropositivity among intravenous drug abusers, paper presented at IC, Atlanta, 1985; Weiss, SH et al., Risk for HTLV-III exposure and AIDS among parenteral drug abusers in New Jersey, paper presented at IC, Atlanta, 1985.Google ScholarPubMed
Craven, DE et al., Prevalence to human T-cell leukemia (lymphotropic) virus, type III (HTLV-III) in parenteral abusers (PDA's) attending a methadone clinic, paper presented at IC, Atlanta, 1985.Google Scholar
Spira, TJ et al., HTLV-III/LAV antibodies in intravenous drugs (IV) abusers—a comparison of high and low risk areas for AIDS, paper presented at IC, Atlanta, 1985.Google Scholar
Ragni, MV et al., Prevalence and seroconversion rate of human T-lymphotropic retrovirus (HTLV-III) antibody in patients with hemophilia, paper presented at IC, Atlanta, 1985; Jason, J et al., Lymphadenopathy-associated virus antibody in persons with hemophilia, paper presented at IC, Atlanta, 1985; Egster, ME, Goedert, JJ, Sargadhavan, MG, Early natural history of HTLV-III antibodies in persons with hemophilia, paper presented at IC, Atlanta, 1985.Google Scholar
CDC, Human T-lymphotropic virus type III/lymphadenopathy-associated virus antibody prevalence in U.S. military recruit applicants, MMWR 1986, 35: 421–24.Google Scholar
Schorr, JB et al., Prevalence of HTLV-III antibody in American blood donors (Letter), New England Journal of Medicine 1985, 313: 384–85.Google Scholar
Public Health Service plan for the prevention and control of AIDS and the AIDS virus, Report of the Koolfont Planning Conference, June 4-6, 1986.Google Scholar
Wong-Staal, F, Gallo, RC, Human T-lymphotropic retroviruses, Nature 1985, 317: 395–403; Zagury, D et al., Long-term cultures of HTLV-III-infected T cells: A model of cytopathology of T-cell depletion in AIDS, Science 1986, 231: 850-53.Google ScholarPubMed
Sodroski, J et al., A second post-transcriptional transactivator gene required for HTLV-III replication, Nature 1986, 321: 412–17.CrossRefGoogle Scholar
Gonda, MA et al., Sequence hemology and morphologic similarity of HTLV-III and Visna virus, a pathogenic lentivirus, Science 1986, 227: 173–77.Google Scholar
Hahn, BH et al., Genetic variation in HTLV-III/LAV over time in patients with AIDS or risk for AIDS, Science 1986, 232: 1548–53.Google ScholarPubMed
Zagury, et al., supra note 23.Google Scholar
Burnet, M, White, PO, Natural history of infectious disease, 4th ed., Cambridge: Cambridge University Press, 1972.Google Scholar
Cooper, DA et al., Acute AIDS retrovirus infection: Definition of a clinical illness associated with seroconversion, Lancet 1985, i: 537–40.Google Scholar
Carne, CA et al., Acute encephalopathy coincident with seroconversion for anti-HTLV-III, Lancet 1985, ii: 1206–8; Goudsmit, J et al., Intrathecal synthesis of antibodies to HTLV-III in patients without AIDS or AIDS-related complex, British Medical Journal 1986, 292: 1231-34.CrossRefGoogle Scholar
Mayer, KH et al., HTLV-III viremia in asymptomatic, high risk, seronegative homosexual men, Annals of Internal Medicine 1986, 104: 194–96.CrossRefGoogle Scholar
Lui, K-J et al., A model-based approach for estimating the mean incubation period of transfusion-associated acquired immunodeficiency syndrome, Proceedings of the National Academy of Science USA 1986, 83: 3051–55.CrossRefGoogle ScholarPubMed
Melbye, M et al., Long-term seropositivity for human T-lymphotropic virus type III in homosexual men without the acquired immunodeficiency syndrome: Development of immunologic and clinical abnormalities, Annals of Internal Medicine 1986, 104: 496–500.Google ScholarPubMed
CDC, 1986, Classification system for human T-lymphotropic virus type III/lymphadenopathy-associated virus infections, MMWR 1986, 35: 334–39.Google Scholar
Melbye, et al., supra note 33.Google Scholar
Stevens, CE et al., Human T-cell lymphotropic virus type III infection in a cohort of homosexual men in New York City, Journal of the American Medical Association 1986, 255: 2167–72.CrossRefGoogle Scholar
Goedert, et al., supra note 11.Google Scholar
Hunter, DJ, DeGruttola, V, Estimation of risk of outcome of HTLV-III infection, Lancet 1986, i: 677–78.CrossRefGoogle Scholar
Vogt, MW et al., Isolation of HTLV-III/LAV from cervical secretions of women at risk for AIDS, Lancet 1986, i: 525–27; Groopman, JE et al., HTLV-III in saliva of people with AIDS-related complex and healthy homosexual men at risk of AIDS, Science 1984, 226: 447-49.CrossRefGoogle Scholar
Archibald, DW et al., Antibodies to human T-lymphotropic virus type III (HTLV-III) in saliva of acquired immunodeficiency syndrome (AIDS) patients and in persons at risk of AIDS, Blood 1986, 67: 831–34.CrossRefGoogle Scholar
Detels, R et al., Relation between sexual practices and T-cell subsets in homosexually active men, Lancet 1983, i: 609–11; Goedert, JJ et al., Determinants of retrovirus (HTLV-III) antibody and immunodeficiency conditions in homosexual men, Lancet 1984, ii: 711-16; Mayer, KH et al., Association of human T-lymphotropic virus type III antibodies with sexual and other behaviors in a cohort of homosexual men from Boston with and without generalized lymphadenopathy, American Journal of Medicine 1986, 80: 357-63.Google Scholar
CDC, Heterosexual transmission of human T-lymphotropic virus type III/lymphadenopathy-associated virus, MMWK 1985, 35: 561–63; Lederman, MM, Transmission of the acquired immunodeficiency syndrome through heterosexual activity, Annals of Internal Medicine 1986, 104: 115-16.Google Scholar
New AIDS studies focus on its spread, New York Times, October 1, 1986, B6.Google Scholar
Stewart, GJ et al., Transmission of human T-cell lymphotropic virus type III (HTLV-III) by artificial insemination by donor, Lancet 1985, ii: 581–84.CrossRefGoogle Scholar
Asjo, B et al., Replicative capacity of human immunodeficiency virus from patients with varying severity of HIV infection, Lancet 1986, ii: 660–62.Google Scholar
Curran, JW et al., Acquired immunodeficiency syndrome (AIDS) associated with transfusions, New England Journal of Medicine 1984, 310: 69–75.Google ScholarPubMed
LaPointe, N et al., Transplacental transmission of HTLV-III virus, New England Journal of Medicine 1985, 312: 1325.Google ScholarPubMed
Parks, WP, Scott, GB, Pediatric AIDS: A disease spectrum causally associated with HTLV-III infection, Cancer Research (Supp) 1985, 45: 4659S–61S.Google ScholarPubMed
Zieglar, JB et al., Postnatal transmission of AIDS-associated retrovirus from mother to infant, Lancet 1985, i: 896–98.CrossRefGoogle Scholar
Hirsch, MS et al., Risk of nosocomial infection with human T-cell lymphotropic virus III (HTLV-III), New England Journal of Medicine 1985, 312: 1–4; Geddes, AM, Risk of AIDS to health care workers, British Medical Journal 1986, 292: 711-12; McCray, E et al., Occupational risk of the acquired immunodeficiency syndrome among health care workers, New England Journal of Medicine 1986, 314: 1127-32; Klein, RS, Phelan, J, Friedland, GH, Prevalence of antibodies (Abs) to HTLV-III/LAV among dental professionals (DP), paper presented at ICA, Paris, 1986; Gerberding, JL et al., Risk to dentists from exposure to patients infected with AIDS virus (AV), paper presented at ICA, Paris, 1986.CrossRefGoogle Scholar
Anonymous, Needlestick transmission of HTLV-III from a patient infected in Africa, Lancet 1984, ii: 1376–77; Stricof, RL, Morse, DL, HTLV-III/LAV seroconversion following a deep intramuscular needlestick injury, New England Journal of Medicine 1986, 314: 1115; Neisson-Vernant, C et al., Needlestick HIV seroconversion in a nurse, Lancet 1986, ii: 814.Google Scholar
Gerberding, JL et al., Transmission of hepatitis B without transmission of AIDS by accidental needlestick, New England Journal of Medicine 1985, 312: 56.Google ScholarPubMed
Kaplan, JE et al., Evidence against transmission of human T-lymphotropic virus/lymphadenopathy-associated virus (HTLV-III/LAV) in families of children with the acquired immunodeficiency syndrome, Pediatric Infectious Disease 1985, 4: 468–71; Connor, E et al., Lack of transmission of HTLV-III from children with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) to household contacts (HC), paper presented at ICA, Paris, 1986; Rogers, MF, White, CR, Sanders, R, Can children transmit HTLV-III/LAV infection?, paper presented at the ICA, Paris, 1986.Google Scholar
Wahn, V et al., Horizontal transmission of HIV infection between two siblings, Lancet 1986, ii: 694.Google Scholar
Friedland, GH et al., Lack of transmission of HTLV-III/LAV infection to household contacts of patients with AIDS or AIDS-related complex with oral candidiasis, New England Journal of Medicine 1986, 314: 344–49.Google ScholarPubMed
Lawrence, DN et al., HTLV-III/LAV antibody status of spouses and household contacts assisting in home infusion of hemophilia patients, Blood 1985, 66: 703–5; Jason, JM et al., HTLV-III/LAV antibody and immune status of household contacts and sexual partners of persons with hemophilia, Journal of the American Medical Association 1986, 255: 212-15.CrossRefGoogle ScholarPubMed