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Drotman DP; Curran JW; Centers for Disease Control, Atlanta, GA 30333
September 30, 1985
AIDS. The Epidemic of Kaposi's Sarcoma and Opportunistic Infections.

For the purpose of epidemiologic studies, only patients (pts) with biopsy-proven Kaposi's sarcoma (KS) or biopsy-proven life-threatening opportunistic infection are defined by the Center for Disease Control (CDC) as having the Acquired Immune Deficiency Syndrome (AIDS). This excludes many pts who fall within the spectrum of AIDS, including those with other malignancies, unexplained lymphadenopathy, idiopathic thrombocytopenic purpura, or transient immunologic defects, as well as asymptomatic carriers. As of September 1983, 2,374 cases had been reported to the CDC, of which 968 (41%) had resulted in death. The mortality rate was 87.5% for cases diagnosed in 1979; 88.6%, for 1980, 78.4%, for 1981; 49.3%, for 1982; and 25.0%, for 1983. AIDS has been reported in 40 states and in 20 countries, but 59.7% of the cases are from New York City, Los Angeles and San Francisco. The pts are male in 93% of cases and homosexual or bisexual in 75% of these. The KS is more common in homosexual men than in Haitians or in iv drug abusers, suggesting a two-step pathogenesis. In a national CDC case-control study, 50 AIDS cases were matched for age, race, sexual orientation, area of residence, and interviewer. Compared with controls, the AIDS cases had increased median values for number of lifetime sexual partners, proportion of sexual partners from bathhouses, history of syphilis, number of different street drugs, and frequency of hepatitis A antibody, but not for age of initiating regular homosexual behavior, frequency of hepatitis B, treatment for enteric parasites, or specific sexual practices. Studies of case clustering indicate that AIDS is transmitted sexually. The authors conclude that sexual contact with AIDS pts should be avoided; that having multiple sexual partners increases the risk of AIDS in high risk groups; that members of high risk groups should refrain from donating blood; that screening procedures for blood products should be developed; that transfusions should be given only when strictly indicated; and that safer blood products for hemophiliac pts should be investigated. (4 Refs)

Acquired Immunodeficiency Syndrome/COMPLICATIONS/*EPIDEMIOLOGY Adult California Homosexuality Human Male New York City Pneumonia, Pneumocystis carinii/COMPLICATIONS Sarcoma, Kaposi's/COMPLICATIONS Sex Behavior Space-Time Clustering Syphilis/COMPLICATIONS United States MEETING PAPER REVIEW