2nd International AIDS Conference Paris, France - June 23-25, 1986

VARIATION IN AIDS RELATED ILLNESSES: IMPACT ON CLINICAL RESEARCH

Int Conf AIDS 1986 Jun 23-24; 2:5 (abstract no. SP4)

P. Volberding, M.D.
San Francisco, USA

Clinical manifestations of AIDS are changing as the epidemic unfolds. These variations may be: risk group dependent, geographically dependent and time dependent.

Clinical consequences of AIDS virus infections vary among risk groups. Hemophiliacs develop AIDS less frequently than other groups, while infected infants have a much higher AIDS incidence with a shorter incubation. Homosexuals frequently develop Kaposi's sarcoma which is rare in heterosexuals with AIDS.

The spectrum of clinical disease in AIDS differs around the world. In the United States, Mycobacterium avium intracellulare infections are most frequent on the East Coast. In Europe, this infection is extremely rare. Pneumocystis pneumonia is the most common AIDS-related opportunistic infection in the United States, and much of Europe, but is uncommon in Africa where malaria, tuberculosis and cryptococcosis are much more frequent.

The clinical manifestations of AIDS may vary over time in the same patient population. Kaposi's sarcoma, is declining in incidence in homosexual men with AIDS in the United States. Central nervous system disease caused by the AIDS virus,on the other hand, is being more commonly recognized in all risk groups as are certain bacterial infections.

Variations in clinical AIDS effect resources needed for patient care and on clinical trials design. In AIDS related dementia, the need for long term institutional care may increase dramatically, if this manifestation becomes more common. Clinical variations in AIDS are also important as clinical research results may be misleading if not carefully adjusted to the study population. Also, clinical changes make the use of historical control groups problematic. It is hoped that changes in the clinical spectrum of AIDS may offer new insights into the biology of the AIDS virus and the human host defense system.

1986-06-22
SP4

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