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Acquired Immune Deficiency Syndrome (AIDS): A Review

Acquired Immune Deficiency Syndrome (AIDS): A Review Abstract • Acquired immune deficiency syndrome (AIDS) is a newly recognized disease of unknown etiology, characterized by deregulation of the cell-mediated immune function system and manifested by opportunistic infections, unusual neoplasms (particularly Kaposi's sarcoma) in previously healthy persons. Male homosexuals, drug addicts, Haitian immigrants, and hemophiliacs constitute the group at high risk of having AIDS. The disease is probably caused by an as yet unidentified agent that is transmitted from person to person via sexual contact, blood, or blood products. Available therapy cannot reverse the underlying immune defect. Mortality at two years exceeds 70%. This article reviews the current state of our knowledge about AIDS. Selected aspects of the epidemiology, diagnosis, treatment, immunology, and etiology of the disease are discussed. (Arch Intern Med 1983;143:2307-2309) References 1. Gottlieb MS, Schroff R, Schanker HM, et al: Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men. N Engl J Med 1981;305:1425-1431.Crossref 2. Masur H, Michelis MA, Greene JB, et al: An outbreak of community-acquired Pneumocystis carinii pneumonia. N Engl J Med 1981;305:1431-1438.Crossref 3. Siegal FP, Lopez C, Hammer GS, et al: Severe acquired immunodeficiency in male homosexuals manifested by chronic perianal ulcerative Herpes simplex lesions. N Engl J Med 1981;305:1439-1444.Crossref 4. Follansbee SE, Busch DF, Wofsy CB, et al: An outbreak of Pneumocystis carinii pneumonia in homosexual men. Ann Intern Med 1982;96(pt 1):705-713.Crossref 5. Mildvan D, Mathur V, Enlow RW, et al: Opportunistic infections and immune deficiency in homosexual men. Ann Intern Med 1982;96(pt 1): 700-704.Crossref 6. Friedman-Kien AE, Laubenstein LJ, Rubinstein P, et al: Disseminated Kaposi's sarcoma in homosexual men. Ann Intern Med 1982;96(pt 1):693-700.Crossref 7. Masur H, Michelis MA, Wormser GP, et al: Opportunistic infections in previously healthy women. Ann Intern Med 1982;97:533-539.Crossref 8. Poon M, Landay A, Prasthofer EF, et al: Acquired immunodeficiency syndrome with Pneumocystis carinii pneumonia and Mycobacterium avium-intracellulare infection in a previously healthy patient with classic hemophilia. Ann Intern Med 1983;98:287-290.Crossref 9. Elliot JL, Hoopes WL, Platt MS, et al: The Acquired immunodeficiency syndrome and Mycobacterium avium-intracellulare bacteremia in a patient with hemophilia. Ann Intern Med 1983;98:290-293.Crossref 10. Vieria J, Frank E, Spira T, et al: Acquired immune deficiency in Haitians: Opportunistic infections in previously healthy Haitian immigrants. N Engl J Med 1983;308:125-129.Crossref 11. Pitchenik AE, Fischl MA, Dickinson GM, et al: Opportunistic infections and Kaposi's sarcoma among Haitians: Evidence of a new acquired immunodeficiency state. Ann Intern Med 1983;98:277-284.Crossref 12. Possible transfusion-associated acquired immune deficiency syndrome (AIDS)—California. MMWR 1982;31:652-654. 13. Ziegler JL, Drew WL, Miner RC, et al: Outbreak of Burkitt's like lymphoma in homosexual men. Lancet 1982;2:631-633.Crossref 14. Snider WD, Simpson DM, Aronyk KE, et al: Primary lymphoma of the nervous system associated with acquired immune-deficiency syndrome. N Engl J Med 1983;308:45. 15. Morris L, Distenfeld A, Amorosi E, et al: Autoimmune thrombocytopenic purpura in homosexual men. Ann Intern Med 1982;96(pt 1):714-717.Crossref 16. Harris C, Burkus Small C, Lein R, et al: Immunodeficiency in female sexual partners of men with acquired immunodeficiency syndrome. N Engl J Med 1983;308:1181-1184.Crossref 17. Curran JW, Evatt BL, Lawrence DN: Acquired immune deficiency syndrome: The past is prologue. Ann Intern Med 1983;98:401-403.Crossref 18. Wormser GP, Krupp LB, Hanrahan JP, et al: Acquired immunodeficiency syndrome in male prisoners. Ann Intern Med 1983;98:297-303.Crossref 19. Rubinstein A, Sicklick M, Gupta A, et al: Acquired immunodeficiency with reversed T4/T8 ratios in infants born to promiscuous and drug-addicted mothers. JAMA 1983;249:2350-2356.Crossref 20. Oleske J, Mimmefor A, Cooper R Jr, et al: Immune deficiency syndrome in children. JAMA 1983;249:2345-2349.Crossref 21. Amman JA, Cowan MJ, Wara D: Acquired immunodeficiency in an infant: Possible transmission by means of blood products. Lancet 1983;1: 956-958.Crossref 22. Gallo RC, Savin PS, Gelman EP, et al: Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS). Science 1983;220:865-867.Crossref 23. Gelman EP, Popovic M, Blayney D, et al: Proviral DNA of a retrovirus human T-cell leukemia virus in two patients with AIDS. Science 1983;220: 862-864.Crossref 24. Essex M, McLane MF, Lee TH, et al: Antibodies to cell membrane antigens associated with human T-cell leukemia virus in patients with AIDS. Science 1983;220:859-862.Crossref 25. Brunet JB, Bouvet E, Leibowitch J, et al: Acquired immunodeficiency syndrome in France. Lancet 1983;1:700-701.Crossref 26. Clumeck N, Mascart-Lemone F, DeMaubeuge J, et al: Acquired immune deficiency syndrome in black Africans. Lancet 1983;1:642.Crossref 27. Marmor M, Friedman-Kien A, Laubenstein L, et al: Risk factors for Kaposi's sarcoma in homosexual men. Lancet 1982;1:1083-1087.Crossref 28. Detels R, Fahey JL, Schwartz K, et al: Relationship between sexual practices and T-cell subsets in homosexually active men. Lancet 1983;2: 609-611.Crossref 29. Menitove JE, Aster RH, Casper JT, et al: T-lymphocyte subpopulations in patients with classic hemophilia treated with cryoprecipitate and lyophilized concentrations. N Engl J Med 1983;308:83-86.Crossref 30. Lederman MM, Ratnoff OD, Scillian JJ, et al: Impaired cell-mediated immunity in patients with classic hemophilia. N Engl J Med 1983;308:79-83.Crossref 31. Henrickson RV, Osborn KG, Madden DL: Epidemic of acquired immunodeficiency in rhesus monkeys. Lancet 1983;1:388-391.Crossref 32. Persistent, generalized lymphadenopathy among homosexual males. Centers for Disease Control. MMWR 1982;31:249-251. 33. Luft BJ, Conley F, Remington JS: Outbreak of central nervous system toxoplasmosis in western Europe and North America. Lancet 1983;1:781-783.Crossref 34. Greene JB, Sidhu GS, Lewin S, et al: Mycobacterium avium-intracellulare: A cause of disseminated life threatening infection in homosexuals and drug abusers. Ann Intern Med 1982;97:539-546.Crossref 35. Masur H: Mycobacterium avium-intracellulare: Another scourge for individuals with the acquired immunodeficiency syndrome. JAMA 1982; 248:3013.Crossref 36. Ma P, Soave R: Three-step stool examination for cryptosporidiosis in ten homosexual men with protracted watery diarrhea. J Infect Dis 1983; 147: 824-828.Crossref 37. Drew WL, Miner RC, Ziegler JL: Cytomegalovirus and Kaposi's sarcoma in young homosexual men. Lancet 1982;2:125-127.Crossref 38. Lopez C, Fitzgerald P, Siegal FP: Severe acquired immune deficiency syndrome in homosexuals: Diminished capacity to make interferon α in vitro is associated with severe opportunistic infections. J Infect Dis , in press. 39. DeStefano E, Friedman RM, Friedman-Kien AE, et al: Acid-labile human leukocyte interferon in homosexual men with Kaposi's sarcoma and lymphadenopathy. J Infect Dis 1982;146:451-455.Crossref 40. Laubenstein LJ, Krigel R, Friedman-Kien A, et al: Treatment of epidemic Kaposi's sarcoma with VP-16-213 (Etoposide) plus doxorubicin, bleomycin, and vinblastine. J Clin Oncol , in press. 41. Krown SE, Real FX, Cunningham-Rundles S, et al: Preliminary observations on the effect of recombinant leukocyte A interferon in homosexual men with Kaposi's sarcoma. N Engl J Med 1983;308:1071-1074.Crossref 42. Acquired immune deficiency syndrome (AIDS): Precautions for clinical and laboratory staffs. MMWR 1982;31:577-580. 43. An evaluation of the acquired immunodeficiency syndrome (AIDS) reported in health-care personnel—United States. MMWR 1983;32:358-360. 44. Prevention of acquired immune deficiency syndrome (AIDS): Report on the interagency recommendations. MMWR 1983;32:101-102. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Acquired Immune Deficiency Syndrome (AIDS): A Review

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350120101021
Publisher site
See Article on Publisher Site

Abstract

Abstract • Acquired immune deficiency syndrome (AIDS) is a newly recognized disease of unknown etiology, characterized by deregulation of the cell-mediated immune function system and manifested by opportunistic infections, unusual neoplasms (particularly Kaposi's sarcoma) in previously healthy persons. Male homosexuals, drug addicts, Haitian immigrants, and hemophiliacs constitute the group at high risk of having AIDS. The disease is probably caused by an as yet unidentified agent that is transmitted from person to person via sexual contact, blood, or blood products. Available therapy cannot reverse the underlying immune defect. Mortality at two years exceeds 70%. This article reviews the current state of our knowledge about AIDS. Selected aspects of the epidemiology, diagnosis, treatment, immunology, and etiology of the disease are discussed. (Arch Intern Med 1983;143:2307-2309) References 1. Gottlieb MS, Schroff R, Schanker HM, et al: Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men. N Engl J Med 1981;305:1425-1431.Crossref 2. Masur H, Michelis MA, Greene JB, et al: An outbreak of community-acquired Pneumocystis carinii pneumonia. N Engl J Med 1981;305:1431-1438.Crossref 3. Siegal FP, Lopez C, Hammer GS, et al: Severe acquired immunodeficiency in male homosexuals manifested by chronic perianal ulcerative Herpes simplex lesions. N Engl J Med 1981;305:1439-1444.Crossref 4. Follansbee SE, Busch DF, Wofsy CB, et al: An outbreak of Pneumocystis carinii pneumonia in homosexual men. Ann Intern Med 1982;96(pt 1):705-713.Crossref 5. Mildvan D, Mathur V, Enlow RW, et al: Opportunistic infections and immune deficiency in homosexual men. Ann Intern Med 1982;96(pt 1): 700-704.Crossref 6. Friedman-Kien AE, Laubenstein LJ, Rubinstein P, et al: Disseminated Kaposi's sarcoma in homosexual men. Ann Intern Med 1982;96(pt 1):693-700.Crossref 7. Masur H, Michelis MA, Wormser GP, et al: Opportunistic infections in previously healthy women. Ann Intern Med 1982;97:533-539.Crossref 8. Poon M, Landay A, Prasthofer EF, et al: Acquired immunodeficiency syndrome with Pneumocystis carinii pneumonia and Mycobacterium avium-intracellulare infection in a previously healthy patient with classic hemophilia. Ann Intern Med 1983;98:287-290.Crossref 9. Elliot JL, Hoopes WL, Platt MS, et al: The Acquired immunodeficiency syndrome and Mycobacterium avium-intracellulare bacteremia in a patient with hemophilia. Ann Intern Med 1983;98:290-293.Crossref 10. Vieria J, Frank E, Spira T, et al: Acquired immune deficiency in Haitians: Opportunistic infections in previously healthy Haitian immigrants. N Engl J Med 1983;308:125-129.Crossref 11. Pitchenik AE, Fischl MA, Dickinson GM, et al: Opportunistic infections and Kaposi's sarcoma among Haitians: Evidence of a new acquired immunodeficiency state. Ann Intern Med 1983;98:277-284.Crossref 12. Possible transfusion-associated acquired immune deficiency syndrome (AIDS)—California. MMWR 1982;31:652-654. 13. Ziegler JL, Drew WL, Miner RC, et al: Outbreak of Burkitt's like lymphoma in homosexual men. Lancet 1982;2:631-633.Crossref 14. Snider WD, Simpson DM, Aronyk KE, et al: Primary lymphoma of the nervous system associated with acquired immune-deficiency syndrome. N Engl J Med 1983;308:45. 15. Morris L, Distenfeld A, Amorosi E, et al: Autoimmune thrombocytopenic purpura in homosexual men. Ann Intern Med 1982;96(pt 1):714-717.Crossref 16. Harris C, Burkus Small C, Lein R, et al: Immunodeficiency in female sexual partners of men with acquired immunodeficiency syndrome. N Engl J Med 1983;308:1181-1184.Crossref 17. Curran JW, Evatt BL, Lawrence DN: Acquired immune deficiency syndrome: The past is prologue. Ann Intern Med 1983;98:401-403.Crossref 18. Wormser GP, Krupp LB, Hanrahan JP, et al: Acquired immunodeficiency syndrome in male prisoners. Ann Intern Med 1983;98:297-303.Crossref 19. Rubinstein A, Sicklick M, Gupta A, et al: Acquired immunodeficiency with reversed T4/T8 ratios in infants born to promiscuous and drug-addicted mothers. JAMA 1983;249:2350-2356.Crossref 20. Oleske J, Mimmefor A, Cooper R Jr, et al: Immune deficiency syndrome in children. JAMA 1983;249:2345-2349.Crossref 21. Amman JA, Cowan MJ, Wara D: Acquired immunodeficiency in an infant: Possible transmission by means of blood products. Lancet 1983;1: 956-958.Crossref 22. Gallo RC, Savin PS, Gelman EP, et al: Isolation of human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS). Science 1983;220:865-867.Crossref 23. Gelman EP, Popovic M, Blayney D, et al: Proviral DNA of a retrovirus human T-cell leukemia virus in two patients with AIDS. Science 1983;220: 862-864.Crossref 24. Essex M, McLane MF, Lee TH, et al: Antibodies to cell membrane antigens associated with human T-cell leukemia virus in patients with AIDS. Science 1983;220:859-862.Crossref 25. Brunet JB, Bouvet E, Leibowitch J, et al: Acquired immunodeficiency syndrome in France. Lancet 1983;1:700-701.Crossref 26. Clumeck N, Mascart-Lemone F, DeMaubeuge J, et al: Acquired immune deficiency syndrome in black Africans. Lancet 1983;1:642.Crossref 27. Marmor M, Friedman-Kien A, Laubenstein L, et al: Risk factors for Kaposi's sarcoma in homosexual men. Lancet 1982;1:1083-1087.Crossref 28. Detels R, Fahey JL, Schwartz K, et al: Relationship between sexual practices and T-cell subsets in homosexually active men. Lancet 1983;2: 609-611.Crossref 29. Menitove JE, Aster RH, Casper JT, et al: T-lymphocyte subpopulations in patients with classic hemophilia treated with cryoprecipitate and lyophilized concentrations. N Engl J Med 1983;308:83-86.Crossref 30. Lederman MM, Ratnoff OD, Scillian JJ, et al: Impaired cell-mediated immunity in patients with classic hemophilia. N Engl J Med 1983;308:79-83.Crossref 31. Henrickson RV, Osborn KG, Madden DL: Epidemic of acquired immunodeficiency in rhesus monkeys. Lancet 1983;1:388-391.Crossref 32. Persistent, generalized lymphadenopathy among homosexual males. Centers for Disease Control. MMWR 1982;31:249-251. 33. Luft BJ, Conley F, Remington JS: Outbreak of central nervous system toxoplasmosis in western Europe and North America. Lancet 1983;1:781-783.Crossref 34. Greene JB, Sidhu GS, Lewin S, et al: Mycobacterium avium-intracellulare: A cause of disseminated life threatening infection in homosexuals and drug abusers. Ann Intern Med 1982;97:539-546.Crossref 35. Masur H: Mycobacterium avium-intracellulare: Another scourge for individuals with the acquired immunodeficiency syndrome. JAMA 1982; 248:3013.Crossref 36. Ma P, Soave R: Three-step stool examination for cryptosporidiosis in ten homosexual men with protracted watery diarrhea. J Infect Dis 1983; 147: 824-828.Crossref 37. Drew WL, Miner RC, Ziegler JL: Cytomegalovirus and Kaposi's sarcoma in young homosexual men. Lancet 1982;2:125-127.Crossref 38. Lopez C, Fitzgerald P, Siegal FP: Severe acquired immune deficiency syndrome in homosexuals: Diminished capacity to make interferon α in vitro is associated with severe opportunistic infections. J Infect Dis , in press. 39. DeStefano E, Friedman RM, Friedman-Kien AE, et al: Acid-labile human leukocyte interferon in homosexual men with Kaposi's sarcoma and lymphadenopathy. J Infect Dis 1982;146:451-455.Crossref 40. Laubenstein LJ, Krigel R, Friedman-Kien A, et al: Treatment of epidemic Kaposi's sarcoma with VP-16-213 (Etoposide) plus doxorubicin, bleomycin, and vinblastine. J Clin Oncol , in press. 41. Krown SE, Real FX, Cunningham-Rundles S, et al: Preliminary observations on the effect of recombinant leukocyte A interferon in homosexual men with Kaposi's sarcoma. N Engl J Med 1983;308:1071-1074.Crossref 42. Acquired immune deficiency syndrome (AIDS): Precautions for clinical and laboratory staffs. MMWR 1982;31:577-580. 43. An evaluation of the acquired immunodeficiency syndrome (AIDS) reported in health-care personnel—United States. MMWR 1983;32:358-360. 44. Prevention of acquired immune deficiency syndrome (AIDS): Report on the interagency recommendations. MMWR 1983;32:101-102.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Dec 1, 1983

References