Epidemiology

The first reported cases of AIDS were described in 1981 when individuals with Pneumocystis carinii pneumonia and Kaposi sarcoma were discovered among previously healthy homosexual men. The principal pathologic characteristic of AIDS was subsequently determined to be a defect in cell-mediated immunity. In 1983, isolation of a retrovirus (HIV) established the etiologic basis of AIDS. The development of an antibody assay for HIV in 1985 allowed for serologic diagnosis of infected individuals and led to an appreciation of the major modes and principal risk factors for HIV transmission.

The diagnosis of AIDS is most commonly made with laboratory evidence of HIV infection and the presence of one or more "indicator conditions." The most recent

Centers for Disease Control and Prevention (CDC) definition of AIDS for reporting purposes was published in 1993 ( Table 13.9.-1.).1 The case definition of AIDS

includes either the presence of one or more indicator conditions (now including pulmonary tuberculosis, recurrent bacterial pneumonia, or invasive cervical cancer), or a laboratory measure of severe immunosuppression (CD4 T-lymphocyte count <200 cells/pL).

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