Current Trends Update: Acquired Immunodeficiency Syndrome (AIDS)
-- United States
As of September 2, 1983, physicians and health departments in
the
United States and Puerto Rico had reported 2,259 persons with
acquired
immunodeficiency syndrome (AIDS) who met the surveillance case
definition.* Of these, 917 (41%) are known to have died.
Fifty-eight
(3%) cases were diagnosed before 1981; 231 (10%) in 1981; 883 (39%)
in
1982; and 1,087 (48%) to date in 1983. Pneumocystis carinii
pneumonia
(PCP) is the most common life-threatening opportunistic infection
in
AIDS patients, accounting for 52% of primary diagnoses; 26% of
patients have Kaposi's sarcoma (KS) without PCP, and 7% have both
PCP
and KS. Many of these patients may also have other opportunistic
infections, and 15% of AIDS patients have such infections without
KS
or PCP. The proportion of patients with each of these primary
diagnoses has remained relatively constant during the last 12
months,
although the proportion with KS has decreased slightly, and the
proportion with opportunistic infections other than PCP has
increased
from approximately 10% of all cases a year ago. Cases have
occurred
in all primary racial/ethnic groups in the United States: 57% of
those reported have been white, 26% black, 14% Hispanic, and 3%
other
or unknown. One hundred forty-seven (7%) cases have been reported
in
women.
Eighty-nine percent of patients with AIDS can be placed in
groups** that suggest a possible means of disease acquisition: 71%
are men with homosexual or bisexual orientations; 17% (including
51%
of the women) have used intravenous (IV) drugs; and 1% are
hemophiliacs. Of the other 11% of cases, means of disease
acquisition
is less clear, but in none of these cases does casual contact
appear
to be involved. This group of 11% includes cases for whom
information
about risk factors is either absent or incomplete (3% of total),
and
others whose risk and exposure factors are under investigation.
The
latter includes patients who were born in Haiti but are now living
in
the United States (5% of total). Also under investigation are
heterosexual partners of persons with AIDS or persons at increased
risk of AIDS (1% of total), and those exposed to blood transfusions
(1% of total). Finally, some thoroughly investigated cases belong
to
none of the above groups (1% of total).
Almost 47% of AIDS patients are 30-39 years old at diagnosis;
an
additional 22% are 20-29 and 40-49 years old, respectively. The
age
of drug-abuse patients clusters more tightly, with 81% being 20-39
years old. Compared with the average for all AIDS patients,
Haitian
entrants with AIDS tend to be younger (47% are 20-29 years old);
the
patients who received blood transfusions before developing AIDS
tend
to be older (median age more than 50 years old); and those with
hemophilia tend to have a broader age range without clustering.
Most cases continue to be reported among residents of large
cities. The New York City standard metropolitan statistical area
(SMSA) has reported 42% of all cases meeting the surveillance
definition; the San Francisco SMSA, 11% of cases; the Los Angeles
SMSA, 7% of cases; and the Miami SMSA, 5% of cases. Cases have
been
reported from 41 states, the District of Columbia, and Puerto Rico
(Figure 4).
Reported by City, State, and Territorial Epidemiologists; AIDS
Activity, Center for Infectious Diseases, CDC.
Editorial Note
Editorial Note: AIDS cases have been classified into groups at
greatest risk of acquiring the disease. Classification is an
essential element of any epidemiologic investigation and serves
such
purposes as formulating prevention recommendations, providing
direction for research, and identifying medical needs. However,
the
classification of certain groups as being more closely associated
with
the disease has been misconstrued by some to mean these groups are
likely to transmit the disease through non-intimate interactions.
This view is not justified by available data. Nonetheless, it has
been used unfairly as a basis for social and economic
discrimination.
The occurrence of AIDS cases among homosexual men, IV drug
abusers, persons with hemophilia, sexual partners of members of
these
groups, and recipients of blood transfusions is consistent with the
hypothesis that AIDS is caused by an agent that is transmitted
sexually or, less commonly, through contaminated needles or blood.
About 91% percent of reported cases have occurred in these patient
groups. Among the remaining cases, there has been no evidence that
the disease was acquired through casual contact with AIDS patients
or
with persons in population groups with an increased incidence of
AIDS. AIDS is not known to be transmitted through food, water,
air,
or environmental surfaces.
The great majority of persons in population groups with
increased
incidences of AIDS have not been affected by the disease. Until
epidemiologic studies identify the subgroups within these
populations
that are truly at increased risk for acquiring AIDS, the
classification system will lack precision. However, such
classifications should not be construed to imply that usual social
contact with such groups is involved in the transmission of AIDS.
Disclaimer
All MMWR HTML documents published before January 1993 are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.
**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.
