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  1. 1
    069586

    The epidemiological evolution of HIV infection.

    Greco D

    ANTIBIOTICS AND CHEMOTHERAPY. 1991; 43:1-13.

    Delphi techniques used by the World Health Organization predict more than 6 million cases of AIDS and millions more to be infected with HIV by the year 2000. In the absence of quick solutions to the epidemic, one must prepare to work against and survive it. The modes of HIV transmission are constant and seen widely throughout the world. Transmission may occur through sexual intercourse and the receipt of donated semen; transfusion or surgically-related exposure to blood, blood products, or donated organs; and perinatally from an infected mother to child. There are, however, 3 patterns of transmission. Pattern I transmission is characterized by most cases occurring among homosexual or bisexual males and urban IV-drug users. Pattern II transmission is predominantly through heterosexual intercourse, while pattern III of only few reported cases is observed where HIV was introduced in the early to mid-1980s. Both homosexual and heterosexual transmission have been documented in the latter populations. Significant case underreporting exists in some countries. Investigators are therefore working to find incidence rates of both infection and AIDS cases to better estimate actual present and future needs in the fight against the epidemic. Surveillance data does reveal a rapidly rising and marked number of reported AIDS cases. The cumulative number reported to the World Health Organization increased over 15-fold over the past 4 years to reach 141,894 cases by March 1, 1989. Large, increasing numbers of cases are reported from North and Latin America, Oceania, Western Europe, and areas of central, eastern and southern Africa. 70% of all reported cases were from 42 countries in the Americas. 85% of these are within the United States. Increases in the proportion of IV-drug users who are infected with HIV are noteworthy especially in Western Europe and the U.S. The epidemic in Italy is also specifically discussed.
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  2. 2
    066757
    Peer Reviewed

    The value of a clinical definition for epidemic KS in predicting HIV seropositivity in Africa.

    Desmond-Hellmann SD; Mbidde EK; Kizito A; Hellmann NS; Ziegler JL

    Journal of Acquired Immune Deficiency Syndromes. 1991; 4(7):647-51.

    Kaposi's sarcoma (KS) in African adults can present in both endemic (non-HIV related) and epidemic (HIV related) forms and in this paper, the authors evaluated the usefulness of a clinical case definition for epidemic KS in predicting HIV seropositivity. A total of 235 patients with KS presenting to the Uganda Cancer Institute from January 1, 1988-March 31, 1990 were evaluated with history and physical examination. Symptomatic patients underwent chest radiography and upper gastrointestinal endoscopy. 174 (80%) underwent HIV ELISA testing with Western blot confirmation. The clinical case definition had a 91% sensitivity and a 95% specificity in predicting HIV seropositivity. Oral KS was the most sensitive specific site of involvement in predicting HIV seropositivity. The clinical case definition is useful in assessing patients to determine prognosis and likelihood of responding to aggressive therapy. (author's)
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