Facts on AIDS
(This article is based on "Acquired
Immune Deficiency Syndrome: Current
Epidemic May be New Threat from Old Foe;
Herpes Virus" in the Harvard Medical
Area Focus, Jan. 27, 1983. The edi
torial help of a local gay physician
is gratefully acknowledged.)
The search for the cause of acquired
immune deficiency syndrome (AIDS) began
less than two years ago at a medical
meeting in Los Angeles. AIDS is the
name given an apparently new immune dis
order with a long incubation period,
protracted and debilitating course, and
poor prognosis. Cases of AIDS have
doubled every 6 months since the first
was reported in June 1981 and the prin
cipal targets (75 percent) are very
sexually active gay men. AIDS has
claimed the lives of about half its
victims, and it is expected that the
fatality rate will rise further when
more data accrue.
Dr. Robert Schooley of the Harvard
Medical School says the epidemiology of
AIDS strongly suggests that a transmis
sible agent is responsible, "This puta
tive agent is probably a virus. No
definitive agent has yet been recovered
from AIDS patients, however."
Whatever the cause, AIDS results in a
profound depression of the cell-mediated
arm of the body’s immune system, and
leaves the gradually failing patient
susceptible to at least one form of
cancer, Kaposi's sarcoma, as well as a
plethora of opportunistic infections.
Pre-AID Syndrome?
AIDS often begins with enlarged lymph
nodes, weight loss, malaise, and lab
oratory findings of cell—mediated immune
dysfunction. The incubation period is 8
to 20 months.
The weight loss and general decline
is followed by any number and kind of
recurring Infections, commonly Pneumo
cystis pheumonia, intractable wide
spread herpes simplex, disseminated can
didiasis (thrush), and severe diarrhea.
AIDS is also marked by blood tests that
show an Inverted ratio of helper to
suppressor T cells that tilts the
balance toward suppressor cells. Nor
mally, helper cells that "turn on the
immune system are more numerous than the
suppressor cells that "turn it off.
The fatality rate is close to 80%,
and no one has yet been cured of this
disease.
More than 1,300 cases have been
reported in the U.S., and the
Communicable Diseases Center (CDC) in
Atlanta has been receiving reports of
two to three new cases daily. AIDS is
thought not to be highly communicable
through the usual social encounters, and
about 35% of AIDS cases have occur
red in people outside the known high
risk groups. In addition to gay men,
these include recent Haitian^ immigrants,
intravenous drug abusers, female sex
partners of bisexual males, and hemo
philiacs .
Intimate Contact, Blood Products
The predominance of these groups
among AIDS cases points to sexual or
other intimate contact with an infected
person, and/or the receiving of blood or
blood products from an infected person
as the means of transmission. People
with hemophilia require injections of
clotting factors, derived for the most
part from large pools of donor plasma.
AIDS became the second leading cause of
death among hemophiliacs in 1982, the
first year of AIDS' appearance in this
group. In at least one case of AIDS in
a transfused patient with no other risk
factors, donor blood was traced to. a
homosexual man who felt well at the time
of donation but later died of AIDS.
A more mystifying primary risk group
are Haitian immigrants to the U.S., who
account for about 6% of reported cases.
More than 20 cases of AIDS have been
identified in Haiti itself, but the
meaning of the Haitian association is
unclear. Dr. Schooley said.
Only a few AIDS cases have not been
linked to one of the above risk factors.
A U.S. Department of Health and Human
Services advisory committee is examining
the blood banking system to consider
safety guidelines. However, since no
causative organism has been identified,
no screening test exists for AIDS, and
screening for homosexual activity,
Haitian nationality and other risk
categories is largely dependent on the
donor's cooperation. Members of high
risk groups are being asked to volun
tarily limit their blood donations, how
ever, "just as people who have recently
returned from Africa, where malaria is
endemic, and people who have had hepa
titis, are asked not to donate," Dr.
Schooley explained.
"As alarming as this is," he con
tinued, "you have to realize these sus
pected cases of AIDS infection through
transfusion number only 3 or 4, and
millions of units of blood are given
every year." Though the implications of
getting AIDS are more serious than those
of getting hepatitis. Dr. Schooley said
the concensus is that people should not
cancel surgery or other therapy requir
ing blood transfusions out of concern of
getting AIDS.
Haiti and Homosexuals
Dr. Schooley said there is a great
deal of speculation as to why AIDS is
seen in Haitians and homosexuals. He
said that an illness with AIDS symptoms
has been occurring persistently in Haiti
since 1979, but because of minimal
health care facilitities in the country
it is difficult to do retrospective epi—
(continued on p. 8)