Clinical Review ABC of AIDS

Development of the epidemic

BMJ 2001; 322 doi: (Published 19 May 2001) Cite this as: BMJ 2001;322:1226

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  1. Michael W Adler

    The first recognised cases of the acquired immune deficiency syndrome (AIDS) occurred in the summer of 1981 in America. Reports began to appear of Pneumocystis carinii pneumonia and Kaposi's sarcoma in young men, who it was subsequently realised were both homosexual and immunocompromised. Even though the condition became known early on as AIDS, its cause and modes of transmission were not immediately obvious. The virus now known to cause AIDS in a proportion of those infected was discovered in 1983 and given various names. The internationally accepted term is now the human immunodeficiency virus (HIV). subsequently a new variant has been isolated in patients with West African connections—HIV-2.

    This article has been adapted from the forthcoming 5th edition of ABC of AIDS. The book will be available from the BMJ bookshop and at

    AIDS defining conditions without laboratory evidence of HIV

    • Diseases diagnosed definitely

    • Candidiasis: oesophagus, trachea, bronchi, or lungs

    • Cryptococcosis: extrapulmonary

    • Cryptosporidiosis with diarrhoea persisting >1 month

    • Cytomegalovirus disease other than in liver, spleen, nodes

    • Herpes simplex virus (HSV) infection Mucocutaneous ulceration lasting >1 month Pulmonary, oesophageal involvement

    • Kaposi's sarcoma in patient <60 years of age

    • Primary cerebral lymphoma in patient <60 years of age

    • Lymphoid interstitial pneumonia in child <13 years of age

    • Mycobacterium avium: disseminated

    • Mycobacterium kansasii: disseminated

    • Pneumocystis carinii pneumonia

    • Progressive multifocal leucoencephalopathy

    • Cerebral toxoplasmosis

    The definition of AIDS has changed over the years as a result of an increasing appreciation of the wide spectrum of clinical manifestations of infection with HIV. Currently, AIDS is defined as an illness characterised by one or more indicator diseases. In the absence of another cause of immune deficiency and without laboratory evidence of HIV infection (if the patient has not been tested or the results are inconclusive), certain diseases when definitively diagnosed are indicative of AIDS. Also, regardless of the presence of other …

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