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History of HIV/Aids Epidemics

Acquired Immune Deficiency Syndrome (AIDS) is characterized by severe immunosuppression, wasting, dementia, opportunistic infections, and cancers that result from infection with the retrovirus human immunodeficiency virus (HTV). The disease was first recognized in 1981 with the unexplained occurrence of clusters of cases of pneumocystis carinii pneumonia (PCP) and Kaposi’s sarcome (KS) among young homosexual men in California and New York City.

As such, it was initially referred to as Gay Related Immune Disorder (GRID). As similar cases of these and other opportunistic infections associated with unexplained immunosuppression were subsequently reported in persons with hemophilia, recipients of blood products/transfusions, injecting drug users and their heterosexual partners, the disease entity was renamed Acquired Immune Deficiency Syndrome (AIDS).

In 1983, a previously known retrovirus was isolated from persons at risk for AIDS and subsequently, in 1985, serologic tests were developed to detect HIV antibodies. The use of these tests led to the observation that (a) the number of persons infected with HIV was much larger than the number diagnosed with AIDS, and (b) the period between infection and disease development was generally long.

Coordinated by the Centers for Disease Control (CDC), systematized surveillance of AIDS began in 1981; the case definition for adults/adolescents has subsequently been expanded to reflect increased knowledge of the natural history of HIV infection and to remain consistent with the clinical management of HIV disease. These revisions include: In 1985, the addition of a positive antibody test; in 1987, the addition of presumptive diagnosis of some opportunistic infection, HIV wasting, and HIV encephalopathy: and in 1987, the addition of CD4+ lymphocyte count

Since the initial case reports of AIDS in the early 1980s, the number of persons with HIV/AIDS has grown rapidly in the United States, primarily in major metropolitan areas. Abroad, the specific international geographical areas most severely affected include Sub-Saharan Africa and Southeast Asia. According to the CDC in 1997, HIV was the second leading cause of U.S. deaths among adults ages 25-44.