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Acquired Immunodeficiency Syndrome: Epidemiologic, Clinical, Immunologic, and Therapeutic Considerations

ANTHONY S. FAUCI, M.D.; ABE M. MACHER, M.D.; DAN L. LONGO, M.D.; H. CLIFFORD LANE, M.D.; ALAIN H. ROOK, M.D.; HENRY MASUR, M.D.; and EDWARD P. GELMANN, M.D.
[+] Article and Author Information

▸Requests for reprints should be addressed to Anthony S. Fauci, M.D.; National Institutes of Health, Building 10, Room 11B-13; Bethesda, MD 20205.


Bethesda, Maryland


Ann Intern Med. 1984;100(1):92-106. doi:10.7326/0003-4819-100-1-92
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The acquired immunodeficiency syndrome is a new disease whose cause is unknown but is almost surely due to a transmissible agent, most likely a virus. The disease is clearly spread by sexual contact, particularly homosexual activity. Blood-borne transmission constitutes the other major recognized form of spread of the disease, although it is highly likely that the disease is not readily spread through casual, nonsexual, non-blood-borne routes. Although the disease is still highly concentrated in the United States, it is now seen in several countries throughout the world. The common denominator of the disease is a profound suppression of cell-mediated immunity, specifically a quantitative and qualitative defect in the T4 inducer or helper subset of T lymphocytes. Hyperactivity of B lymphocytes is also characteristic. The clinical manifestations are those of severe and life-threatening opportunistic infections and unusual neoplasms, particularly Kaposi's sarcoma. The mortality may well approach 100%, making this one of the most extraordinary transmissible diseases in history.

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