Epidemiology Of The Acquired Immunodeficiency Syndrome Aids

When Pascal James Imperato, MD, assumed the edi • Exclusion by the New York State Departm~nt of Health of qualified laboratories from HIV testmg torship of the New York State Journal of Medicine in 198~, the acquired immunodeficiency syndro. me (AIDS) epI • Protection of health care workers • Responsibilities of physicians and other health care demic in the United States was already SIX years old. Dur ing the time of his editorship, two thematic issues of the workers Journal have been devoted to AIDS. In addition, a large • Public education number of original communications have been regularly • AIDS confidentiality published on the subje~t. This volume ?rings together The Symposium on AIDS in Washington, DC, had important articles published on AIDS m the Journal been so successful that the MSSNY, under the auspices of during 1987 and 1988. . . the task force and the Division of Governmental Affairs, In the early years of the epidemic the Medical Society of held two informational symposia for state senators and the State of New York (MSSNY) was aware that it had a assemblymen and their staffs in Albany, New York. Thes. e responsibility to both the professi?~ an~ the public to add were presented in February 1988 and. March. 1989. ,!,hIS its efforts to those already mobIlized m the attempt to effort has convinced the MSSNY that It has given legisla understand and control this tragic disease. Early on, the tors a better understanding of the overall AIDS problem.

The science of the virus and its effects and the clinical approaches to its treatment and transmission prevention are placed in the context of the history and epidemiology of the HIV-AIDS pandemic. Each organ system of the body is explored as to manifestations of the disease, treatment now and in the future, as well as what the disease has taught us about the immune response. The science of epidemiology, which is so important in allowing for tracking of the disease and potential limitation of transmission, is another aspect of AIDS explored in detail. The pandemic manifests differently in different parts of the world, and the relevance of the volume is enhanced by its international group of contributors. No other text provides the historical and epidemiological context of this disease along with an update of diagnosis and treatment. The underlying science and epidemiology of AIDS are not neglected, so the student or clinician who is treating patients with AIDS can gain a full understanding of HIV/AIDS in individual patients and in their communities.

This book provides an overview of background information on the epidemiology, biology, and pathophysiology of HIV infection. It presents the spectrum of HIV disease from acute infection to specific syndrome. The book reviews the management of specific opportunistic infections.

Eight years after the first recognition of AIDS, new insights into the distribution and expression of the disease continue to accumulate as fast as the inexorable increase in cases. Consequently, there is a need for a thorough review of the major issues in population studies of the disease, as well as a detailed but accessible summary of the biology of the infection. As the first comprehensive text on the epidemiology of AIDS and human immunodeficiency virus (HIV) infection, this book distills voluminous, widely dispersed research data on the AIDS phenomenon in a single, carefully-integrated volume. It provides clear discussions of the biology and clinical manifestations of the infection and the disease, thorough treatment of its occurrence in high and low risk populations, and a detailed account of control efforts, including behavioral intervention, drug therapy, immunization, and other responses of the health care and legal systems. The book will be an invaluable reference for all professionals concerned with AIDS.

AIDS has appeared in more than 130 countries, and over 100,000 cases of AIDS have been reported in the U.S. alone. More and more, the public will be depending on statisticians to provide answers about the future course of this epidemic. This comprehensive work confronts the problems that are unique to AIDS research and unites them under a single conceptual framework. It focuses on methods for the design and analysis of epidemiologic studies, the natural history of AIDS and the transmission of HIV, methods for tracking and projecting the course of the epidemic, and statistical issues in therapeutic trials. The various methods of monitoring and forecasting this disease receive comprehensive treatment. These methods include back-calculation, which the authors developed; interpretation of survey data on HIV prevalence; mathematical models for HIV transmission; and approaches that combine different types of epidemiological data. Much of this material -- such as a discussion of methods for assessing safety of the blood supply, an evaluation of survey approaches, and methods to project pediatric AIDS incidence -- is not available in any other work.