Reports on HIV/AIDS: 1990

FEBRUARY 23, 1990, MMWR, Vol. 39, No. 7, pp. 110-112, 117-119
TABLE 1. Estimates of HIV prevalence* and annual incidence of new HIV infections -
United States, 1986 and 1989
Category January 1986 June 1989
Prevalence -750,000t -1 million"'
Annual incidence
Newborns NA** 1,500-2,000tt
Adults NA ->40,000"
*Total current infections, excluding persons who have died.
tBased on unadjusted figures of 500,000-650,000 HIV infections from back-calculation models,
adjusted to 650,000-900,000 for the effects of AIDS underreporting, HIV disease.not meeting the
AIDS case definition, and deaths before the time of the estimate.
'Based in part on unadjusted figures of 550,000 to 1.1 million, HIV infections from backcalculation models, adjusted to 650,000 to 1.4 million (as in preceding footnote).
'Based in part on the range of 800,000 to 1.2 million HIV infections most consistent with
preliminary seroprevalence data from CDC's family of surveys.
**Not available.
tNational seroprevalence of 1.5 per 1000 for childbearing women multiplied by approximately
1/3 (rate at which infected women transmit HIV perinatally to their infants) times the number of
births (about 4 million).
"Assumes that the observed HIV seroconversion rate in active-duty military personnel is
equalled or exceeded in the general population aged 15-39 years.
HIV Incidence. The incidence of new HIV infections in the U.S. population is an
indicator of the growth of the epidemic at a given time. Incidence can be either
observed directly in groups that are repeatedly screened for HIV infection or
estimated from serial prevalence measurements. Incidence estimates derived from
HIV serosurveys based on blood specimens from newborn infants indicate that
1500-2000 HIV-infected infants (0.5 per 1000 births) were born in 1989 (Table 1).
According to data from the U.S. Department of Defense, approximately 0.6-0.8 per
1000 active-duty personnel acquired HIV infection each year since 1986 (7,8).
Extrapolation from the lower estimate (0.6 per 1000) suggests that at least 40,000 new
HIV infections occurred in adults and adolescents in the United States during 1989,
assuming that the risk of new infection is at least as high for young adult civilians as
for military personnel (Table 1). This is a plausible assumption because the military
actively discourages homosexual/bisexual men and IV-drug users (IVDUs) from
applying for service and has policies against homosexual and drug-using behavior
among military personnel.
Spectrum of Immunologic Deficiency in HIV-Infected Persons
Assessments of immune status in a population infected with HIV help quantify
morbidity, estimate the future burden of HIV disease, and estimate the potential need
for antiretroviral and other therapies. Because the primary target of HIV is the
T-helper lymphocyte (CD4+ cell), monitoring the CD4+ cell counts of persons with
HIV infection provides a measure of HIV-related immune dysfunction. Workshop
participants reviewed data from immunologic studies in active-duty military personnel with HIV infection (9; National Naval Medical Center, unpublished data) and in

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