Reports on HIV/AIDS: 1990

FEBRUARY 23, 1990, MMWR, Vol. 39, No. 7, pp. 110-112, 117-119
cohorts of homosexual/bisexual men (10,11 ). These studies suggest that by 1989
approximately 17%-19% of HIV-infected persons evaluated between 1985 and 1989
had <200 CD4+ cells/mm3. An additional 41%-45% had between 200 and 500 CD4+
cells/mm3. Thus, 58%-64% of persons with HIV infection may have CD4+ cell counts
of <500/mm3
AIDS Case Projections
Participants concluded that AIDS cases in the United States will continue to
increase through 1993 in each of the current principal transmission categories (i.e.,
homosexual/bisexual men, IVDUs, persons infected through heterhsexual transmission, and children infected perinatally). An estimated 37,500 cases diagnosed from
October 1988 through September 1989 eventually will be reported, a 14% increase
over the corresponding count for October 1987 through September 1988 (6).
Between 52,000 and 57,000 cases of AIDS will be diagnosed during 1990, and the
annual count will increase to 61,000-98,000 cases diagnosed during 1993 (Table 2).
These projections include an adjustment for the estimate that about 85% of diagnosed AIDS cases are eventually reported.
Effects of Therapy on Disease Progression
Data presented at the workshop indicate that the use of zidovudine (formerly called
AZT) initially reduces the risk for developing AIDS in HIV-infected persons who are
asymptomatic or mildly symptomatic but who have CD4+ cell counts of <500/mm3.
Current data indicate that, in a clinical trial setting, the risk in treated patients is one
third to one half the risk in untreated patients (National Institute of Allergy and
Infectious Diseases [NIAID], unpublished data). Although the use of zidovudine only
temporarily delays onset of AIDS, the therapeutic benefit may be extended by new
therapies currently being evaluated. Data available at the workshop were insufficient
to estimate the relative contribution of therapeutic interventions, such as zidovudine
or prophylaxis for Pneumocystis carinii pneumonia, to the slowing in the rate of
increase in reported AIDS cases that occurred in the middle of 1987.
TABLE 2. Projected numbers of AIDS cases, deaths attributable to AIDS, and living
persons with AIDS, after adjustments for underreporting* - United States, 1989 -1993
AIDS cases
Year New casest Alive' Deaths
1989 44,000-50,000 92,000-98,000 31,000-34,000
1990 52,000-57,000 101,000-122,000 37,000-42,000
1991 56,000-71,000 127,000-153,000 43,000-52,000
1992 58,000-85,000 139,000-188,000 49,000-64,000
1993 61,000-98,000 151,000-225,000 53,000-76,000
Through 1993' 390,000-480,000 285,000-340,000
*Projections are adjusted for unreported diagnoses of AIDS by adding 18% to projections
obtained from reported cases (corresponding to 85% of all diagnosed cases being reported:
1/0.85= 1.18) and rounded to the nearest 1000.
'Number of cases diagnosed during the year.
'Persons with AIDS alive during the year.
"Rounded to the nearest 5000. Includes an estimated 120,000 AIDS cases diagnosed through
1988, 48,000 persons alive with AIDS at the end of 1988, and 72,000 deaths in diagnosed patients
through 1988.

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