The Relationship Between the Human Immunodeficiency Virus and the Acquired Immunodeficiency Syndrome: Executive Summary (Draft)

DRAFT

14. In cohort studies, severe immunosuppression and AIDS-defining illnesses
occur exclusively in individuals who are HIV-infected. Conversely,
matched controls, individuals with similar lifestyles but without HIV
infection, virtually never suffer these symptoms.
For example, in one cohort in Vancouver, investigators followed 715 homosexual men for a median of 8.6 years. Every case of AIDS in this cohort
occurred in individuals who were positive for HIV antibodies. No AIDS-defining
illnesses occurred in men who remained negative for HIV antibodies, despite
the fact that the these men had similar pattems of illicit drug use and receptive
anal intercourse as men who developed AIDS.
15. Since the appearance of HIV, mortality has increased dramatically among
hemophiliacs.
Through June 30, 1994, 3,618 individuals in the United States with hemophilia
or coagulation disorders had been diagnosed with AIDS. The impact of HIV on
the life expectancy of hemophiliacs has been dramatic. Among those with
severe factor-VIII deficiency, mortality increased six-fold from 1981 to 1990.
Median life expectancy at one year of age for males with hemophilia increased
from 40.9 years at the beginning of the century (1900 to 1920) to a high of 68
years after the introduction of factor therapy (1971 to 1980). In the era of AIDS
(1981 to 1990), life expectancy declined to 49 years.
16. Sex partners of HIV-infected hemophiliacs and transfusion recipients
acquire the virus and develop AIDS without other risk factors.
Ten to 20 percent of wives and sex partners of male HIV-positive hemophiliacs
in the United States are also HIV-infected. Through June 30, 1994, the CDC
had received reports of 235 cases of AIDS in those whose only risk factor was
sex with an HIV-infected person with hemophilia. The CDC had also received
reports of 574 cases of AIDS in individuals whose primary risk factor was sex
with an HIV-infected transfusion recipient.
17. Studies of transfusion-acquired AIDS cases have repeatedly led to the
discovery of HIV in the patient as well as in the blood donor.
An early study showed that of 28 transfusion recipients with AIDS, all were HIVinfected, and each had received blood from at least one HIV-infected donor.
Other studies have shown an almost perfect correlation between the occurrence
of AIDS in a blood recipient and evidence of HIV infection in both the recipient
and the blood donor.
18. Newborn infants have no behavioral risk factors, yet 5,734 children in the
United States developed AIDS through June 30, 1994.

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