Epidemiology and the Human Immunodeficiency Virus

Abstract

The human immunodeficiency virus (HIV) epidemic has repeatedly highlighted the many contributions of epidemiologic research to our understanding of the disease process. For example, substantial differences in clinical manifestations between HIV-infected subgroups may indicate a correlation between host response and disease pathogenesis. Kaposi's See also p 1631. sarcoma, as one case in point, is speculated to be caused by a second sexually transmitted agent primarily because of the unique concentration of this opportunistic malignancy in homosexual men. On the other hand, HIV-related non-Hodgkin's lymphoma occurs with similar frequency in all subgroups and so is considered to arise as a more direct consequence of HIV infection. Clearly, epidemiologic observations can assist us in directing our search into the pathogenesis of these diseases. Epidemiologic findings also have clinical implications. The critically important use of infection prophylaxis relies on data from cohort studies that allow us to predict the risk of specific opportunistic