Human immunodeficiency virus infection in the United Kingdom: Quarterly report 3: The epidemic to 31 March 1988, with special reference to persons injecting drugs

Abstract

Up to 31 March 1988, 1429 cases meeting the World Health Organization/Centers for Disease Control (U.S.A.) definition of the acquired immune deficiency syndrome (AIDS) were reported in the U.K. of which 59 were in visitors and 1370 in U.K. residents. In the same period there were 8459 laboratory reports of human immunodeficiency virus (HIV) antibody-positive tests. Since 1985 the median interval of 2 months between diagnosis and report of AIDS has not changed. Most patients with Kaposi's sarcoma (KS) as an indicator disease when AIDS was diagnosed were homosexual/bisexual males; the proportion in this category has declined. The data support the hypothesis for a co-factor in the aetiology of KS in homosexual/bisexual males and that the effect of this co-factor has progressively weakened. Injecting drugs was a risk factor for 48 patients with AIDS (4%), half of whom were also homosexual/bisexual males, and for 1406 (17%) persons reported as HIV antibody-positive of whom 63 were also homosexual/bisexual males. HIV-infected persons injecting drugs were reported from all parts of the U.K., apart from Northern Ireland, but the cumulative rate per million population in Scotland for such persons was more than six times the rate elsewhere. In the collaborative laboratory study in England, 2.3% of over 3000 persons injecting drugs were HIV antibody-positive; among those who were asymptomatic the prevalence in London was 7.1% compared with 1.3% outside London. By 1987, the incidence rate of acute hepatitis B in persons injecting drugs in England had fallen to less than a third of that for 1985; in Scotland the figure for 1987 was only a quarter of that for 1985. Since the current rate of HIV transmission among persons in the U.K. injecting drugs is unknown, monitoring the prevalence of HIV in this risk group should be intensified.