The Physician's Responsibility for the Care of AIDS Patients: An Opinion

Abstract

Although unknown in the 1970s, the acquired immunodeficiency syndrome (AIDS) has become epidemic in the United States among certain risk groups. According to recent statistics from the Centers for Disease Control (CDC), as of March 21, 1988, the United States had reported a total of 54,233 of these cases. 1 Update: Acquired immunodeficiency syndrome (AIDS)—worldwide. MMWR May 13. 1988; 37: 286-296 Google Scholar Homosexual and bisexual men and IV drug abusers constitute 89 percent of the total cases, while hemophiliacs and transfusion recipients represent an additional 3 percent of the total. Once seroconversion to the human immunodeficiency virus (HIV) occurs, it is likely that most individuals will eventually develop clinical disease and will ultimately die. Seropositivity among high risk groups in large United States cities may be as high as 80 percent. In unselected serial emergency room visitors to The Johns Hopkins Medical Institutions, approximately 5 percent were found to be HIV-seropositive. 2 Baker J.L. Kelen G.D. Sivertson K.T. Quinn T.C. Unsuspected human immunodeficiency virus in critically ill emergency patients. JAMA. 1987; 257: 2609-2611 Crossref PubMed Scopus (126) Google Scholar , 3 Kelen G.D. Fritz S. Qadish B. Brookmeyer R. Baker J.L. Kline R.L. et al. Unrecognized human immunodeficiency virus infection in emergency patients. N Engl J Med. 1988; 318: 1645-1650 Crossref PubMed Scopus (218) Google Scholar Often, those with the most severe trauma, blood loss, and risk to emergency room personnel were seropositive. In fact, the seroprevalence of those with penetrating trauma was 13.6 percent in this 1988 publication. 3 Kelen G.D. Fritz S. Qadish B. Brookmeyer R. Baker J.L. Kline R.L. et al. Unrecognized human immunodeficiency virus infection in emergency patients. N Engl J Med. 1988; 318: 1645-1650 Crossref PubMed Scopus (218) Google Scholar