The AIDS Epidemic: Multidisciplinary Trouble

The author presents an overview of the diversity of issues involved in the acquired immunodeficiency syndrome (AIDS) epidemic. The 1st round of AIDS cases has severely strained both human and societal resources in the US. To appreciate the economics of the problem, its is useful to think of evey case of AIDS as costing the same as a heart transplant. The anticipated doubling in numbers of patients diagnosed in the next year will have far more than twice the impact of the 1st wave on the health care industry, especially in the cities where the majority of cases are concentrated. Progress in the area of biomedical science has been spectacular in terms of the speed with which the virus was isolated and blodd screening techniques were developed. Problematic, however, has been the antigenic variation of the AIDS virus. It is possible that monoclonal technology will help to identify on parts of antigenic molecules that pervade the immune response to many variants and might be effective in neutralization. On the scientific level, there is cause of concern regarding a vaccin for AIDS, since the cellular receptor that the virus requires to initiate infection is the receptor for the T-cell antigen. On the practical level, the logistics of testing such a vaccine are complex. The largest hope for intervention may rest in understanding the role of various co-factors in determining whether a person remains asymptomatic or develops the disease. At present, however, preventive medicine appears to be the solution.