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Saturday, November 22, 2008
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INITIAL
THEORIES
The fact that homosexual men constituted
the initial population in which AIDS occurred in the United States led some to
surmise that a homosexual lifestyle was specifically related to the disease (Goedert
et al., 1982; Hurtenbach and Shearer, 1982; Sonnabend et al., 1983; Durack, 1981;
Mavligit et al., 1984). These early suggestions that AIDS resulted from behavior
specific to the homosexual population were largely dismissed when the syndrome
was observed in distinctly different groups in the United States: in male and
female injection drug users; in hemophiliacs and blood transfusion recipients;
among female sex partners of bisexual men, recipients of blood or blood products,
or injection drug users; and among infants born to mothers with AIDS or with a
history of injection drug use (CDC, 1982b,c,d,f, 1983a; Poon et al., 1983; Elliot
et al., 1983; Masur et al., 1982b; Davis et al., 1983; Harris et al., 1983; Rubinstein
et al., 1983; Oleske et al., 1983; Ammann et al., 1983b). In 1983, for example,
a study found that hemophiliacs with no history of any of the proposed causes
of AIDS in homosexual men had developed the syndrome, and some of the men had
apparently transmitted the infection to their wives (deShazo et al., 1983).
Many public health experts concluded
that the clustering of AIDS cases (Auerbach et al., 1984; Gazzard et al., 1984)
and the occurrence of cases in diverse risk groups could be explained only if
AIDS were caused by an infectious microorganism transmitted in the manner of
hepatitis B virus (HBV): by sexual contact, by inoculation with blood or blood
products, and from mother to newborn infant (Francis et al., 1983; Curran et
al., 1984; AMA, 1984; CDC, 1982f, 1983a,b).
Early suspects for the cause of AIDS
were cytomegalovirus (CMV), because of its association with immunosuppression,
and Epstein-Barr virus (EBV), which has an affinity for lymphocytes (Gottlieb
et al., 1981; Hymes et al., 1981; CDC, 1982f). However, AIDS was a new phenomenon,
and these viruses already had a worldwide distribution. Comparative seroprevalence
studies showed no convincing evidence to assign these viruses or other known
agents a primary role in the syndrome (Rogers et al., 1983). Also lacking was
evidence that these viruses, when isolated from patients with AIDS, differed
significantly from strains found in healthy individuals or from strains found
in the years preceding the emergence of AIDS (AMA, 1984).
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