Cytotoxic Effector Mechanisms in AIDS

The development of the Acquired Immunodeficiency Disease Syndrome, AIDS, in the United States has occurred primarily in certain groups, i.e. homosexual and bisexual men (1,2), I.V. drug abusers (3,4), Haitians (5), and hemophiliacs receiving Factor VIII concentrates (6). Evidence for AIDS in blood transfusion recipients and children of drug abusing or Haitian parents associated with apparent transmission of a newly described retrovirus, HTLV-III, LAV (7,8) has provoked study of critical conditions for AIDS development. It seems logical to assume that AIDS develops in a series of stages, the earliest of which may not be accompanied by any obvious clinical symptoms. Deficiencies in cell mediated immunity have been clearly documented by ourselves and others in patients with AIDS-related opportunistic infections (9,10) and AIDS-related Kaposi’s sarcoma. In addition, we and others have focused much attention upon homosexual men with generalized lymphadenopathy (11–14). Although these patients do not fit the criteria for CDC defined AIDS at the present time, we have observed that an increasingly large number of our originally described population have gone on to develop CDC defined AIDS (11).