Current epidemiological trends of HIV infection in Asia.

AIDS cases were predominantly reported from America Europe and Africa in the early stages of the AIDS pandemic with only few cases reported in Asia. Accordingly people in many Asian countries considered AIDS to be only a foreign disease of little domestic threat. Since then countries have attempted to bar infected foreigners from entry and to segregate infected domestic residents from mainstream society. 1254 AIDS patients were reported from Asia as of 1/1/92. Most Asian countries however have poor surveillance systems and limited diagnostic experience and facilities. The numbers of AIDS patients and HIV-infected individuals are therefore most probably significantly underestimated. Despite limited clinical and epidemiological information evidence suggests that HIV prevalence and the incidence of HIV infection are rapidly growing throughout much of Asia. Most reported transmission has been among adults through sex and needle sharing in drug use. Perinatal transmission and transmission through infected blood and blood products are also observed especially in Thailand and India. Most reported infections have been HIV-1 infections. Available evidence also suggests that opportunistic infections are generally similar to those seen in more developed countries. Mycobacteria and Penicillium marneffei are also important pathogens in the region. HIV and AIDS are spreading generally throughout Asia with most rapid increases among IV drug users and female sex workers. The World Health Organization projects that more Asians than Africans could become infected annually by the mid to late 1990s. 250000 AIDS cases could be reported annually from Asia by the year 2000. HIV and AIDS are currently far from foreign to Asia. The rapid spread of HIV throughout the region reaffirms the viruss ability to disseminate across countries once thought out of danger. Efforts to curb the international travel of people infected with HIV and/or quarantine infected nationals are however discriminatory and ineffective. Instead international and organizational coordination with people with AIDS are needed. Only by working together may countries help reduce the impending destructive impact AIDS will have on medical communities societies and economic and political systems around the world.