Clinical and epidemiological aspects of the first 50 cases of AIDS in Milan

Between April 1984 and December 1985, 50 patients diagnosed as AIDS were observed in our Clinic. Risk factors were homosexuality in 21 cases (42%), drug addiction in 20 (40%), homosexuality and drug addiction in 3 (6%), haemophilia in 1 (2%). In the remaining 5 cases the infection was acquired by vertical transmission in 2 (4%), by promiscuous heterosexual intercourse in 2 (4%) and by a single blood transfusion in 1 (2%). Kaposi's sarcoma (KS) was the main clinical feature in 8 patients, although associated with opportunistic infections (OI) in 7 of them. A total of 91 different OI were diagnosed with a noteworthy prevalence of mycotic infections compared with OI due to other micro-organisms: 40 deep mycoses by Candida albicans, and 5 cryptococcoses. Pneumocystis carinii pneumonia (PCP) was diagnosed in 20 patients. Our data differ from the ones collected in the USA both epidemiologically, since we observed a greater incidence of AIDS in drug-addicts than in homosexuals and clinically, since in Italy a lower rate of neoplastic disease and, conversely, a higher rate of OI other than PCP are reported.