AIDS in Edinburgh drug users: observations on the epidemic and implications for its future management.

We are now witnessing the anticipated explosion of cases of AIDS resulting from the epidemic of HIV infection among Edinburgh drug users in the first half of the last decade. We expect the number of new cases of AIDS to continue to increase, although the rate at which they do so may be mitigated by intervention which slows the rate of progression to AIDS. There is evidence that current management of patients may postpone a diagnosis of AIDS until later in the natural history of HIV infection when immunity is very low as manifested by CD4+ lymphocyte counts. Health care planners need to provide resources for an increasing number of HIV-infected persons who have not yet fulfilled the definition of AIDS but who nevertheless require extensive resources both in the community and in hospital.