Non-HIV AIDS: nature and strategies for its management.

Despite initial claims to the contrary, a cluster of reports of severe opportunistic infections occurring in patients without evidence of HIV infection do not appear to represent a new disease entity or present evidence of epidemiologically associated cases suggesting an infectious agent. Reported cases are reviewed and appear to represent a heterogeneous group, many of which may represent sporadic cases of late onset acquired immunodeficiency. In addition, a small group of asymptomatic subjects have been identified with constitutively low CD4 T cell populations which appear to have little or no clinical significance since these patients have no evidence of clinical immunodeficiency. Newly identified cases should be fully investigated immunologically and virologically after recovery from their presenting infection and continuous or prophylactic therapy instituted only in cases of substantiated long-term severe immunodeficiency.