[Changes in the clinical symptomatology of initial manifestations of aids].

We analysed the clinical spectrum of AIDS manifestations of HIV positive patients treated between 1985 and 1988 at the University Hospital of Düsseldorf, West-Germany. In 1985 32 patients with HIV infection (16 asymptomatic, eleven PGL/ARC, five AIDS), 1986 49 patients (17 asymptomatic, 19 PGL/ARC, 13 AIDS), 1987 104 patients (13 asymptomatic, 54 PGL/ARC, 37 AIDS) and 1988 206 patients (23 asymptomatic, 111 PGL/ARC, 72 AIDS) were treated on a in- and out-patient basis. In 1985 five, in 1986 13, in 1987 36 and in 1988 48 patients developed AIDS. Kaposi-sarcoma was seen in 1985 in 40%, in 1986 in 31%, in 1987 in 12% and in 1988 in 9% of these cases. At the same time the rate of patients with opportunistic infections as the primary manifestation of AIDS grew from 60% (1985), 69% (1986), 88% (1987) to 91% (1988). Concomitantly the rate of homosexual patients dropped from 90% (1985), 82% (1986), 60% (1987) to 62% (1988). The rate of i.v. drug abuser rose from 10% (1985) to 24% (1988). In 1985 10% of HIV patients were female. This rate rose up to 18% in 1988. 1987 and 1988 the main opportunistic infections as the primary manifestation of AIDS were pneumocystis carinii pneumonia, toxoplasma encephalitis and candida esophagitis. In summary there is an alteration in the HIV positive population in the last years and concomitantly the clinical spectrum of AIDS is changing.