THE AIDS EPIDEMIC

The nature of the clinical presentation of HIV infection continues to evolve over time. New cutaneous (e.g., seborrheic dermatitis, onychomy cosis, and tinea pedis) and systemic (e.g., Aspergillus fumigatus and Penicillium marneffei) opportunistic fungal infections can now be adde d to the classic clinical markers for progressive HIV infection, such as Kaposi's sarcoma, Pneumocystis carinii pneumonia, Mycobacterium avi um intercellulare infections, and cryptococcal meningitis. The fact th at the appearance of many of these fungal diseases is directly correla ted with the patient's CD4 cell count is a valuable tool for ongoing c linical evaluation. Although systemic manifestations characterize a pr ogression from asymptomatic HIV infection to AIDS, many of the signs o f disease progression are cutaneous. Prophylaxis against many of the p otentially life-threatening systemic opportunistic infections associat ed with HIV positivity has had a positive impact on the life expectanc y of patients with AIDS.