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Mortality in young Edinburgh males aged 20-34 years was analysed over the period 1979-88. Proportional mortality was calculated from cause of death data: 23% of deaths were caused by accidents, 16% by infection, 15% by suicide and 9% of deaths were due to cancer. Area mortality rates were measured, and rates were significantly higher (P < 0.001) in sectors of low socio-economic status. Edinburgh has the highest HIV positive prevalence rate in the UK (111 per 100,000) and 10% of known UK HIV positive cases in 1988 were traced to Lothian. The Edinburgh rate for AIDS-related deaths in males aged 20-34 years was 0.57 per 100,000, and has been contrasted with the pattern of mortality in New York where the rate was 35.8 per 100,000. The pattern of mortality amongst young Edinburgh males is likely to register a significant change over the next ten years. The results presented may be used as a standard against which change can be measured.

The cause of the abnormal T lymphocyte subsets reported in healthy homosexual men is not known. Frequent sexually transmitted infections including human T cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) are possible causes. To determine if the T lymphocyte subsets were abnormal in this population in an area without endemic acquired immune deficiency syndrome (AIDS), T lymphocyte subsets of 52 homosexual men in Rochester, New York, were enumerated, and evidence of infections known to cause these abnormalities was sought. Unlike the findings in previous reports, relative numbers of T helper and T suppressor cells and helper/suppressor T cell ratios were normal. Prevalence of cytomegalovirus infection (86 percent) was similar to that found in analogous populations, but only 9 percent had seropositive results for HTLV-III/LAV. Men with serologic evidence of nonprimary cytomegalovirus disease had lower helper/suppressor T cell ratios (1.5 +/- 0.2 versus 2.2 +/- 0.2; p less than 0.01). Hence, despite frequent infections with cytomegalovirus and other sexually transmitted pathogens, T cell subsets are normal in homosexual men in an area without endemic AIDS. Therefore, HTLV-III/LAV is primarily responsible for the T cell abnormalities observed elsewhere.