The First Case of Acquired Immunodeficiency Syndrome (AIDS) Diagnosed in Taiwan
1986 Vol.2 NO.4
On January 28, 1986, a young male homosexual Taipei City resident was admitted to National Taiwan University Hospital (NTUH) with a 2－3 day history of severe headaches, dizziness, vomiting, and memory loss. On physical examination, the patient was thin and appeared chronically ill. Neurologic findings included mild bilateral papilledema, bilateral hyperreflexia, and a right-sided Babinski sign. A computed-tomographic brain scan showed multiple, hypodense, contrast-enhancing mass lesions in the right frontal, left frontal-parietal, and occipital areas. Complete blood count on admission showed a hemoglobin of 11.9 g/100 ml and a leukocyte count of 3,800/mm3 with n absolute lymphocyte count of 304/mm3. Lumbar puncture showed an elevated cerebrospinal fluid (CSF) protein. India ink test, acid-fast stain, and bacterial cultures on CSF were negative. CSF antibody titres for toxoplasma, cytomegalovirus, herpes simplex, varicella zoster, Epstein-Barr virus, and adenovirus were all negative. Serology for toxoplasma and viral antigens were also negative. Serum electrophoresis showed elevated levels of IgG and IgA immunoglobulins. Blood cultures were negative. Skin tests against streptokinase/strepto-dornase, tuberculin, and aspergillus antigens were negative; skin test against Candida was positive. The patient was positive for antibody to the human T-lymphotrophic virus type III (HTL V-III) by enzyme immunosorbent assay (EIA) (mean absorbance 0.954, negative cutoff = 0.167, absorbance ratio 5.7)*. Western Blot assay* was also positive for both gp4 1 and p24 protein bands. The patient’s ratio of T-helper to T-suppressor lymphocytes (TH/Ts) was 0.37 (normal: > 1.0). An open brain biopsy did not yield a diagnosis of the brain lesions.