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AIDS in the pre-AIDS era.

D Huminer1, J B Rosenfeld, S D Pitlik

  • 1Department of Internal Medicine C, Beilinson Medical Center, Petah Tiqva, Israel.

Reviews of Infectious Diseases
|November 1, 1987
PubMed
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Before the recognized Acquired Immunodeficiency Syndrome (AIDS) epidemic, 19 cases exhibited symptoms and met diagnostic criteria. These historical cases suggest sporadic, unrecognized instances of AIDS occurred prior to the 1980s.

Area of Science:

  • Medical research
  • Epidemiology
  • Retrospective analysis

Background:

  • Review of medical literature from 1950 onwards to identify pre-epidemic Acquired Immunodeficiency Syndrome (AIDS) cases.
  • Establishment of criteria for retrospective case identification based on the Centers for Disease Control's surveillance definition and clinical presentation.
  • Geographical distribution of reported cases across North America, Western Europe, Africa, and the Middle East.

Observation:

  • Nineteen probable AIDS cases identified prior to the recognized epidemic.
  • Patient demographics: mean age 37 years, male-to-female ratio 1.7:1.
  • Clinical characteristics: 16 cases with opportunistic infections (OIs) without Kaposi's sarcoma (KS), remainder with disseminated KS.
  • Commonest OI was *Pneumocystis carinii* pneumonia; risk factors included homosexuality and residence in Africa or Haiti.
Keywords:
Acquired Immunodeficiency Syndrome--historyAfricaAmericasAsiaBehaviorDeveloped CountriesDeveloping CountriesDiseasesEuropeHistorical SurveyHiv InfectionsHomosexualsLiterature ReviewNorth AmericaNorthern AfricaNorthern AmericaSex BehaviorViral DiseasesWestern AsiaWestern Europe

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  • Evidence of possible iatrogenic or familial transmission in two instances.

    • Findings:

    • Retrospective analysis confirmed 19 cases meeting AIDS surveillance criteria before the epidemic.
    • Opportunistic infections were the predominant clinical manifestation, with *Pneumocystis carinii* pneumonia being most frequent.
    • Kaposi's sarcoma occurred in a minority of cases, often disseminated.

    Implications:

    • The findings suggest that Acquired Immunodeficiency Syndrome (AIDS) occurred sporadically and was unrecognized before the widely acknowledged epidemic.
    • Historical data provides valuable context for understanding the natural history and early evolution of the disease.
    • Highlights the importance of thorough literature review and retrospective analysis in epidemiological studies.