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The First Case

Patricia C. Kloser, MD; Anthony J. Mangia, MD; Joan Leonard, MD; Joseph M. Lombardo, MD, PhD; Jennifer Michaels, MD; Thomas N. Denny; Leroy Sharer, MD; Sadna Sathe, MD, PhD; Stanley H. Weiss, MD; Charles Schable, MS; Charles Robert Horsburgh, Jr, MD; James Oleske, MD; Rajendra Kapila, MD

Arch Intern Med. 1989;149(8):1875-1877.

Abstract
• A 41-year-old woman from the Cape Verde Islands, Africa, who had been residing in the United States for 11 months was found to have human immunodeficiency virus type 2 (HIV-2)-associated acquired immunodeficiency syndrome (AIDS). Antibody to HIV-2 was found by enzyme immunoassay and was verified by radioimmunoprecipitation. The patient was being treated for pulmonary tuberculosis at the time of her admission to our institution. Further laboratory and clinical evaluation at our facility revealed depressed CD4 lymphocytes, oral candidiasis, and cryptococcal meningitis with indeterminate results on serologic testing for HIV type 1 (HIV-1). The biopsy specimen of a lesion in the right occipital lobe of the brain documented Toxoplasma gondii, indicating a clinical diagnosis of AIDS. To our knowledge, our study presents the first known patient with HIV2-associated AIDS in the United States. Our patient provides further evidence that HIV-2 causes severe immunodeficiency and opportunistic infection. The condition should be suspected in the face of normal or repeatedly equivocal HIV-1 antibody test results in the presence of clinically documented AIDS.

(Arch Intern Med. 1989;149:1875-1877)

Author Affiliations
From the Departments of Medicine (Drs Kloser, Mangia, Leonard, Sathe, and Kapila), Infectious Diseases (Drs Kloser, Mangia, Sathe, Oleske, and Kapila), Pathology (Drs Lombardo and Sharer), Neurosciences (Dr Michaels), Preventive Medicine (Dr Weiss), and Pediatric Allergy—Immunology (Drs Oleske and Mr Denny), University of Medicine and Dentistry of New Jersey, Newark, and the AIDS Program, Centers for Disease Control, Atlanta, Ga (Mr Schable and Dr Horsburgh).

Footnotes
Accepted for publication December 6,1988.

Reprint requests to Department of Medicine, Division of Infectious Disease, University of Medicine and Dentistry of New Jersey, 185 S Orange Ave, Newark, NJ 07103-2757 (Dr Kloser).

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