An Autopsy-Proved Case of Aids in Taiwan

The 1st case of acquired immunodeficiency syndrome (AIDS) in Taiwan reported in 1986 involved a 25-year-old unmarried man with a 10-year history of homosexual activity with over 100 partners. Clinical signs and symptoms which began in 1985 included abdominal pain loose stools weight loss fever cough headache dizziness loss of memory facial hyperpigmentation and extensive oroesophageal candidiasis. Laboratory studies revealed severe lymphopenia with a reversed T-helper: T-suppressor ratio cutaneous anergy and polyclonal gammopathy. Antibodies to human immunodeficiency virus (HIV) were detected by enzyme-linked immunosorbent assay and Western blot. Autopsy indicated disseminated cytomegalovirus infection extensive central nervous system toxoplasmosis and early lesions of Kaposis sarcoma. The fact that this patient continued his promiscuous sexual activity until June 1985 when symptoms emerged suggests that he probably infected other Taiwanese homosexuals and bisexuals. However since homosexuality is viewed as a disgrace in Taiwan educational efforts aimed at controlling the spread of AIDS in this high-risk group or estimating its prevalence are likely to be met with resistance.