Gerrard J G, McGahan S L, Milliken J S, Mathys J M, Wills E J
Royal Prince Alfred Hospital, Camperdown, NSW.
Med J Aust. 1994 Mar 7;160(5):247-50.
To present the earliest Australian case of the acquired immunodeficiency syndrome (AIDS) reported to date.
A 72-year-old man developed a prolonged illness, beginning in February 1981, characterised by anorexia, malaise, weight loss and an episode of herpes zoster. In July he noted the insidious onset of dyspnoea with a productive cough. He was admitted to hospital in August, where Pneumocystis carinii pneumonia was diagnosed from a transbronchial lung biopsy. Splenomegaly and generalised lymphadenopathy were noted but a scalene lymph node biopsy examined at that time failed to establish an underlying diagnosis. The patient was single and lived alone in an inner suburb of Sydney. He had never left Australia and had never received a blood transfusion. His sexual history is not recorded, nor is there any documented history of intravenous drug use.
The patient died in September 1981. Recent re-examination of the preserved lymph node specimen by means of an in-situ hybridisation method detected human immunodeficiency virus (HIV). Preserved prostatic tissue from a resection performed in January 1980 on the same patient was also found to be HIV positive.
AIDS existed in Australia as early as July 1981, around the time of the publication of the first American case reports. Whether this represents an isolated case in a man who progressed rapidly because of his relatively advanced age, or whether HIV was present earlier in Australia than previously thought, remains unanswered.
呈现迄今所报告的澳大利亚最早的获得性免疫缺陷综合征（艾滋病）病例。
一名72岁男性自1981年2月起患病，病程迁延，表现为厌食、不适、体重减轻及一次带状疱疹发作。7月，他注意到隐匿起病的呼吸困难伴咳痰。8月入院，经支气管肺活检诊断为卡氏肺孢子虫肺炎。发现脾肿大及全身淋巴结病，但当时进行的斜角肌淋巴结活检未能明确潜在诊断。患者单身，独居在悉尼内城区。他从未离开过澳大利亚，也从未接受过输血。其性病史未记录，也无静脉注射毒品的记录病史。
患者于1981年9月死亡。近期通过原位杂交方法对保存的淋巴结标本进行重新检查，检测到人类免疫缺陷病毒（HIV）。1980年1月对同一患者进行前列腺切除术时保存的前列腺组织也被发现HIV阳性。
早在1981年7月澳大利亚就存在艾滋病，大约是美国首次病例报告发表之时。这究竟是一名因年龄较大而病情进展迅速的男性的孤立病例，还是HIV在澳大利亚出现的时间比之前认为的更早，尚无定论。
