Opportunistic Infections and Kaposi's Sarcoma Among Haitians: Evidence of a New Acquired Immunodeficiency State

Abstract

Twenty Haitian patients, hospitalized from 1 April 1980 to 20 June 1982, had Pneumocystis carinii pneumonia, central nervous system toxoplasmosis, esophageal candidiasis, cryptococcosis, disseminated cytomegalovirus, progressive herpes simplex virus, chronic enteric coccidiosis, or invasive Kaposi's sarcoma. Ten patients died. Opportunistic infections were frequently multiple and were recurrent in three patients. In seven patients disseminated tuberculosis preceded the other infections by 2 to 15 months. There was no evidence of an underlying immunosuppressive disease, and no history of homosexuality or intravenous drug abuse. At least three patients probably acquired the syndrome in Haiti. Lymphadenopathy was common. Seventeen patients tested had anergy, and 18 had lymphopenia. Monoclonal antibody analysis of peripheral-blood T-cell subsets done on 11 patients showed a marked decrease in T-helper cells and an inversion of the normal ratio of T-helper cells to T-suppressor cells. This syndrome among heterosexual Haitians is strikingly similar to the syndrome of immunodeficiency described recently among American homosexuals.

The emergence of HIV/AIDS in the Americas and beyond

“…Peripheral blood mononuclear cell (PBMC) samples were collected in 1982 and 1983 at Jackson Memorial Hospital in Miami, FL, during one of the first investigations establishing that Haitians in Haiti and elsewhere were at risk for AIDS (6). One of the six PBMC samples obtained for this study failed to yield any amplifiable HIV-1 PCR products.…”

“…Soon after the initial recognition of AIDS (5), evidence of a high prevalence of the syndrome among Haitian immigrants in the United States (6) helped fuel speculation that Haiti may have been the source of the mysterious newly identified syndrome (7). It has since become clear that the causative agent, HIV-1 group M, actually originated not in Haiti but in central Africa, apparently sometime around 1930 (8,9).…”

“…To test these hypotheses, we recovered complete HIV-1 env and partial gag gene sequences from archival specimens collected in 1982-1983 from five Haitian AIDS patients, all of whom had recently immigrated to the United States and were among the first recognized AIDS victims (6). Being independent of and much older than the few previously published Haitian HIV-1 full-length env strains, these archival sequences offer a unique opportunity for resolving the origin and emergence of subtype B.…”

Influence of Molecular Sizes of Cryptococcus neoformans Capsular Polysaccharide on Phagocytosis

“…The Cryptococcosis is the only deep-seated mycosis that strikes even in immunocompetent persons in Japan, and is also an important disease to the implanted or AIDS patients (13,19). Cryptococcus neoformans (C. neoformans), the single pathogen of cryptococcosis, usually invades through the lower respiratory tracts, and has a great affinity for the meninx (12).…”

Using next generation sequencing to tackle non-typhoidal Salmonella infections

“…The greatest contributor to disease burden over the past decade is undoubtedly the increase in HIV-NTS co-infection [3,4,5,6] associated with a very high mortality [7,8]. The first report of NTS in an acquired immune deficiency syndrome (AIDS) patient was from Haiti in 1983 [9] and five case reports from New York, United States of America (USA,) all with S. Typhimurium, were reported in 1985 [10]. Since then the impact of HIV on the cause of invasive salmonellosis has been dramatic: In one hospital in Ho Chi Minh City, Viet Nam, positive blood cultures for S. Typhi dropped from hundreds per year in the 1990s to tens in the 2000s with an associated increase in NTS and Penicillium marneffei as the most common blood culture isolate [11].…”