Vall d’Hebron Hospital diagnosed the first case of HIV in Spain

In October 1981, Vall d’Hebron University Hospital diagnosed the first case of AIDS in Spain. The patient was a 35-year-old man who was admitted with deterioration in his general, neurological, respiratory and skin conditions. A scan and the medical team identified a three-centimetre tumour in the brain, which was interpreted as a metastasis. He underwent emergency surgery, but four days after the operation, the patient died.
 
Dr Carmen Navarro, who at the time was head of the Pathological Anatomy Section at Vall d’Hebron, was responsible for analysing the tumour and conducting the neurological autopsy, where, instead of tumour cells, she found parasitised cells that she linked to toxoplasmosis. The finding was surprising, as it was an infection seen only in newborns. They experienced that moment with great uncertainty, as they had to make a diagnosis based on the clinical data and the findings of the pathological anatomy analysis, which, on the face of it, did not match.
 
This was the first case of HIV described in Spain, but also the first time that Toxoplasma brain infection was linked to AIDS. The case was published in an article in The Lancet, which linked the outbreak of Kaposi’s sarcoma and other opportunistic infections that had recently appeared among the homosexual population in the United States to Toxoplasma infection. This detail was key to diagnosing AIDS in future patients.
 
At the time, the disease had not yet been named Acquired Immunodeficiency Syndrome (AIDS). It was not until two years later, in 1983, that French virologist Luc Montagnier, from the Pasteur Institute in Paris and Nobel Prize winner in Medicine in 2008, isolated and identified the virus that was wreaking havoc, particularly among the homosexual population.
 
Although the first cases were detected in men who had sex with men, the disease soon began to appear in patients with haemophilia or drug addictions, and not only in men, but also in women and children.
 
After the first case, there was a constant flow of patients with opportunistic infections, and the 30 beds that Vall d’Hebron Hospital allocated to these patients were always occupied. In the Infectious Diseases Department, which was headed by Dr Albert Pahissa at the time, the care burden was extremely high.
 
In those early years, there was practically nothing that could be done for the patients. In 1987, the first antiretroviral drug, AZT, was introduced. It blocked the replication of the virus, but it was highly toxic. It was not until 1996 that a combination of three drugs became available, reversing mortality and changing the course and prognosis of the disease. Today, AIDS is a chronic disease, and patients have a life expectancy similar to that of the general population.

What the media (did not) report

At the time, the media did not report on the diagnosis. In fact, La Vanguardia published its first article about AIDS on 16 January 1983, shortly after creating a dedicated science section. The article, titled “AIDS: a new and enigmatic disease”, was written by Dr Antonio Salgado from Vall d’Hebron Hospital. It was published with a photograph and across five columns in the newspaper’s science section, highlighting the enigmatic nature of the disease.