Robert R. (early 1953 – May 15 or May 16, 1969) was an American teenager from Missouri who was the victim of the first confirmed case of HIV/AIDS in North America. His death at the age of 16 baffled doctors, and not until 1984 was the cause of his death identified.
In early 1968, Robert R. (whose last name has been kept confidential), an American teenager, admitted himself to the Barnes-Jewish Hospital (then called the Barnes Hospital) in St. Louis, Missouri. His legs and genitals were covered in warts and sores he also had severe swelling in the testicles and pelvic region (which later spread to his legs, causing a mis-diagnosis of lymph node edema); he had grown thin and pale, and suffered from shortness of breath. Robert told the doctors that he had suffered symptoms since at least late 1966, and tests discovered a severe chlamydia infection. Robert explicitly declined a rectal examination request from hospital personnel. Robert said he was sexually active with a girl from his neighborhood, but doctors suspected he was homosexual or bisexual. Doctors who have investigated the Robert R. case have noted that his symptoms were most commonly found in homosexuals, and speculated that he may have been a male prostitute.
In late 1968, Robert's condition seemed to have stabilized, but by March 1969 his symptoms reappeared, and had worsened. He had more trouble breathing and his white blood cell count had plummeted. The doctors found that his immune system had somehow ceased to function. He developed a fever and died at 11:20pm on May 15, 1969.
On the day of Robert's death, an autopsy uncovered several abnormalities. The autopsy, led by Dr. William Drake, revealed small purplish lesions on Robert's left thigh and his soft tissue. Drake concluded that the lesions were Kaposi's sarcoma, a rare type of cancer that, up to that time, mostly affected elderly Jewish and Italian men. Kaposi's sarcoma was later determined to be an AIDS defining illness. The sarcomas were also found in Robert's rectum and anus, which had never occurred in previous cases.
These findings baffled the attending doctors, and a review of Robert's case was eventually published in a medical journal in 1973. After the autopsy, samples of some of his tissues were kept in cold storage at facilities at the University of Arizona and at the laboratory of Dr. Memory Elvin-Lewis, who had assisted in Robert's autopsy.
In early 1968, Robert R. (whose last name has been kept confidential), an American teenager, admitted himself to the Barnes-Jewish Hospital (then called the Barnes Hospital) in St. Louis, Missouri. His legs and genitals were covered in warts and sores he also had severe swelling in the testicles and pelvic region (which later spread to his legs, causing a mis-diagnosis of lymph node edema); he had grown thin and pale, and suffered from shortness of breath. Robert told the doctors that he had suffered symptoms since at least late 1966, and tests discovered a severe chlamydia infection. Robert explicitly declined a rectal examination request from hospital personnel. Robert said he was sexually active with a girl from his neighborhood, but doctors suspected he was homosexual or bisexual. Doctors who have investigated the Robert R. case have noted that his symptoms were most commonly found in homosexuals, and speculated that he may have been a male prostitute.
In late 1968, Robert's condition seemed to have stabilized, but by March 1969 his symptoms reappeared, and had worsened. He had more trouble breathing and his white blood cell count had plummeted. The doctors found that his immune system had somehow ceased to function. He developed a fever and died at 11:20pm on May 15, 1969.
On the day of Robert's death, an autopsy uncovered several abnormalities. The autopsy, led by Dr. William Drake, revealed small purplish lesions on Robert's left thigh and his soft tissue. Drake concluded that the lesions were Kaposi's sarcoma, a rare type of cancer that, up to that time, mostly affected elderly Jewish and Italian men. Kaposi's sarcoma was later determined to be an AIDS defining illness. The sarcomas were also found in Robert's rectum and anus, which had never occurred in previous cases.
These findings baffled the attending doctors, and a review of Robert's case was eventually published in a medical journal in 1973. After the autopsy, samples of some of his tissues were kept in cold storage at facilities at the University of Arizona and at the laboratory of Dr. Memory Elvin-Lewis, who had assisted in Robert's autopsy.
In 1984, when HIV was officially discovered and had started spreading at dangerous levels in New York City and Los Angeles, Dr. Marlys Witte, one of the doctors who, like Elvin-Lewis, had cared for Robert before death and also assisted in the autopsy, thawed and tested preserved tissue samples from Robert's autopsy. Five years later, in June 1989, Witte decided to test the tissue samples again using more recent technology, settling on western blot, the most sensitive test for antibodies then available. The western blot found that antibodies against all nine detectable HIV proteins were present in Robert's blood. A second test found identical results.
Robert had never traveled outside the United States and, indeed, never left the Midwest, and had told doctors that he had never received a blood transfusion. Since Robert's infection was almost certainly through sexual contact and he had never left the country, it is obvious that he must have received the virus from somebody else already living with it in the United States, meaning that AIDS was present in North America before Robert began showing symptoms in 1966. He also never ventured into cosmopolitan cities such as New York, Los Angeles, or San Francisco which were the sites where the HIV-AIDS epidemic was first observed in the United States.
In his 1999 book The River, journalist Edward Hooper questioned whether Robert really died from AIDS. Hooper noted that Robert's grandfather had reportedly suffered from similar symptoms (suggesting a congenital immunodeficiency) and that he may have been exposed to toxins in his childhood. Hooper claimed that Robert's symptoms were (with the exception of his Kaposi's sarcoma) not wholly typical of AIDS patients. Hooper also noted that Robert's sexual history may have been more prosaic than suspected, and reported that one apparent sexual partner of Robert's was still alive decades later. Hooper also claimed that the HIV testing carried out might have used a technique (a more powerful form of the Western blot test developed by Biotech) that he claimed could generate false positives. However, Hooper has also promoted the scientifically discounted OPV AIDS hypothesis, and his ideas about AIDS have not always been well-received by medical professionals (en.wikipedia.org)
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