       Document 0582
 DOCN  M9440582
 TI    Absence of prolonged immunosilent infection with human immunodeficiency
       virus in individuals with high-risk behaviors.
 DT    9404
 AU    Coutlee F; Olivier C; Cassol S; Voyer H; Kessous-Elbaz A; Saint-Antoine
       P; He Y; Fauvel M; Centre de Recherche, Hopital Notre-Dame, Montreal,
       PQ, Canada.
 SO    Am J Med. 1994 Jan;96(1):42-8. Unique Identifier : AIDSLINE MED/94136505
 AB    PURPOSE: The presence in some individuals of a prolonged phase of
       infection with human immunodeficiency virus type 1 (HIV-1) before
       seroconversion remains controversial. This study was undertaken to
       determine with a sensitive in vitro amplification technique, the
       polymerase chain reaction (PCR), whether seronegative individuals with
       high-risk behaviors could harbor HIV-1 sequences in their peripheral
       blood mononuclear cells (PBMCs) and remain seronegative for more than 6
       months. PATIENTS AND METHODS: Seronegative individuals who engaged in
       unprotected anogenital intercourse with HIV-1-infected partners or with
       more than 10 individuals per year, and seronegative individuals who
       shared needles with seropositive partners, were recruited prospectively
       over 18 months. HIV-1 DNA and RNA sequences were detected in PBMCs of
       these individuals with three PCR assays using SK38/SK39, SK145/SK431,
       and SK68/SK69. Seronegative but PCR-positive patients were also
       evaluated with p24 antigen capture assay, radioimmunoprecipitation
       assay, and Western blot. The latter patients were followed prospectively
       to reproduce PCR-positive results and monitor serologic responses.
       RESULTS: Sixty-one men and 18 women, with an average age of 34.1 +/- 7.6
       years, were recruited: 56 were homosexual men, 18 were heterosexual
       women, and 5 were heterosexual men. Amplification reactions for HIV-1 of
       104 PBMC specimens from 79 patients with negative or indeterminate
       serologies revealed that 4 patients (5.1%) were positive with PCR for
       HIV-1 DNA and RNA at the time of enrollment. Positive amplification
       reactions could not be reproduced in prospective samples for one
       patient. The analysis of a variable human genomic locus in this
       patient's PBMCs demonstrated that the first PCR-positive sample and
       following PCR-negative samples originated from different patients,
       suggesting a specimen mix-up. Two of the three PCR-positive seronegative
       patients had symptoms suggestive of acute retroviral disease. Sera from
       all three patients contained p24 antigen. Two patients seroconverted
       within 1 month whereas one patient could not be followed prospectively.
       CONCLUSION: Prolonged infection with HIV-1 without seroconversion was
       not found in our population of patients at very high risk for HIV-1
       infection. All PCR-positive patients seroconverted in less than 1 month.
 DE    Adult  Female  Human  HIV Antibodies  *HIV Seronegativity  *HIV
       Seropositivity  *HIV-1/IMMUNOLOGY  Male  Needle Sharing  Polymerase
       Chain Reaction  Prospective Studies  Risk-Taking  *Sex Behavior
       Substance Abuse, Intravenous  Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

