ABSENCE OF PROLONGED IMMUNOSILENT INFECTION WITH HUMAN-IMMUNODEFICIENCY-VIRUS IN INDIVIDUALS WITH HIGH-RISK BEHAVIORS

被引:19
作者
COUTLEE, F
OLIVIER, C
CASSOL, S
VOYER, H
KESSOUSELBAZ, A
SAINTANTOINE, P
HE, YL
FAUVEL, M
机构
[1] CTR EXCELLENCE HIV AIDS,VANCOUVER,BC,CANADA
[2] INST CANC RES,MONTREAL,PQ,CANADA
[3] LAB SANTE PUBL QUEBEC,MONTREAL,PQ,CANADA
[4] UNIV MONTREAL,DEPT MICROBIOL,MONTREAL,PQ,CANADA
[5] UNIV MONTREAL,DEPT IMMUNOL,MONTREAL,PQ,CANADA
[6] CLIN MED ACTUEL,MONTREAL,PQ,CANADA
关键词
D O I
10.1016/0002-9343(94)90114-7
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 HTV-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. HTV-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.
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页码:42 / 48
页数:7
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