Loss of Human Immunodeficiency Virus Type 1 (HIV-I) Antibodies with Evidence of Viral Infection in Asymptomatic Homosexual Men

doi:10.1059/0003-4819-108-6-785

Loss of Human Immunodeficiency Virus Type 1 (HIV-I) Antibodies with Evidence of Viral Infection in Asymptomatic Homosexual Men

A Report from the Multicenter AIDS Cohort Study

HOMAYOON FARZADEGAN, Ph.D.;
MICHAEL A. POLIS, M.D., M.P.H.;
STEVEN M. WOLINSKY, M.D.;
CHARLES R. RINALDO, Jr., Ph.D.;
JOHN J. SNINSKY, Ph.D.;
SHIRLEY KWOK, B.S.;
ROBERT L. GRIFFITH, B.S.;
RICHARD A. KASLOW, M.D., M.P.H.;
JOHN P. PHAIR, M.D.;
B. FRANK POLK, M.D., M.Sc.; and
ALFRED J. SAAH, M.D., M.P.H.

Baltimore and Bethesda, Maryland; Emeryville and Los Angeles, California; Chicago, Illinois; and Pittsburgh, Pennsylvania

Abstract

Four asymptomatic homosexual men reverted from positive to negative serologic results for the human immunodeficiency virus, type 1 (HIV-I) over 2.5 years, as shown by enzyme-linked immunosorbent assay (ELISA) and Western blot. Antibody bands in the Western blot from three men were undetectable 6 to 12 months after being positive; gradual fading of the number and intensity of bands was seen in the other man. No HIV-1-p24 antigenemia was detected; cryopreserved peripheral blood mononuclear cells were negative for HIV-1 by standard culture assay. Polymerase chain reaction (gene amplification) assays were done on peripheral blood mononuclear cells and showed the HIV-1 provirus in all subjects 6 to 18 months after the last positive antibody test. Serum specimens from each participant were genetically identical. Polymerase chain reaction showed that peripheral blood mononuclear cells from one subject at different times matched by HLA DNA typing. Clinical and laboratory features of these four men were similar to those of other seronegative subjects. Rare, asymptomatic persons seropositive for HIV-1 may not remain seropositive, but may remain latently infected with HIV-1.

Article and Author Information

▸From The Johns Hopkins University School of Hygiene and Public Health, Baltimore; National Institute of Allergy and Infectious Diseases and National Cancer Institute, National Institutes of Health, Bethesda, Maryland; Howard Brown Memorial Clinic, Northwestern University, Chicago, Illinois; University of California, Los Angeles; Departments of Infectious Diseases and Human Genetics, Cetus Corporation, Emeryville, California; University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
Baltimore: The Johns Hopkins University School of Hygiene and Public Health: B. Frank Polk, M.D., M.Sc., Principal Investigator; Alfred J. Saah, M.D., M.P.H., Homayoon Farzadegan, Ph.D., Robin Fox, M.S., Joseph Margolick, M.D., Ph.D., Justin McArthur, M.B., B.S.
Chicago: Howard Brown Memorial Clinic—Northwestern University Medical School: John P. Phair, M.D., Principal Investigator; Joan S. Chmiel, Ph.D.; Steven M. Wolinsky, M.D.
Los Angeles: University of California, Los Angeles: Roger Detels, M.D., M.S., Principal Investigator; Barbara R. Visscher, M.D., Dr. P.H.; John L. Fahey, M.D., M.S.; Janis V. Giorgi, Ph.D.; Jan Dudley, M.P.H., Anne Coulson, M.D.
Pittsburgh: University of Pittsburgh Graduate School of Public Health: Charles R. Rinaldo, Jr., Ph.D., Principal Investigator; Monto Ho, M.D.; Lawrence A. Kingsley, Dr. P.H.; David W. Lyter, M.D.; Phalguni Gupta, Ph.D.; Ronald O. Valdiserri, M.D.; Alan Winkelstein, M.D.
National Institutes of Health: National Institute of Allergy and Infectious Diseases: Harold M. Ginzburg, M.D., J.D., M.P.H., Project Officer; Richard A. Kaslow, M.D., M.P.H.; Mark J. VanRaden, M.A.; Michael A. Polis, M.D., M.P.H.; National Cancer Institute: Iris Obrams, M.D., M.P.H.
Departments of Infectious Diseases and Human Genetics, Cetus Corporation, Emeryville, CA 94608.
Data Coordinating Center: CAMACS, The Johns Hopkins School of Hygiene and Public Health: Alvaro Munoz, Ph.D., Principal Investigator; L.P. Jacobson, K.Y. Liang, C. Meinert, S. Su, M.C. Wang, S. Zeger.
Grant support: by grants N01-AI-72631, 72632, 72634, 72676, and 32535.
▸Requests for reprints should be addressed to Homayoon Farzadegan, Ph.D.; Department of Epidemiology, The Johns Hopkins University, School of Hygiene and Public Health, 615 N. Wolfe Street; Baltimore, MD 21205.