title: Resolution of infection status of human immunodeficiency virus (HIV)-seroindeterminate donors and high-risk seronegative individuals with polymerase chain reaction and virus culture: absence of persistent silent HIV type 1 infection in a high-prevalence area.
abstract: To address concerns over the prevalence of silent (antibody-negative) infections among blood donors and high-risk populations, a combination of proviral amplification by polymerase chain reaction (PCR) and viral isolation by co-culture techniques was employed to resolve the human immunodeficiency virus type 1 (HIV-1) infection status of well-characterized groups of suspect blood donors and others identified in the blood bank setting. No silent infections were found in 65 follow-up samples from 26 persistently HIV-1-seroindeterminate blood donors, 16 persistently seronegative heterosexual partners of infected transfusion recipients, and 6 high-risk seronegative homosexual men identified through donor look-back investigations. In contrast, 21 seropositive controls tested positive. These results suggest a low prevalence of persistently silent infections in at-risk populations, even in high HIV prevalence regions. The PCR assay, with a co-detected internal positive control, and appropriate confirmatory algorithms, was found to be a useful direct assay to rule out infection, especially in concert with confirmatory virus isolation.
authors.affiliation: Department of Laboratory Medicine, University of California, San Francisco.
authors.forename: B E
authors.initials: BE
authors.lastname: Eble
authors.forename: M P
authors.initials: MP
authors.lastname: Busch
authors.forename: H
authors.initials: H
authors.lastname: Khayam-Bashi
authors.forename: M A
authors.initials: MA
authors.lastname: Nason
authors.forename: S
authors.initials: S
authors.lastname: Samson
authors.forename: G N
authors.initials: GN
authors.lastname: Vyas
mesh_terms: D001782:Blood Donors; D015483:HIV Antibodies / Q000032:analysis*; D015658:HIV Infections / Q000097:blood* / Q000453:epidemiology / Q000382:microbiology; D006679:HIV Seropositivity / Q000175:diagnosis; D015497:HIV-1 / Q000302:isolation & purification; D006716:Homosexuality; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012680:Sensitivity and Specificity; D014776:Virus Cultivation
chemical_list: D015483:HIV Antibodies