title: Evaluation of an atypical HIV type 1 antibody. Serologic pattern leading to detection of HIV type 2 infection in North America.
abstract: The variability and discordance of human immunodeficiency virus type 1 (HIV-1) antibody enzyme immunoassay determinations on serial specimens derived, to our knowledge, from the first documented case of HIV-2 infection in North America are described. The initial specimen was weakly reactive, but two subsequent serum specimens were both nonreactive by enzyme immunoassay. All specimens were indeterminate for HIV-1 antibody by HIV-1 Western blot analysis. Serum HIV-2 antibody was demonstrated by enzyme immunoassay using whole virus lysate, HIV-2-specific synthetic peptide assays, and HIV-2 Western blot analysis. Human immunodeficiency virus type 2 genomic sequences were demonstrated in peripheral blood mononuclear cells using gene amplification technology. Human immunodeficiency virus type 2, isolated from peripheral blood lymphocytes, had typical morphologic features of lenti-virus by electron microscopy. Western blot analysis and other specific assays should be considered in individuals with clinical evidence suggesting HIV infection who are nonreactive for HIV-1 antibody by enzyme immunoassay or who have atypical reactivity patterns.
authors.affiliation: Department of Pathology, University of Medicine and Dentistry of New Jersey, Newark.
authors.forename: J M
authors.initials: JM
authors.lastname: Lombardo
authors.forename: C R
authors.initials: CR
authors.lastname: Horsburgh
authors.forename: T N
authors.initials: TN
authors.lastname: Denny
authors.forename: J
authors.initials: J
authors.lastname: Michaels
authors.forename: C
authors.initials: C
authors.lastname: Schable
authors.forename: M F
authors.initials: MF
authors.lastname: Meyenhofer
authors.forename: K
authors.initials: K
authors.lastname: Shriver
authors.forename: L R
authors.initials: LR
authors.lastname: Sharer
authors.forename: C Y
authors.initials: CY
authors.lastname: Ou
authors.forename: M A
authors.initials: MA
authors.lastname: Rayfield
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000097:blood / Q000276:immunology* / Q000473:pathology; D000914:Antibodies, Viral / Q000032:analysis*; D015153:Blotting, Western; D002478:Cells, Cultured; D004279:DNA, Viral / Q000032:analysis; D005069:Evaluation Studies as Topic; D005784:Gene Amplification; D015497:HIV-1 / Q000276:immunology*; D015498:HIV-2 / Q000276:immunology*; D006801:Humans; D007124:Immunoenzyme Techniques; D008214:Lymphocytes / Q000648:ultrastructure; D008854:Microscopy, Electron; D009656:North America
chemical_list: D000914:Antibodies, Viral; D004279:DNA, Viral