title: Normal immune function and inability to isolate virus in culture in an individual with long-term human immunodeficiency virus type 1 infection.
abstract: A detailed, longitudinal study was undertaken to investigate the immunological and virological features of an individual with hemophilia infected with human immunodeficiency virus type-1 (HIV-1) for 10 years without disease. Methods applied to serial samples of peripheral blood included Western blot analysis, neutralizing antibody assays, antibody-dependent cell-mediated cytotoxicity (ADCC) titration, HIV-1 specific cytotoxic T lymphocyte (CTL) assays, viral cultures, and PCR with sequence analysis of viral regulatory genes. Strong antibody responses against HIV-1 antigens as measured by Western blot and ADCC assays have persisted throughout infection. Repeated attempts to isolate HIV-1 using sensitive culture techniques and to demonstrate viremia with standard PCR methods have failed. Using the "booster" PCR technique, a period of viremia in peripheral blood mononuclear cells was demonstrated. Concurrent with detection of circulating virus, titers of neutralizing antibodies and circulating HIV-1-specific CTLs became measurable. Sequencing studies of a portion of the viral genome showed no significant abnormalities of the regulatory genes. In this individual, the combination of low viral load in the peripheral blood and a strong, responsive immune system is associated with long-term, disease-free coexistence with HIV-1 infection.
authors.affiliation: Department of Pediatrics, University of Massachusetts Medical School, Worcester 01605.
authors.forename: T C
authors.initials: TC
authors.lastname: Greenough
authors.forename: M
authors.initials: M
authors.lastname: Somasundaran
authors.forename: D B
authors.initials: DB
authors.lastname: Brettler
authors.forename: R M
authors.initials: RM
authors.lastname: Hesselton
authors.forename: A
authors.initials: A
authors.lastname: Alimenti
authors.forename: F
authors.initials: F
authors.lastname: Kirchhoff
authors.forename: D
authors.initials: D
authors.lastname: Panicali
authors.forename: J L
authors.initials: JL
authors.lastname: Sullivan
mesh_terms: D000920:Antibody-Dependent Cell Cytotoxicity; D004279:DNA, Viral / Q000235:genetics / Q000302:isolation & purification; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000150:complications / Q000276:immunology* / Q000382:microbiology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006467:Hemophilia A / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D016133:Polymerase Chain Reaction; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D013997:Time Factors; D014766:Viremia / Q000382:microbiology; D014776:Virus Cultivation; D014779:Virus Replication
chemical_list: D004279:DNA, Viral; D015483:HIV Antibodies