title: Detection of human immunodeficiency virus type 1 infection by polymerase chain reaction in a cohort of seronegative intravenous drug users.
abstract: The frequency of serologically undetected human immunodeficiency virus type 1 (HIV-1) infection among a large cohort of seronegative intravenous drug users (IVDUs) was determined by polymerase chain reaction (PCR). In total, 2159 blood specimens were obtained from 945 seronegative IVDUs; of these, 182 had 1 specimen, 339 had 2, 397 had 3, and 27 had 4 semiannual specimens. No proviral DNA was detected in 2134 (98.8%) of the samples. Specimens from 7 persons (0.3%) were reactive by PCR. Within 6 months, all 5 of these 7 who returned for follow-up visits had seroconverted. Serum from 19 persons (0.9%) were equivocal by PCR analysis, that is, single primer pair amplification; 1 person seroconverted while others subsequently remained seronegative and nonreactive by PCR. The concordance between PCR and serology was 98.6%. It is concluded that immunosilent HIV-1 infection is uncommon and that serologic screening for HIV-1 antibodies is highly sensitive in this population.
authors.affiliation: Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.
authors.forename: H
authors.initials: H
authors.lastname: Farzadegan
authors.forename: D
authors.initials: D
authors.lastname: Vlahov
authors.forename: L
authors.initials: L
authors.lastname: Solomon
authors.forename: A
authors.initials: A
authors.lastname: Muñoz
authors.forename: J
authors.initials: J
authors.lastname: Astemborski
authors.forename: E
authors.initials: E
authors.lastname: Taylor
authors.forename: A
authors.initials: A
authors.lastname: Burnley
authors.forename: K E
authors.initials: KE
authors.lastname: Nelson
mesh_terms: D000293:Adolescent; D000328:Adult; D002460:Cell Line; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D006679:HIV Seropositivity / Q000382:microbiology; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D011446:Prospective Studies; D015819:Substance Abuse, Intravenous / Q000150:complications*