title: Human immunodeficiency virus type 1 nucleic acids detected before p24 antigenemia in a blood donor.
abstract: A blood donation from a 46-year-old homosexual man was discarded because of elevated alanine aminotransferase levels. Thirteen days later, the patient presented with symptomatic primary human immunodeficiency virus type 1 (HIV-1) infection. Virologic investigations were performed retrospectively on blood samples (including the donated blood) obtained before the symptoms. The HIV-1 genome was present, either integrated in mononuclear cell DNA or circulating in plasma, 39 days before the appearance of p24 antigen and 65 days before the appearance of HIV-1 or HIV type 2 antibody. It is concluded that p24 antigenemia is present during only a fraction of the seronegative "window" period. This case illustrates the risk of infection associated with blood transfusion in spite of HIV-1 antibody testing and stresses the need to improve nontechnical exclusion procedures as well as non-antibody-based diagnostic tests.
authors.affiliation: Central Laboratory of Virology, Geneva University Hospital, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: de Saussure
authors.forename: S
authors.initials: S
authors.lastname: Yerly
authors.forename: E
authors.initials: E
authors.lastname: Tullen
authors.forename: L H
authors.initials: LH
authors.lastname: Perrin
mesh_terms: D001483:Base Sequence; D001782:Blood Donors; D016655:HIV Core Protein p24 / Q000097:blood*; D006679:HIV Seropositivity / Q000382:microbiology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data
chemical_list: D016655:HIV Core Protein p24