Document 2740
 DOCN  M94A2740
 TI    Seroreversion in patients with end-stage HIV disease.
 DT    9412
 AU    Gutierrez M; Soriano V; Bravo R; Vallejo A; Gonzalez-Lahoz J; Service of
       Microbiology, Instituto de Salud Carlos III, Madrid,; Spain.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):235 (abstract no. PB0370). Unique
       Identifier : AIDSLINE ICA10/94369835
 AB    Diagnosis of HIV infection depends primarily on detection of specific
       antibodies (Ab). High HIV-Ab levels generally persist until late in the
       course of infection when HIV-Ab to core antigens may decrease,
       reflecting: 1) insufficiency of the perturbed immune system to sustain
       an adequate humoral response; and 2) immune complex formation secondary
       to overproduction of HIV antigens. Seroreversion from positive for
       antibodies to HIV to negative can have far-reaching effects, leading to
       misidentification of persons which can unnoticedly transmit the virus to
       contacts, and whom cannot be benefied themselves from antiretroviral and
       prophylactic therapies. We analyzed the serological reactivity of 29
       subjects (25 men and 4 women; mean age 32) fulfilling criteria for AIDS,
       and whom had positive PCR for specific HIV-1 genomic sequences. All them
       were hospitalized and had less than 50 CD4+ cells/microL. Ten (34%) died
       during the next 3 months of the study. They acquired HIV infection
       through intravenous drug addiction practices (n = 18), homosexual
       contacts (n = 8), and heterosexual relations (n = 3). Sera from all them
       were reactive by third-generation ELISA, and any in the cut-off range.
       HIV antigenemia was detected in 18 (62%) of sera. Reactivity on line
       immunoassay (LIA) was present in all samples, even though one showed
       very weakly reactivity. On Western blot (WB) analysis, 4 sera showed
       exclusive reactivity to one band (gp160 in all them). In addition, 3
       samples only showed reactivity to several env bands. More than a half of
       sera were indeterminate by WB using CDC, FDA, ARC, and CRSS WB
       interpretation criteria. The WHO WB interpretation criteria (which
       requires env reactivity alone to considers positivity) yielded the
       higher sensitivity. Acid pre-treatment of sera allowed to partial
       recovery of gag and pol bands on WB strips in many sera. CONCLUSION:
       Absolute seroreversion, if exist, seems to be a very rare phenomenon.
       However, indeterminate results on WB and likely on first-generation
       ELISAs are common in patients with very advanced HIV disease, as a
       result of a loss of Ab to core proteins.
 DE    Acquired Immunodeficiency Syndrome/CLASSIFICATION/*DIAGNOSIS/
       IMMUNOLOGY  Adult  Blotting, Western  Enzyme-Linked Immunosorbent Assay
       Female  Human  HIV Antibodies/BLOOD  HIV Antigens/BLOOD  HIV
       Seropositivity/CLASSIFICATION/*DIAGNOSIS/IMMUNOLOGY  *HIV-1  Leukocyte
       Count  Male  Polymerase Chain Reaction  T4 Lymphocytes/IMMUNOLOGY
       MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).