From: Sam Damon <[email-masked]>
Date: Wed, 23 Feb 1994 04:05:14 -0500 (EST)

> Date: Sun, 20 Feb 1994 16:49:31 -0600
> From: [email-masked]
> Subject: 6 months and still negative?
> 
> Some have been throwing around info on the gaynet that there are people 
> who have tested negative after the 6 month window period, even though they
> were really positive all along.  A phone call to the CDC will let you know
> that this is false information, and not ONE documented case of the above
> described scenario is known of.

I'm not sure what criteria the CDC uses to determine documentation but here
are several cases.  I did a search on the name "Imagawa" because I was
familiar with his studies.  These studies were both published in very
reputable journals (Annals of Internal Medicine, and The New England Journal
of Medicine).  Please note that the cases cited in both studies may be the
same.

===============================

                            MEDLINE (R) 1989                        4 of 12
TI: Human immunodeficiency virus type 1 (HIV-1) infection a median of 18
months before a diagnostic western blot. Evidence from a cohort of
homosexual men [see comments]
CM: Comment in: Ann Intern Med 1990 May 15;112(10):797-8
AU: Wolinsky-SM; Rinaldo-CR; Kwok-S; Sninsky-JJ; Gupta-P; Imagawa-D;
Farzadegan-H; Jacobson-LP; Grovit-KS; Lee-MH; et-al
AD: Northwestern University Medical School, Chicago, Illinois.
SO: Ann-Intern-Med. 1989 Dec 15; 111(12): 961-72
ISSN: 0003-4819
PY: 1989
LA: ENGLISH
CP: UNITED-STATES
AB: STUDY OBJECTIVE: To study the natural history of human immunodeficiency
virus type 1 (HIV-1) infection, we used an in-vitro amplification technique
to detect HIV-1 nucleic acid sequences in sequential aliquots of peripheral
blood mononuclear cells from homosexual men enrolled in the Multicenter AIDS
Cohort Study. DESIGN and PATIENTS: Blinded, longitudinal study of 24
homosexual men who were positive for HIV-1 antibodies at a recent follow-up
visit. MEASUREMENTS and MAIN RESULTS: Coded clinical samples were evaluated
using two enzyme-linked immunosorbent assays (whole virus and gp120-gp41
fragment), Western blot, a p24 antigen capture assay, virus cocultivation,
and in-vitro amplification of conserved regions from the HIV-1 gag and env
open-reading frames. In 20 of the 24 men an HIV-1 enzymatically amplified
product was detected before HIV-1 antibody seroconversion: at 42 months
before seroconversion in two cases; at 36 months in one case; at 30 months
in one case; at 24 months in four cases; at 18 months in eight cases; at 12
months in one case; and at 6 months in three cases (median, 18 months). In
the four other men, detection of an HIV-1 enzymatically amplified product
was concurrent with confirmation of antibody seroconversion by Western blot.
CONCLUSIONS: There is a long and variable interval between virus acquisition
and a diagnostic serum antibody response, perhaps due to the prolonged,
persistent infection characteristic of the lentiviruses (family
Retroviridae).
MESH: Blotting,-Western; Enzyme-Linked-Immunosorbent-Assay;
Gene-Amplification; Gene-Products,-gag-analysis; Homosexuality-;
HIV-Antigens-analysis; HIV-1-genetics; HIV-1-immunology;
HIV-1-isolation-and-purification; Prospective-Studies; Proviruses-genetics;
Proviruses-isolation-and-purification; T-Lymphocytes; Time-Factors;
Viral-Core-Proteins-analysis; Virus-Cultivation
MESH: *AIDS-Serodiagnosis; *HIV-Infections-diagnosis; *HIV-1
TG: Human; Male; Support,-U.S.-Gov't,-P.H.S.
PT: JOURNAL-ARTICLE
CN: N01AI72631; N01AI72632; N01AI72634
RN: 0; 0; 0; 0
NM: Gene-Products,-gag; HIV-Antigens; HIV-Core-Protein-p24;
Viral-Core-Proteins
AN: 90087496
UD: 9003
SB: AIM

                            MEDLINE (R) 1989                        8 of 12
TI: Human immunodeficiency virus type 1 infection in homosexual men who
remain seronegative for prolonged periods.
AU: Imagawa-DT; Lee-MH; Wolinsky-SM; Sano-K; Morales-F; Kwok-S; Sninsky-JJ;
Nishanian-PG; Giorgi-J; Fahey-JL; et-al
AD: Department of Pediatrics, University of California at Los Angeles,
School of Medicine, Torrance 90509.
SO: N-Engl-J-Med. 1989 Jun 1; 320(22): 1458-62
ISSN: 0028-4793
PY: 1989
LA: ENGLISH
CP: UNITED-STATES
AB: Infection with the human immunodeficiency virus type 1 (HIV-1), as
demonstrated by viral cultures, has been described in some patients before
antibodies to HIV-1 can be detected, but the duration and frequency of such
latent infections are uncertain. We selected prospectively a cohort of 133
seronegative homosexual men who continued to be involved in high-risk sexual
activity, and we cultured 225 samples of their peripheral-blood lymphocytes,
using mitogen stimulation to activate the integrated HIV-1 genome. HIV-1 was
isolated in blood samples from 31 of the 133 men (23 percent), 27 of whom
have remained seronegative for up to 36 months after the positive culture.
The other four men seroconverted 11 to 17 months after the isolation of
HIV-1. In three of them, we studied cryopreserved lymphocytes obtained
earlier, using the polymerase chain reaction to amplify small amounts of
viral DNA, and we demonstrated that HIV-1 provirus had been present 23, 35,
and 35 months before seroconversion. We conclude that HIV-1 infection in
homosexual men at high risk may occur at least 35 months before antibodies
to HIV-1 can be detected. A prolonged period of latency in such infections
may be more common than previously recognized; the degree of infectiousness
during such periods is unknown.
MESH: DNA,-Viral-analysis; HIV-Antibodies-analysis;
HIV-Seropositivity-microbiology; HIV-1-isolation-and-purification;
Proviruses-isolation-and-purification; Time-Factors
MESH: *Acquired-Immunodeficiency-Syndrome-immunology; *Homosexuality-;
*HIV-Seropositivity-immunology
TG: Human; Male; Support,-U.S.-Gov't,-P.H.S.
PT: JOURNAL-ARTICLE
CN: AI32511; AI72631
RN: 0; 0
NM: DNA,-Viral; HIV-Antibodies
AN: 89238486
UD: 8908
SB: AIM