From: Sam Damon Date: Wed, 23 Feb 1994 04:05:14 -0500 (EST) > Date: Sun, 20 Feb 1994 16:49:31 -0600 > From: cmarshall@METGEM.GCN.uoknor.edu > 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