Absence of Reproducibly Detectable Low-level HIV Viremia in Highly Exposed Seronegative Men and Women

Overview

Journal AIDS

Specialty Infectious Diseases

Date 2011 Feb 8

PMID 21297421

Citations 2

Authors

Eric Delwart

Flavien Bernardin

Tzong-Hae Lee

Valerie Winkelman

Chenglong Liu

Haynes Sheppard

Albert Liu

Ruth Greenblatt

Katryn Anastos

Jack DeHovitz

Marek Nowicki

Mardge Cohen

Elizabeth T Golub

Jason Barbour

Susan Buchbinder

Michael P Busch

Affiliations

Soon will be listed here.

Abstract

Objective: Transient HIV infections have been invoked to account for the cellular immune responses detected in highly virus-exposed individuals who have remained HIV-seronegative. We tested for very low levels of HIV RNA in 524 seronegative plasma samples from 311 highly exposed women and men from three longitudinal HIV cohorts.

Design: Two thousand and seventy-three transcription-mediated amplification (TMA) HIV RNA tests were performed for an average of 3.95 TMA assays per plasma sample. Quadruplicate TMA assays, analyzing a total of 2 ml of plasma, provided an estimated sensitivity of 3.5 HIV RNA copies/ml.

Results: Four samples from individuals who did not seroconvert within the following 6 months were positive for HIV RNA. For one sample, human polymorphism DNA analysis indicated a sample mix-up. Borderline HIV RNA detection signals were detected for the other three positive samples but further replicate TMA testing yielded no positive results. Nested PCR assays (n = 254) for HIV proviral DNA in peripheral blood mononuclear cells (PBMCs) from these three individuals were negative.

Conclusion: Transient viremia was not reproducibly detected in highly HIV-exposed seronegative men and women. If transient infections do occur, plasma HIV RNA levels may remain below the detection limits of the sensitive assay used here, be of very short duration, or viral replication may be restricted to mucosal surfaces or their draining lymphoid tissues.

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