Diagnosis of Human Immunodeficiency Virus Infection in Seronegative Homosexuals Presenting With an Acute Viral Syndrome FREE

Harold A. Kessler, MD; Bernard Blaauw, MD; Joel Spear, MD; Deborah A. Paul, PhD; Lawrence A. Falk, PhD; Alan Landay, PhD

[+] Author Affiliations

Reprint requests to Rush-Presbyterian—St Luke's Medical Center, Section of Infectious Diseases, 1753 W Congress Pkwy, Chicago, IL 60612 (Dr Kessler).

JAMA. 1987;258(9):1196-1199. doi:10.1001/jama.1987.03400090080038

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ABSTRACT

ABSTRACT | REFERENCES

Early diagnosis of acute human immunodeficiency virus (HIV) infection is difficult because patients may be seronegative for HIV at the time of presentation. We have used a serum HIV antigen (HIV-Ag) enzyme immunoassay (EIA) to diagnose acute HIV infection in four high-risk patients. The clinical syndrome in these four patients was characterized by fever (four), rash (three), myalgiasarthralgias (three), and pharyngitis (two). All patients had spontaneous resolution of their symptoms within eight to 12 days. Serum HIV antibody, as measured by a commercially available screening EIA and by Western blot analysis, was negative in all patients at time of presentation and all seroconverted on subsequent testing. Human immunodeficiency virus was isolated from two of two patients during the acute illness. Initial serum samples from all four patients were positive for HIV-Ag. Serum samples of three of four patients became negative for HIV-Ag and positive for HIV antibody. These data suggest that serum HIV-Ag detection by EIA may be useful in the diagnosis of the acute syndrome caused by HIV infection.

(JAMA 1987;258:1196-1199)

REFERENCES

ABSTRACT | REFERENCES

Sarngadharan MG, Popovic M, Bruch L, et al: Antibodies reactive with a human T-lymphotropic retrovirus (HTLV-III) in the serum of patients with AIDS . Science 1984;;224:506-508.

Gallo RC, Salahuddin SZ, Popovic M, et al: Frequent detection and isolation of cytopathic retroviruses (HTLV-III) from patients with AIDS and at risk for AIDS . Science 1984;;224:500-503.

Schupbach J, Popovic M, Gildren RV, et al: Serological analysis of a subgroup of human T-lymphotropic retroviruses (HTLV-III) associated with AIDS . Science 1984;;224:503-505.

Popovic M, Sarngadharan MG, Reed E, et al: Detection, isolation, and continuous production of cytopathic retroviruses (HTLV-III) from patients with AIDS and pre-AIDS . Science 1984;;224: 497-500.

Barre-Sinoussi F, Chermann JC, Rey F, et al: Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS) . Science 1983;;220:868-871.

Klatzman D, Barre-Sinoussi F, Nugeyre MT, et al: Selective tropism of lymphoadenopathy associated virus (LAV) for helper-inducer T-lymphocytes . Science 1984;;225:59-63.

Dalgleish AG, Beverley PCL, Clapham PR, et al: The CD4 (T4) antigen is an essential component of the receptor for the AIDS retrovirus . Nature 1984;;312:763-767.

Klatzman D, Champagne E, Chamaret S, et al: T-lymphocyte T4 molecule behaves as the receptor for human retrovirus LAV . Nature 1984;;312:767-768.

Ho DD, Rota TR, Hirsch MS: Infection of monocyte/macrophages by human T-lymphotropic virus type III . J Clin Invest 1986;;77:1712-1715.

Needlestick transmission of HTLV-III from a patient infected in Africa . Lancet 1984;;2:1376-1377.

Cooper DA, Gold J, MacLean P, et al: Acute AIDS retrovirus infection: Definition of a clinical illness associated with seroconversion . Lancet 1985;; 1:547-550.

Carne CA, Tedder RS, Smith A, et al: Acute encephalopathy coincident with seroconversion for anti-HTLV-III . Lancet 1985;;2:1206-1208.

Ho DD, Sarngadharan MG, Resnick L, et al: Primary human T-lymphotropic virus type III infection . Ann Intern Med 1985;;103:880-883.

Ho DD, Rota TR, Schooley RT, et al: Isolation of HTLV-III from cerebrospinal fluid and neural tissues of patients with neurologic syndromes related to the acquired immunodeficiency syndrome . N Engl J Med 1985;;313:1493-1497.

Goudsmit J, DeWolf F, Paul DA, et al: Expression of human immunodeficiency virus antigen (HIV-Ag) in serum and cerebrospinal fluid during acute and chronic infection . Lancet 1986;;2:177-180.

Paul DA, Falk LA, Kessler HA, et al: Correlation of serum HIV antigen and antibody with clinical status in HIV infected patients . J Med Virol , in press.

Goudsmit J, Lange JMA, Paul DA, et al: Antigenemia and antibody titers to core and envelope antigens in AIDS, AIDS-related complex and subclinical human immunodeficiency virus infection . J Infect Dis 1987;;3:558-560.

Allain JP, Paul DA, Laurian Y, et al: Serological markers in early stages of human immunodeficiency virus infection in hemophiliacs . Lancet 1986;;2:1233-1236.

Groopman JE, Chen FW, Hope HA, et al: Serological characterization of HTLV-III infection in AIDS and related disorders . J Infect Dis 1986;; 153:736-742.

Chase RA, Kessler HA, Landay A, et al: Sensitivity and specificity of an HIV antibody assay . AIDS Res Ther 1986;;2:369-375.

Wall RA, Denning DW, Amos A: HIV antigenemia in acute HIV infection . Lancet 1987;;1: 566.

Mayer KH, Stoddard AM, McCusker J, et al: Human T-lymphotropic virus type III in high-risk, antibody-negative homosexual men . Ann Intern Med 1986;;104:194-196.

Rao TKS, Fillipone EJ, Nicastri AD, et al: Associated focal and segmental glomerulosclerosis in the acquired immune deficiency syndrome . N Engl J Med 1984;;310:664-673.

Pardo V, Aldana M, Colton RM, et al: Glomerular lesions in the acquired immunodeficiency syndrome . Ann Intern Med 1984;;101:429-434.

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