Human Immunodeficiency Virus (HIV)–Specific Cytotoxic T Lymphocyte Activity in HIV‐Exposed Seronegative Persons

Repeated exposure to human immunodeficiency virus (HIV) does not always result in seroconversion. Understanding the conditions that permit or protect against progressive infection with HIV is important for vaccine development. Nineteen subjects at risk for HIV infection were CCR-5 genotyped and screened for virus-specific memory cytotoxic T lymphocytes (CTL). None had the Delta32CCR-5/Delta32CCR-5 genotype associated with HIV resistance. HIV-specific CTL were detected in 7 (41.1%) of 17 exposed uninfected subjects versus 0 of 14 seronegative subjects with no HIV risk factors (P=.006, chi2 test). Recognition of virus by CTL in exposed uninfected subjects was major histocompatibility complex class I-restricted and multispecific, and specificity could change with time. Activity could persist up to 34 months after the last virus exposure. The presence of HIV-specific CTL in a greater proportion of seronegative HIV-exposed versus unexposed subjects supports the notion that in some cases, virus exposure induces HIV immunity without seroconversion or disease progression.