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Indeterminate human immunodeficiency virus type 1 western blot may indicate an abortive infection in some low‐risk blood donors
Author(s) -
Georgoulias V.A.,
Malliaraki N. E.,
Theodoropoulou M.,
Spanakis E.,
Fountouli P.,
Tsatsaki D.,
Kotsaki S.,
KarvelaAggelaki A.,
MalliarakiPinetidou E.
Publication year - 1997
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1997.37197176953.x
Subject(s) - western blot , virology , polymerase chain reaction , southern blot , peripheral blood mononuclear cell , dot blot , blot , clone (java method) , virus , reverse transcriptase , cd8 , microbiology and biotechnology , antibody , biology , complementary dna , indeterminate , reverse transcription polymerase chain reaction , immunology , gene , gene expression , immune system , in vitro , genetics , mathematics , pure mathematics
BACKGROUND : The infectious status of persons with an indeterminate human immunodeficiency virus type 1 (HIV‐1) Western blot must be established. STUDY DESIGN AND METHODS : Evaluation of the CD4 and CD8 T‐ cell subsets and the expression of HIV‐1‐integrated sequences by Southern blot and polymerase chain reaction were studied in a group of low‐risk subjects with an indeterminate Western blot. RESULTS : From a total of 45,000 blood donors and 50 patients with chronic renal failure on hemodialysis who were tested during the period of 1985 through 1990, 50 sera (0.1%) had an indeterminate Western blot. A low CD4:CD8 ratio (0.7‐1.2) was detected in 14 of 24 tested subjects, whereas the unfractionated and adherence‐enriched cells of 7 (32%) and 5 (23%) of 22 patients, respectively, could be stained with a p24 monoclonal antibody. A transient positive culture was detected in 3 of 20 subjects, but these viral isolates could not be transmitted to CEM‐A310 cells. Ultracentrifuged culture supernatants hybridized under high‐ stringency conditions with genomic gag‐pol (4 cases), env (3 cases), and tat (1 case) cDNA fragments of the HXB2 HIV‐1 clone. In one case, DNA obtained from adherent but not unfractionated mononuclear cells contained 3.3‐ and 3.9‐kb env‐ and gag‐pol ‐related HIV‐1 sequences, respectively; these sequences were heavier than expected. Polymerase chain reaction analysis for gag and pol but not env sequences was positive in 1 and 2 of 7 cases, respectively. A female patient with a positive viral culture and who was positive for pol in polymerase chain reaction demonstrated a full seroconversion 19 months later. CONCLUSION : The results strongly suggest that, rarely, some low‐risk subjects with indeterminate Western blot results might be infected with low‐level replicative strains or HIV‐related viruses; thus, an exhaustive immunologic and virologic workup is needed for the investigation of these subjects.