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Persistent Lack of Detectable HIV-1 Antibody in a Person With HIV Infection—Utah, 1995
Arch Dermatol. 1996;132(8):873-874.
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INFECTION WITH human immunodeficiency virus (HIV) is diagnosed routinely by the enzyme immunoassay (EIA) for HIV-1 antibody; a nonreactive blood sample is designated as negative without further testing. However, one limitation of this screening algorithm is that a blood sample may be obtained from a patient with recent HIV infection before detectable HIV antibody is present ("window period"). This report describes a patient with confirmed HIV infection in whom EIAs for HIV antibody (HIV-ElAs) were persistently negative beyond the expected "window period."*
Case Investigation.
In October 1995, the Utah Department of Health referred to CDC blood samples obtained from a man who had had onset of persistent fatigue and malaise during January 1995. During January-June 1995, he had sought medical care at several clinics. When he was admitted to a hospital in June because of respiratory illness and recent weight loss of 27 lbs, HIV-EIA was negative. In August, he
. . . [Full Text PDF of this Article]
Footnotes
Single copies of this report will be available until March 8, 1997, from the CDC National AIDS Clearinghouse, P.O. Box 6003, Rockville, MD 20849-6003; telephone (800) 458-5231 or (301) 217-0023.
DNA sequence analysis determined that sequences from the patient and his wife differed by 7.4% over 345 nucleotides of the C2V3 region of the env gene, and 3.1% over 393 nucleotides of the p17 region of gag. Phylogenetic tree constructions demonstrated the close relation between the HIV sequences from the patient and his wife, with a bootstrap support of 98% and 100%, respectively, for each gene region.
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