Journal Article

Absence of Detectable Antibody in a Patient Infected with Human Immunodeficiency Virus

Larry Reimer, Susan Mottice, Charles Schable, Patrick Sullivan, Allyn Nakashima, Mark Rayfield, Randy Den and Charles Brokopp

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 1, pages 98-100
Published in print July 1997 | ISSN: 1058-4838
Published online July 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514491
Absence of Detectable Antibody in a Patient Infected with Human Immunodeficiency Virus

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Infection with human immunodeficiency virus (HIV) is routinely and easily diagnosed with use of enzyme immunoassay (EIA) test kits. We describe an unusual patient who developed AIDS despite testing negative for antibodies to HIV 35 times over a 4-year period. HIV infection was confirmed by the results of p24-antigen assays and polymerase chain reaction amplification of proviral DNA. Sequence analysis of the virus demonstrated that it was closely related to a strain obtained from the patient's sexual partner. The explanation for this patient's persistently negative EIA results is unclear. However, this case does suggest that physicians who treat patients with AIDS-defining conditions but for whom standard HIV antibody testing is negative should consider the possibility that HIV infection is present and may be identified by additional testing procedures.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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