Long-term Symptomless HIV-1 Infection in Recipients of Blood Products From a Single Donor

Lancet. 1992 Oct 10;340(8824):863-7. doi: 10.1016/0140-6736(92)93281-q.

Abstract

There have been reported cases of long-term symptomless human immunodeficiency virus type 1 (HIV-1) infection, but it is not clear whether the benign course of infection was due to host, viral, or other unknown factors. During follow-up of subjects with transfusion-acquired HIV-1 infection in New South Wales, Australia, we identified a group of 6 subjects who had been infected through a single common donor. We were therefore able to study the contributions of various factors to the course of infection. Throughout follow-up (range 6.8-10.1 years after infection), 5 of the recipients and the donor (last follow-up 10.2 years after infection of the first recipient) remained clinically free of symptoms, with normal CD4 cell counts and no p24 antigenaemia. HIV-1 was isolated from only 1 recipient; the isolate did not induce syncytia in a SUPT1 co-culture assay and had a limited in-vitro host range. 1 infected recipient (who had received extensive immunosuppressive treatment for systemic lupus erythematosus) developed Pneumocystis carinii pneumonia and died 4.3 years after infection. The frequency of progression to AIDS or a CD4 cell count below 0.50 x 10(9)/l was significantly lower among the 6 subjects with a common donor (1/6) than among 101 other HIV-infected transfusion recipients for whom data from 7 years of follow-up were available (94/101; p less than 0.0001). These findings suggest that the subjects were infected by a less virulent strain of HIV-1. The identification of this group of subjects should stimulate a search for other similar groups, which will provide important information on the immunopathogenesis of HIV-1 disease.

Publication types

  • Case Reports

MeSH terms

  • Acquired Immunodeficiency Syndrome / microbiology*
  • Adolescent
  • Adult
  • Aged
  • Blood Donors*
  • CD4-CD8 Ratio
  • CD4-Positive T-Lymphocytes / metabolism
  • CD4-Positive T-Lymphocytes / microbiology
  • Female
  • HIV Core Protein p24 / metabolism
  • HIV Infections / microbiology
  • HIV Seropositivity / microbiology*
  • HIV-1 / isolation & purification*
  • HIV-1 / pathogenicity
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • T-Lymphocytes, Regulatory / metabolism
  • T-Lymphocytes, Regulatory / microbiology
  • Transfusion Reaction*
  • Virulence
  • beta 2-Microglobulin / metabolism

Substances

  • HIV Core Protein p24
  • beta 2-Microglobulin