Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
HIV seroconverters in domestic HIVNET studies: clinical, epidemiologic, virologic and immunologic findings in primary HIV infection.
Conf Adv AIDS Vaccine Dev. 1997 May 4-7;:27. Unique Identifier : AIDSLINE MED/97927017 Celum CL; Sheppard HW; Donnell D; Wilson SE; Douglas J; Mayer K; Flores J; Marmor M; Buchbinder SP; Seattle HIVNET, Seattle, WA. Fax: (206) 521-5828.
Abstract:
HIVNET is an NIH-funded multi-site HIV prevention trials network. HIVNET studies include a phase II vaccine trial in conjunction with AVEG, microbicide, perinatal and behavioral intervention trials with biologic outcomes. In the HIVNET Vaccine Preparedness Study, 8 domestic sites enrolled 4892 high-risk HIV-negative gay and bisexual men, injection drug users, and heterosexual women. Eighty-one prospectively-identified seroconverters have been enrolled in a longitudinal study of primary HIV infection of whom 69 are gay men, 5 heterosexual non-IDU women, and 7 IDU. Seven of the 81 were identified during acute infection with a positive PCR or evolving indeterminate Western Blot (WB); the remaining seroconverters had a positive WB an average of 6 months after the last negative test. Initial median plasma viral load by Roche Amplicor assay was 22,242 copies (less than 200-63,774); initial median semen viral load was 296 (less than 200-1501). Four of the 81 seroconverters had syncitium-inducing HIV-1 strains at their first and all follow-up visits. All the seroconverters had clade B virus. Initial median CD4 count was 560 (170-1432). CTL studies have been completed for 24 recent seroconverters (less than 12 months since the estimated time of seroconversion) using freshly isolated PBMC stimulated in vitro and assayed for cytotoxic activity against Therion vaccinia constructs expressing env gp160, gp41), gag (p55), pol and nef antigens. Positive CTL responses (specific lysis greater than 10.0, CD4- or CD8-depletion reducing lysis by 50% at 50:1 or 25:1 E:T ratio) were observed in 16/24 against gp160, 11/24 against gp41, 23/24 against gag p55, 21/24 against pol, and 5/7 against nef. Preliminary CTL analysis indicates that the most significant gp160 and gp41-specific CTL responses are observed in seroconverters with higher viral loads. Additional data on CTL, CCR5 status, and neutralizing antibodies will be presented. The HIVNET has prospectively identified a non-referral based cohort of early HIV seroconverters and is collecting useful data on viral load in plasma and semen and early cellular and humoral immune responses.
Keywords: *AIDS Vaccines/THERAPEUTIC USE *HIV Infections/PREVENTION & CONTROL 971130
M97B1201
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Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.
