AEGiS-11IAC: Identification of group O HIV infection in the United States.

11th International AIDS Conference


Vancouver, British Columbia — July 7-12, 1996

Print this Article


Identification of group O HIV infection in the United States.

Int Conf AIDS 1996 Jul 7-12; 11:18 (abstract no. Th.A.922)
Sullivan PS, Simon P, Ward JW, Britvan L, Gould K, Dryjanski J, Schable CA, Rayfield M, Otten R, Subbarao S, Schochetman G; Centers for Disease Control and Prevention, Atlanta, GA. Fax: (404) 639-2980.

Background: Group O variants of HIV, found in patients from West African countries, are genetically divergent from the group M strains commonly found in the United States (US). Group O strains elicit an antibody response that is inconsistently detected by commercially available EIA (CA-EIA) antibody assays used in the US.

METHODS: Using HIV/AIDS surveillance data, we identified patients born in West African countries where group O strains are prevalent to allow laboratory characterization of HIV strains in these patients. Infection with group O HIV was detected by type-specific peptide serology, and by culture of clinical isolates followed by genomic sequencing and phylogenetic analysis comparing viral sequence with the sequences from prototypic group O (ANT70 and MVP5180) and group M viruses.

RESULTS: Group O infection with HIV was confirmed in a woman in the US who was born in West Africa. The woman's possible modes of exposure to HIV include 2 male sexual partners in West Africa, a male sexual partner in the United States, surgery with possibly non-sterile instruments in West Africa, and two scarification procedures performed with razor blades in West Africa. Her clinical history in the US includes low CD4 counts, thrombocytopenia, and an 18-month history of generalized lymphadenopathy. Tests for HIV antibodies were performed in the US in February (non-reactive by CA-EIA kit A, s/c ratio=0.7), October and November 1995 (reactive by CA-EIA kit B, WB indeterminate), and a test for HIV-1 DNA by PCR was negative in December 1995. As part of the CDC investigation, analysis of specimens from the patient indicated that some EIA tests licensed in the US did not identify antibodies to HIV in the patient's serum. Based on type-specific peptide serology, samples from the West African patient reacted with the V3 peptide of the ANT70 prototype and the gp41 immunodominant region of the MVP5180 prototype group O strains, but not with peptides from group M subtypes. When phylogenetic analysis of the HIV DNA sequences was performed, the env, gag and protease genes consistently clustered with the prototypic group O sequences.

CONCLUSIONS: The report of the first group O infection in the US is a sentinel event that should prompt a reconsideration of the configuration of HIV antibody assays. HIV/AIDS surveillance provides a population-based means for identifying persons at high risk for infection with unusual strains of HIV.

Keywords: AEGIS, HIV Infections, HIV Antibodies, Acquired Immunodeficiency Syndrome, CD4 Lymphocyte Count, Immunodominant Epitopes, Polymerase Chain Reaction, Peptides, Equine Infectious Anemia, Africa, United States, Human, Female, Animal, Male, ICA11KWDaegis,hivinfections,hivantibodies,acquiredimmunodeficiencysyndrome,cd4lymphocytecount,immunodominantepitopes,polymerasechainreaction,peptides,equineinfectiousanemia,africa,unitedstates,human,female,animal,male,ica11

960707
ThA922

Copyright © 1996 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.