AEGiS-GMHC: HIV-Negative AIDS?

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

HIV-Negative AIDS?

TREATMENT ISSUES, Volume 6, Number 8 - September, 1992; The Gay Men's Health Crisis Newsletter of Experimental Therapies
Gabriel Torres, M.D.

The report which received most attention at the VIII International Conference on AIDS was a presentation describing several cases of severe immuno-deficiency in persons without detectable HIV at a "Recent Reports" session at the conference, Dr. Jeffrey Laurence of Cornell Medical Center reported five cases of immune suppression characterized by low T4 cell counts, opportunistic infections, like CMV colitis, PCP and KS. Some patients had risk factors for HIV-1 infection yet none had any evidence of HIV-1 or HIV-2. Dr. James Curran, Director of AIDS at the Centers for Disease Control (CDC), reported six additional cases which had been reported to the CDC in the past years. The agency chose not to report these cases and received severe criticism by many researchers for that decision. Other researchers reported similar HlV-negative cases of immune-suppression, including Dr. David Ho with 11 cases of patients. These were mostly gay men with low T4 cell counts, three of whom had OIs. In addition, Luc Montagnier, the co-discover of HIV-1, reported experience with a similar case. He claimed to have found HIV in the urine of a patient whose blood had no traces of the virus after PCR analysis.

Another researcher, Dr. Sudhir Gupta from the University of California at Irvine reported evidence of a new virus in a 66 year old woman who had developed severe immunodeficiency and OIs many years after receiving blood transfusions. Dr. Gupta described the virus as a "human intracisternal retroviral particle" or "HICVR" because it was found in closed spaces called cisterns in the cytoplasm of cells. Other researchers countered that these particles represented lab contaminants and not viruses. Dr. Max Essex of Harvard's School of Public Health argued that this virus-like particle was probably a "retroid"--a fragment of the normal human gene that resembles a virus, yet which have no pathogenic potential. In this case, as in four of Dr. Ho's cases, reverse transcriptase (the enzyme that copies HIV inside infected cells) was present. However, this is a non-specific finding that occurs during Hepatitis C, Grave's disease, and Kawasaki's disease.

Other researchers from New York reported cases of Kaposi's sarcoma (KS) in gay men who were not infected with HIV. Most of these cases were relatively mild (non-extensive, less than 10 lesions and without oral involvement) and their meant T4 cell count was 768. Tumor samples failed to show HIV-1 OI HIV-2, but one patient's tumor revealed evidence of HTLV-1. It has been postulated that an undetermined sexually transmitted agent may be responsible for the development of KS in these men. Officials from the World Health Organization and the CDC plan to organize an international meeting to investigate all these cases of HIV negative AIDS from both a basic science and an epidemiological perspective. In the meantime, The New York City Department of Health is gathering information about any immune suppressed illness that may be related to these cases. Doctors, health care providers, people with HIV and others are encouraged to contact Allen Greenberg at (212) 566-5062, who is conducting investigations.

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