Phair J, Hoover D, Huprikar J, Detels R, Kaslow R, Rinaldo C, Saah A
Howard Brown Memorial Clinic, Northwestern University Medical School, Chicago, Illinois 60611.
J Acquir Immune Defic Syndr (1988). 1992 Oct;5(10):988-92.
The objective of this study was to determine the frequency and significance of nondiagnostic Western blot (WB) assays in homosexual/bisexual men at risk of infection with HIV-1. The presence of a positive enzyme-linked antibody assay (EIA) confirmed by a positive WB was used as evidence of infection and seroconversion. Indeterminate WB assays were defined as reactions to only one viral gene product of HIV-1. Three analyses were conducted to (a) determine the frequency of such reactions in men who, during a 4-year period, did not develop diagnostic serologic reactions; (b) determine, retrospectively, the preseroconversion frequency of indeterminate WB assays in 286 men who seroconverted; and (c) evaluate in vitro production of specific antibody by peripheral blood mononuclear cells (PBMCs) as a method of indicating whether or not an indeterminate WB assay represents HIV-1 infection. Reactions to products of gag, pol, or env were noted in 8.0, 4.0, and 6.7% of 1,595 first-visit tests of men who remained seronegative for 4 years. Indeterminate reactions occurred in 204 men with negative EIAs who subsequently seroconverted and in 82 men with positive EIAs preconversion. Supernatants harvested from PBMCs of 2 of 36 seroconverters obtained one or two visits preseroconversion and cultured with pokeweed mitogen were antibody-positive. All were positive at the visit, with diagnostic serology. None of the supernatants from cells of 19 men with EIA-negative WB-indeterminate serologic assays were antibody-positive. Our results suggest that persistently EIA-negative homosexual/bisexual men who have indeterminate WB assays are unlikely to be infected with HIV-1.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是确定在有感染HIV-1风险的男同性恋者/双性恋男性中，非诊断性免疫印迹法（WB）检测的频率及意义。酶联抗体检测（EIA）呈阳性且经WB确认为阳性作为感染和血清转化的证据。不确定的WB检测定义为仅对HIV-1的一种病毒基因产物产生反应。进行了三项分析：（a）确定在4年期间未出现诊断性血清学反应的男性中此类反应的频率；（b）回顾性确定286例发生血清转化的男性中不确定WB检测的血清转化前频率；（c）评估外周血单核细胞（PBMC）体外产生特异性抗体的情况，以此作为一种方法来表明不确定的WB检测是否代表HIV-1感染。在1595例首次就诊检测中，对gag、pol或env产物有反应的情况在4年血清学仍为阴性的男性中分别占8.0%、4.0%和6.7%。不确定反应发生在204例EIA阴性但随后发生血清转化的男性以及82例血清转化前EIA阳性的男性中。在血清转化前一到两次就诊时采集的36例血清转化者中2例的PBMC上清液，用商陆有丝分裂原培养后呈抗体阳性。在就诊时诊断性血清学检测均为阳性。19例EIA阴性、WB不确定血清学检测的男性细胞上清液均无抗体阳性。我们的结果表明，WB检测不确定但EIA持续阴性的男同性恋者/双性恋男性不太可能感染HIV-1。（摘要截短于250字）
