Palenicek J, Fox R, Margolick J, Farzadegan H, Hoover D, Odaka N, Rubb S, Armenian H, Harris J, Saah A J
Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205.
J Acquir Immune Defic Syndr (1988). 1992 Dec;5(12):1204-11.
Thirty-six sexually active couples serologically discordant for human immunodeficiency virus, type 1 (HIV-1), within the Baltimore Multicenter AIDS Cohort Study (MACS) were assessed to determine whether evidence of HIV-1 infection could be detected in the HIV-1-antibody-negative partners and whether factors associated with lack of transmission of HIV from the seropositive to the seronegative partner could be ascertained. Six HIV-1 seropositive couples and 18 seronegative couples were followed concurrently for comparison. None of the seropositive subjects had an AIDS-defining illness at entry into the study, and all subjects were followed for 1 year. A separate evaluation of unprotected anal receptive and insertive intercourse between discordant couples indicated high-risk activities for a median of 40 months, as reported by the HIV seropositive partner. Despite this finding, none of the HIV-1 seronegative men in discordant couples had evidence of HIV-1 infection by viral culture, p24 antigen testing, or polymerase chain reaction for HIV-1 DNA. Discordant seronegatives and seropositives did not differ from concordant seronegatives and seropositives in numbers of circulating CD4, CD8, and natural killer lymphocytes or in prevalence of antibodies to herpes simplex virus, type 1, Epstein-Barr virus, or cytomegalovirus, except that discordant seronegative men were less likely than their seropositive partners to have antibodies to herpes simplex virus, type 2. The reason for the apparent lack of HIV-1 infection in seronegative discordant individuals remains unexplained and did not appear to be associated with type of sexual activity, T-lymphocyte subsets or natural killer cells, or early stage of HIV-1 disease.
在巴尔的摩多中心艾滋病队列研究（MACS）中，对36对1型人类免疫缺陷病毒（HIV-1）血清学结果不一致的性活跃夫妇进行了评估，以确定在HIV-1抗体阴性的伴侣中是否能检测到HIV-1感染的证据，以及能否确定与HIV从血清阳性伴侣向血清阴性伴侣传播失败相关的因素。同时随访了6对HIV-1血清阳性夫妇和18对血清阴性夫妇以作比较。血清阳性受试者在进入研究时均无艾滋病界定疾病，所有受试者均随访了1年。对血清学结果不一致的夫妇间无保护的肛门接受性和插入性行为的单独评估显示，据HIV血清阳性伴侣报告，这些高危行为的中位持续时间为40个月。尽管有这一发现，但血清学结果不一致的夫妇中，HIV-1血清阴性男性均未通过病毒培养、p24抗原检测或HIV-1 DNA聚合酶链反应检测到HIV-1感染的证据。血清学结果不一致的血清阴性者和血清阳性者在循环CD4、CD8和自然杀伤淋巴细胞数量或1型单纯疱疹病毒、EB病毒或巨细胞病毒抗体患病率方面与血清学结果一致的血清阴性者和血清阳性者并无差异，只是血清学结果不一致的血清阴性男性比其血清阳性伴侣患2型单纯疱疹病毒抗体的可能性更低。血清学结果不一致的血清阴性个体中明显缺乏HIV-1感染的原因仍无法解释，且似乎与性活动类型、T淋巴细胞亚群或自然杀伤细胞，或HIV-1疾病的早期阶段无关。
