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  • Title: Isolation of human immune deficiency virus from African AIDS patients and from persons without AIDS or IgG antibody to human immune deficiency virus.
    Author: McCormick JB, Krebs JW, Mitchell SW, Feorino PM, Getchell JP, Odio W, Kapita B, Quinn TC, Piot P.
    Journal: Am J Trop Med Hyg; 1987 Jan; 36(1):102-6. PubMed ID: 2949638.
    Abstract:
    We previously reported a high incidence of acquired immune deficiency syndrome (AIDS) in Kinshasa, Zaire, as well as a high frequency of antibody to human immunodeficiency virus (HIV), which includes HTLV-III and LAV viruses, in persons without AIDS. In this report we assessed the frequency of HIV virus infection in persons with and without clinical AIDS and the association of virus isolation to presence of antibody. We isolated HIV from 27 (77%) of 35 patients with AIDS, and 5 of 9 patients with AIDS-related complex (ARC). Virus was also isolated from plasma and cerebrospinal fluid of patients in the study. The presence of antibody was a reliable marker for virus infection in African patients with AIDS. HIV was isolated from 5 of 27 control patients without AIDS, 3 of whom had normal T helper to T suppressor ratios and normal numbers of T helper cells. Two of these patients had no detectable antibody to HIV by ELISA or Western blot methods. In a population, such as the general heterosexual population of Kinshasa, with frequent infection by HIV and with few clearly definable risk groups, screening for antibodies to HIV may not be sufficient to identify some virus infected persons. This study represented the 1st attempt to isolate human immunodeficiency virus (HIV) from African acquired immunodeficiency syndrome (AIDS) patients and controls. HIV was isolated from 27 (77%) of 35 Zairians with AIDS and from 5 (55%) of 9 patients with AIDS-related complex (ARC). In addition, 5 (19%) of 27 controls admitted to Zaire's Mama Yemo Hospital for causes unrelated to AIDS were found to be positive for antibodies to HIV. Next, an effort was made to isolate the virus from 42 AIDS or ARC patients on whom data were already available on the results of an enzyme-linked immunosorbent assay (ELISA). HIV was isolated from 30 (81%) of 37 patients with positive ELISA tests and from none of the 5 patients with a negative assay. Among controls, antibodies were found in a higher proportion of patients with abnormal helper: suppressor ratios or a low absolute T helper cell count. On the other hand, these abnormalities were not found in 3 of the 5 control patients from whom HIV was isolated, including 2 without HIV antibody. This suggests that neither of these criterion are good indicators of virus infection. The isolation of HIV infection from 5 hospital controls with no clinical signs of infection suggests that either the rate of asymptomatic HIV virus infection is high in Zaire or that common tropical diseases such as malaria or tuberculosis may be associated with HIV infection. The frequency of HIV isolation from AIDS and ARC patients in this study is higher than that in earlier reports from non-Africans, but is comparable to current statistics from the US.
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