Human Immunodeficiency Virus Type 1 (HIV-l) Genomic Sequences and Distinct Changes in CD8+ Lymphocytes Precede Detectable Levels of HIV-l Antibodies in High-Risk Homosexuals

Abstract

Polymerase chain reaction (PCR) identified regions of the gag, LTR, and env genes of human immunodeficiency virus type 1 (HIV-l) in 5 (13%) of 38 high-risk homosexual men who were negative for HIV-1 antibodies by Western blot (WB). Significant increases in CD8⁺ cells, particularly those bearing activation CD8⁺CD38⁺ and CD8⁺Ia⁺ antigens, and marked reductions in CD4⁺ cells were detected in WB⁻PCR⁺ subjects compared with 33 WB⁻PCR⁻ homosexuals. WB⁻PCR⁺ subjects had impaired B cell but not T cell functions. Immunologic characteristics of WB⁻PCR⁺ homosexuals were indistinguishable from those of 17 WB⁺PCR⁺ subjects. Subjects progressing from WB⁻PCR⁻ to WB⁻PCR⁺ to WB⁺PCR⁺ showed sequential phenotypic and functional alterations in their Band T cell compartments. These changes and the presence of HIV-1 genomic sequences were the first indications of HIV-1 infection and together with p24 antigenemia signified an inevitable progression to AIDS.