PCR ANALYSIS OF HIV-SERONEGATIVE, HETEROSEXUAL PARTNERS OF HIV-INFECTED INDIVIDUALS

A cohort of human immunodeficiency virus (HIV)-discordant couples was established to evaluate risk factors associated with heterosexual vira l transmission. Polymerase chain reaction (PCR) was utilized to docume nt the HIV-uninfected status among members of discordant heterosexual couples and to rule out immunosilent infection. HIV DNA PCR specific f or a gag gene region was performed on peripheral blood mononuclear cel l samples from 203 HIV antibody-negative adults who have long-term het erosexual relationships with HIV-infected partners. The results were n egative for 200 but consistently positive in three individuals. More e xtensive evaluation of these three individuals with an additional prim er pair specific for the envelope gene, quantitative DNA PCR, multiple additional time points, and variable nucleotide tandem repeat analyse s revealed specimen processing problems in two cases but an apparent t rue positive PCR assay in the third case. This subject remains antibod y and PCR negative for a 32-month follow-up period. These results conf irm previous studies that document a negligible incidence of occult HI V infection as delineated by PCR in antibody negative heterosexual par tners of HIV-infected individuals, Specimen processing errors occur at a low rate (1% in this study) and require careful evaluation. The pos sibility of transient, aborted infection versus successful infection w ith a long immunosilent period was observed in a single individual. De finitive resolution of infection status will require long-term evaluat ion.