ABSENCE OF RECOVERABLE INFECTIOUS VIRUS AND UNIQUE IMMUNE-RESPONSES IN AN ASYMPTOMATIC HIV-TERM SURVIVOR( LONG)

We have studied a woman with transfusion-acquired HIV who appears to h ave contained infectious virus to consistently undetectable levels ove r a 13-year period without antiviral treatment. She received the infec ted transfusion for intra- and postpartum blood loss immediately after delivery of her second child in 1981, She had no acute febrile syndro me and has never had HIV-associated clinical signs or symptoms in the 13 years since infection. She was first tested and found positive for HIV antibodies in 1985, and the infected blood donor was diagnosed wit h AIDS in 1986 and died of AIDS-related complications in 1989. Two oth er recipients of packed erythrocytes from this donor (in 1980 and 1982 ) also became infected and were subsequently diagnosed with AIDS. Betw een January 1986 and April 1994, in the setting of continuous and unam biguous Western blot HIV-specific antibodies and intermittently positi ve low-level HIV DNA signal after polymerase chain reaction (PCR) ampl ification, more than 30 separate cell cocultures performed in several independent laboratories failed to yield evidence of infectious virus, despite special efforts to induce and detect HIV replication. Immunol ogically, a strong in vitro proliferative response to HIV envelope pro teins also distinguished this subject from other asymptomatic HIV+ ind ividuals.