Identification of a new recipient in the Sydney Blood Bank Cohort: A long-term HIV type 1-infected seroindeterminate individual

We have reported previously a cohort of long-term survivors of HIV-1 infect ion, known as the Sydney Blood Bank Cohort, who received HIV-1-positive blo od from a common infected donor. A new recipient, C135, has been identified . This recipient became infected after receiving blood donated during the p resumed time of seroconversion of the donor in February 1981, C135 has been infected for more than 18 years without signs of disease progression. The virus load in this recipient has remained below the detectable level (<20 R NA copies/ml of plasma) and repeated Western blot analyses have given an in determinate result. By booster PCR techniques we have demonstrated that thi s individual is infected with HIV-1 and have characterized the viral nef an d nef/LTR region sequences present. The strain of HIV-1 identified contains deletions of 88 bp from the nef alone region and a total of 139 bp deleted from the nef/LTR overlap and LTR regions, The LTR contains three wild-type Sp1 transcription factor-binding sites, the 3' wildtype NF-kappa B site, a nd a duplicated Sp1 and NF-kappa B region. A truncated Nef protein of only 19 amino acids is encoded. The deletions and rearrangements in the nef gene and LTR sequences are characteristic of Sydney Blood Bank Cohort strains o f virus. The identification of C135 increases the Sydney Blood Bank Cohort size to nine individuals and represents a rare example of a genuine, long-t erm HIV-1 infection accompanied by indeterminate anti-HIV-1 serology.