ABSENCE OF DETECTABLE ANTIBODY IN A PATIENT INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

Infection with human immunodeficiency virus (HIV) is routinely and eas ily diagnosed with use of enzyme immunoassay (EIA) test kits, We descr ibe an unusual patient who developed AIDS despite testing negative for antibodies to HIV 35 times over a 4-year period, HIV infection was co nfirmed by the results of p24-antigen assays and polymerase chain reac tion amplification of proviral DNA. Sequence analysis of the virus dem onstrated that it was closely related to a strain obtained from the pa tient's sexual partner, The explanation for this patient's persistentl y negative EIA results is unclear, However, this case does suggest tha t physicians who treat patients with AIDS-defining conditions but for whom standard HIV antibody testing is negative should consider the pos sibility that HIV infection is present and may be identified by additi onal testing procedures.