interesting article from aidsinfobbs
#34826 - 05/28/02 06:56 PM
Immunosuppression Without HIV-1 Or HIV-2
Organizers of the Harvard-Amsterdam AIDS Conference
assembled a special session to discuss recent reports of AIDS-
defining diseases in individuals without laboratory evidence of
infection with HIV-1 or HIV-2. Physicians and researchers have
identified approximately 35 HIV negative individuals in the U. S.
and Europe with AIDS-associated opportunistic infections. All of
these individuals showed evidence of immune suppression, as
measured by a low number of T-helper cells (CD4 lymphocytes).
Some of these individuals have died. The special session called
to discuss these reports was headed by Dr. James Curran of the
Federal Centers for Disease Control (CDC), Dr. Anthony Fauci of
the NIAID and Dr. Jeffrey Laurence of New York's Cornell
University Medical College.
Dr. Laurence discussed 5 patients with AIDS or severe ARC,
but negative for both HIV-1 and HIV-2, HTLV-1 and HTLV-2. Tests
performed included screening ELISAs, confirmatory Western Blots,
Polymerase Chain Reaction (PCR) and viral cultures.
Opportunistic infections in the 4 men and one woman included PCP,
oral candidiasis, CMV colitis and tuberculosis. Four of the 5
did have risk behavior histories for HIV. All had abnormally low
T-helper counts. Two have died. Dr. Laurence indicated that his
report has been submitted for publication in the medical journal
Dr. Curran reported on another 5 or 6 similar cases known to
the CDC, from 4 different states. They were also negative for
both HIV' s and both HTLV's. Since the Amsterdam meeting, the
CDC has received reports of 9 additional cases, for a total of 14
individuals from 10 different states. Eight of the 14 have an
AIDS-defining diagnosis; 6 have unspecified pneumonia. All but 1
are alive as of August 1992. The age ranges are 31-70 years,
with a median of 48 years of age. On the average, they are 13
years older than the median age of U. S. AIDS cases. As of
August 10, 1992, no sexual or household clustering was reported
among the 14 cases. No other known causes of immunosuppression
were observed. Approximately one-third of these individuals has
known risk behavior for HIV.
At the Amsterdam Conference, Dr. Luc Montagnier, co-
discoverer of HIV, reported 2 intriguing cases, 1 in a man and
the other in a Portuguese woman with PCP. These cases had
borderline serologies, with HIV glycoprotein found in the urine
of both. The woman's virus had a defective envelope observed on
electron microscopy, suggesting an HIV variant.
Dr. David Ho of the New York Aaron Diamond AIDS Research
Center reported 11 additional cases over the last 3 years, some
in gay men with low T-helper counts. All were negative for HIV-1
The total number of reported cases of immunosuppression
without HIV at the special session in Amsterdam was 26. Adding
in the 9 subsequently reported to the CDC, the total equals 35.
Dr. Sudhir Gupta, an immunologist from the University of
California at Irvine, has also revealed his report on 2 of his
patients, a 66 year old woman and her daughter. Dr. Gupta
suggests that he may have discovered a new retrovirus, human
intracisternal retrovirus (HICRV), in the woman with a low T-
helper count and PCP, and in her asymptomatic daughter. Dr.
Gupta's article on these unusual cases is scheduled for
publication in the Proceedings of the National Academy of
It is not clear whether these reports represent a group of
different disorders, or a new viral or other infectious cause of
the immunosuppression, possibly due to a variant of HIV-1 or
HIV-2, or a previously undescribed retrovirus.
In 1989-1990 there were rare reports in The Lancet and the
New England Journal of Medicine of immunosuppression without HIV,
1 in a patient with leishmaniasis (a parasitic disease) and the
other in a patient with oral candidiasis. However, neither of
these reports indicated results of PCR or viral cultures. Dr.
Vincent Sarrano reported another case in The Lancet of T-helper
cell depletion, KS and Tb in a married man without evidence of
HIV-1 or HIV-2 infection.
Immunosuppression has been observed in other clinical
disorders, even before HIV was discovered. Severe malnutrition
among children in World War II led to clustered outbreaks of PCP.
Infusion of either blood (for transfusion) clotting factor VIII
(for hemophiliacs) or bone marrow (for transplantation), may lead
independently to immune abnormalities, including abnormal
lymphocytes and killer T-cell functioning. Each of the following
has been shown independently to cause abnormal lymphocyte
functioning: (1) chronic alcoholism; (2) opiate narcotic usage;
(3) rectal deposition of semen in rabbits; and (4) intravenous
injection of foreign material. Certain immune system tumors
alone, (e.g. lymphoma), as well as other cancers, also have been
linked with immune dysfunction. Cancer or transplant
chemotherapy, including prednisone administration, causes severe
immunosuppression. It is certainly possible that in a few
individuals with 1 or more of these cofactors for immune
suppression, the degree of immune suppression, with other
cofactors (including herpes viruses) may be severe enough to
cause diseases associated with low T-helper counts in individuals
without HIV-1 or HIV-2. An HIV variant, or a new retrovirus must
also be considered.
The CDC, NIAID and the World Health Organization are
actively investigating these reported cases of immunosuppression
without HIV-1, HIV-2, HTLV-1, HTLV-2. It is likely that more
information will be available by the time this article is
printed. The CDC has scheduled a meeting for August 14,1992 to
discuss cases of immunosuppression without HIV. It appears that
the recent reports are indeed rare, and that the cause is
unlikely to represent a significant public health threat,
particularly for individuals practicing safe-sex, or for health
providers practicing recommended infection control guidelines.
Special Session on Immunodeficiency Without HIV-1 or HIV-2. VIII
International Conference on AIDS. Amsterdam, July 1992.
Ablin et al. Blood product immunosuppression and AIDS. Annals
of Internal Medicine 104(1):130. January 1986.
Atkinson et al. Evidence that immune deficiency after marrow
transplantation is not caused by AIDS-associated retrovirus New
England Journal of Medicine. July 18, 1985.
Plant, M. Alcohol, sex and AIDS. Alcohol and Alcoholism 25
Cozon et al. Profound CD4 lymphocytopenia in the absence of HIV
infection in a patient with visceral leishmaniasis. New England
Journal of Medicine. January 11, 1990.
Paukhurst et al. Reduced CD4 and T-cells and severe oral
candidiasis in absence of HIV infection. The Lancet. March 25,
Altman L. U. S. is treating AIDS-like illness. New York Times.
August 10,1992. A-11.
McKeown LA. AIDS-like illness a mystery. Medical Tribune
33(15):1,8. August 6,1992.
Chamaret, Montagnier et al. Presence of antibodies against HIV-1
in the urine of 2 patients with indetermine serologic reactions.
VIII International Conference on AIDS. Amsterdam, July 1992.
Abstract PuC 8035.
last date i see is 1992. who cares if this is 10 years old!?!?! was this published recently? doesn't appear that way. interesting i guess, but maybe not relevant today?
This sooo funny: "Physicians and researchers have
identified approximately 35 HIV negative individuals in the U. S. and Europe with AIDS-associated opportunistic infections." Duh I wonder why? Maybe cause hiv does not cause AIDS. No they will coem up with some other insane theory!
that was 10 years ago. new strains have been openly identified since then, but were not known about at the time. antibody tests (e.g. EIA) have been fine tuned to detect those strains. i cant believe that you have read back that far to attempt to find proof. get a test; get a life.
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