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J Infect Dis. 1993 Aug;168(2):327-31.

Detection of human immunodeficiency virus type 1 infection by polymerase chain reaction in a cohort of seronegative intravenous drug users.

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Department of Epidemiology, Johns Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205.


The frequency of serologically undetected human immunodeficiency virus type 1 (HIV-1) infection among a large cohort of seronegative intravenous drug users (IVDUs) was determined by polymerase chain reaction (PCR). In total, 2159 blood specimens were obtained from 945 seronegative IVDUs; of these, 182 had 1 specimen, 339 had 2, 397 had 3, and 27 had 4 semiannual specimens. No proviral DNA was detected in 2134 (98.8%) of the samples. Specimens from 7 persons (0.3%) were reactive by PCR. Within 6 months, all 5 of these 7 who returned for follow-up visits had seroconverted. Serum from 19 persons (0.9%) were equivocal by PCR analysis, that is, single primer pair amplification; 1 person seroconverted while others subsequently remained seronegative and nonreactive by PCR. The concordance between PCR and serology was 98.6%. It is concluded that immunosilent HIV-1 infection is uncommon and that serologic screening for HIV-1 antibodies is highly sensitive in this population.

[Indexed for MEDLINE]

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