VANCOUVER, BC--AIDS test results are not always what they seem,
and current vaccine research may be headed in the wrong direction,
Luc Montagnier, MD, said at the 11th International Conference
on AIDS. Dr. Montagnier, of the Institut Pasteur, is a co-discoverer
of HIV-1, the AIDS virus.
Dr. Montagnier presented two examples of misleading HIV antibody
test results. The first was a woman who remained seronegative
despite repeated sexual exposure to her infected male partner.
After several years, she abruptly presented with multiple opportunistic
infections and died of AIDS one year later, still without antibody
against HIV. The virus isolated was a subtype similar to that
of the male partner.
"The case indicates that the so-called resistant seronegative
partner may not be fully resistant to virus infection, and that
the lack of antibody response, probably due to a tolerance to
HIV antigens, can actually accelerate progression toward AIDS,"
Dr. Montagnier warned.
The second case was a woman who tested seropositive for antibodies
against all HIV proteins except gp120. The researchers were unable
to isolate HIV from her lymphocytes or to detect virus using polymerase
chain reaction. The subject remains healthy.
No anti-HIV antibody was found in the woman's urine, but there
were antibodies against two peptides characteristic of a family
of human endogenous retroviral genes.
"Human endogenous retroviruses exist as multiple copies that
represent approximately 1% of the human genome," Dr. Montagnier
said. "The false-positive HIV antibody response may represent
autoantibody to these normal endogenous retroviral proteins."
This finding has important epidemiologic implications, since there
are many similar indeterminate serologic reactions in Africa and
other parts of the world, he said.
Finally, Dr. Montagnier predicted that "the AIDS epidemic
will not decline without the availability of preventive vaccines
that induce protection against mucosal transmission of many variants
of HIV." He is concerned by the fact that most current vaccine
research is directed at preventing virus infection, and suggested
that it could be easier to induce protection against disease.