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.