Oral HIV Exposure May Result in Transient Infection

描述（由申请人提供）：我们有旧的和最近的数据表明，处于艾滋病毒感染高风险的成年人有时会短暂感染艾滋病毒。这包括：(1)针对gp41/gp160构象表位的血清抗体（Ab）的短暂出现；(2)在许多病例中，HIV与Ab同时出现在PBMCs中；(3)在抗体和病毒呈阳性时以及在抗体和病毒均呈阴性时采集的PBMC样本的父系分型表明它们来自同一受试者；(4)对暂时感染对象体内存在的病毒进行序列分析，表明它们不是实验室污染物；(5)在一宗个案中，证明暂时受感染的对象所携带的病毒与其艾滋病毒阳性伴侣所携带的生殖器分泌液中的病毒有基因上的关系。对37名高危人群4年的纵向统计表明，短暂性感染比进行性感染更常见，前者与无保护的口交有关，后者与无保护的生殖器性交有关。用PCR方法在一名短暂性HIV感染者的扁桃体中发现了HIV，但在PBMCs中未检测到。我们假设短暂的HIV感染确实发生在高危成人中，这主要是由于感染途径，即口腔感染。然而，我们将把这个项目的重点放在证明短暂感染发生的假设上。我们的具体目标是：(1)获得绝大多数令人信服的短暂性HIV感染病例的文件；(2)确定扁桃体活检检测HIV和唾液检测抗gp41抗体IgA、IgG和IgM是否比血液检测更好或提供更多信息。虽然暂时感染目前存在争议，但我们的数据强烈表明它确实存在，并且可能是由于口腔感染引起的。

DESCRIPTION (provided by applicant): We have both old and more recent data which indicate that adults at high-risk for HIV infection sometimes become transiently infected with HIV. This includes: (1) transient appearance of serum antibodies (Ab) to conformational epitopes to gp41/gp160; (2) transient appearance of HIV in the PBMCs at the same time as Ab in many cases; (3) paternity typing of PBMC samples taken at the time of Ab and virus positivity and later when the subject is negative for both, showing that they are from the same subject; (4) sequence analysis of the viruses present in transiently infected subjects, showing that they are not lab contaminants; and (5) demonstration in one case in which the virus in a transiently infected subject was genetically related to the virus in genital fluids from his HIV+partner. Longitudinal statistics from studies of 37 high-risk subjects over 4 years showed that transient infections were more frequent than progressive infections, and that the former was associated with unprotected oral sex, while the latter was associated with unprotected genital sex. HIV was found by PCR in the tonsil of one such transiently HIV infected subject, but it was not detected in the PBMCs. We hypothesize that transient HIV infections do occur in high-risk adults and that this is due principally to the route of infection, i.e. oral infection. However, we will focus this project only on proving the hypothesis that transient infection occurs. Our specific Aims are: (1) to obtain overwhelmingly convincing documentation of cases of transient HIV infection; and (2)determine if monitoring for HIV in tonsil biopsies and anti-gp41 Ab IgA, IgG and IgM in saliva is better than or provides more information than monitoring in blood. Although transient infection is presently controversial, our data strongly indicate that it occurs and that it may be due to oral infection.