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gp 41/gp 160的构象表位的血清抗体（Ab）的瞬时出现;（2）在许多情况下，HIV与Ab同时在PBMC中瞬时出现;（3）在Ab和病毒阳性时以及稍后当受试者对两者均为阴性时采集的PBMC样品的亲子鉴定分型，表明它们来自同一受试者;（4）对短暂感染受试者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）在一例病例中证明，短暂感染受试者体内的病毒与其HIV+伴侣生殖器液中的病毒在遗传上相关。对37名高危受试者进行的4年以上研究的纵向统计显示，一过性感染比进行性感染更常见，前者与无保护的口交有关，而后者与无保护的生殖器性交有关。通过PCR在一个这样的瞬时HIV感染受试者的扁桃体中发现HIV，但在PBMC中未检测到HIV。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仅仅放在证明短暂感染发生的假设上。我们的具体目标是：（1）获得暂时性HIV感染病例的压倒性令人信服的文件;（2）确定扁桃体活检和唾液中抗gp 41 Ab伊加、IgG和IgM的HIV监测是否优于血液监测或提供更多信息。虽然暂时性感染目前是有争议的，我们的数据强烈表明，它发生，它可能是由于口腔感染。

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.