The Earliest Known AIDS Patient in the United States was Infected with an HIV-1 Strain Closely Related to IIIB/LAI

Allyson M. Haislip,1 Marlys H. Witte,2 Karen A. Sullivan,3 Margaret Wolfe,3 A. Arthur Gottlieb,1,3,4 Marise S. Gottlieb,3,4 William R. Cole, 5 Charles L. Witte2 and Robert F.

Department of Microbiology and Immunology,1 and Medicine,3 Tulane University School of Medicine, New Orleans, LA, USA; Department of Surgery, University of Arizona College of Medicine, Tucson, AR USA2; Imreg, Inc., New Orleans, LA, USA4; Department of Surgery, University of Missouri School of Medicine, Columbia, MO USA.5

XIIth International Congress of Virology, Sydney Australia, August 8-13, 1999

In 1968, a 15-year-old black male was admitted to St. Louis City Hospital with extensive lymphedema of the genitalia and lower extremities. Chlamydia were widely disseminated and isolated from numerous body fluids and organs. Over the ensuing 16 months the clinical course of this patient progressively deteriorated, and at autopsy widespread Kaposi's sarcoma (KS) of the aggressive, disseminated type was present in most soft tissues. Western blot and antigen capture assays on serum and autopsy specimens frozen since 1969 disclosed that this sexually-active teenager was infected with a virus closely-related or identical to HIV-1. HLA analysis of tissues from the 1968 St. Louis AIDS/KS case indicated that all samples came from the same individual. Polymerase chain reaction (PCR) analysis of LTR, gag, pol, env and vpr gene sequences from these tissues indicate that this patient was infected with a clade B subtype of HIV-1 closely related to strain IIIB/LAI. The HIV-1 sequences present in tissues of this individual are unlikely to be a laboratory contaminant because the PCR was performed on DNA isolated directly from the patient's tissue without culture, and the sequence differed at several sites from HIV-1 strains present in the laboratory. These clinical, immunological, and genetic studies together suggest that HIV-1 existed in the United States prior to the late 1970's. They also suggest that viruses related to strain IIIB/LAI may have been more prevalent prior to the pandemic spread of the virus than current virus strains.

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