Long-term human immunodeficiency virus infection in asymptomatic homosexual and bisexual men with normal cd4+ lymphocyte counts: Immunologic and virologie characteristics

From a prospective cohort study, 24 asymptomatic men were identified who had been antibody positive for human immunodeficiency virus (HIV) for at least 5 years (median = 9.1) with CD4⁺lymphocyte counts ⩾ 400 cells/mm³. Of these “nonprogressors,” 23 (96%) had evidence of HIV infection by either HIV culture or the polymerase chain reaction (PCR) for HIV DNA, although only 1 (4%) had a positive assay for HIV RNA (by PCR) and no one was positive for p24 antigen. Compared with 24 antibody-negative men and 14 men with AIDS, nonprogressors had higher CD8⁺ counts and lower natural killer cell activity. Nonprogressors had higher β 3₂-microglobulin levels than did seronegative controls, suggesting some degree of immune system activation. Compared with men with AIDS, nonprogressors seemed to have a stronger antibody response to six different HIV-related proteins but did not differ significantly in neutralizing antibody or antibody- dependent cellular cytotoxic activity.