Seronegative HIV-1 infection has important implications for diagnosis and prevention. We describe a case of HIV-1 infection without seroconversion and fast progression to AIDS and death. Genetic and phylogenetic analysis indicated that the patient was infected with a CRF14_BG-like strain selectively transmitted by his seropositive sexual partner. The results suggest a massive infection with a highly aggressive CRF14_BG-like strain and/or the presence of an unidentified immunological deficiency that has prevented the formation of HIV-1-specific antibodies.
aUnidade dos Retrovírus e Infecções Associadas, Centro de Patogénese Molecular, Faculdade de Farmácia de Lisboa, Lisbon, Portugal
bCentro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Sul, Caparica, Portugal
cLaboratório de Biologia Molecular, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal
dInstituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal
eServiço de Medicina 1, Hospital Distrital de Santarém, Santarém, Portugal.
Received 30 July, 2009
Revised 2 September, 2009
Accepted 9 September, 2009