HTLV-1 polymyositis.

The case is described of an HTLV-1 seropositive Jamaican woman who presented with signs and symptoms of polymyositis and myelopathy. A muscle biopsy showed features of myositis with a mononuclear inflammatory infiltrate, variation in fibre size and evidence of regeneration. Immunocytochemistry showed the mononuclear cells were composed of macrophages and T-lymphocytes suggesting a cell-mediated response. Multiplex PCR demonstrated the presence of the HTLV-1 tax gene within the muscle.

HTLV-1 polymyositis

The case is described of an HTLV-1 seropositive Jamaican woman who presented with signs and symptoms of polymyositis and myelopathy. A muscle biopsy showed features of myositis with a mononuclear inflammatory infiltrate, variation in fibre size and evidence of regeneration. Immunocytochemistry showed the mononuclear cells were composed of macrophages and T-lymphocytes suggesting a cell-mediated response. Multiplex PCR demonstrated the presence of the HTLV-I tax gene within the muscle. (AU)

An efficient method for the rescue and analysis of functional HIV-1 env genes: evidence for recombination in the vicinity of the tat/rev splice site.

OBJECTIVE: To establish a robust procedure for the isolation and characterization of full-length expression-competent HIV-1 env genes directly from patient samples. DESIGN: HIV exists as a quasispecies which can be disturbed by in vitro culture, in which numerous members of the population are likely to be defective due to the high error rate of the viral reverse transcriptase. Defective viruses are unlikely to play a dominant role in disease progression. Since env gene translation products play major roles in the initiation and spread of infection we need to study genes with open reading frames. METHODS: A nested polymerase chain reaction (PCR) approach has been used to rescue intact (2.6 kb) env genes, which are cloned into a T7-promoter-containing vector. Expression of gp160 in CV-1 cells is detected by Western blot. Expression-competent clones are sequenced and resulting sequences used for phylogenetic studies. Translation products are analysed in relation to the known immunogenic structure of gp160. RESULTS: From random patient samples collected in London clinics, only HIV-1 subtype B was found. Two of the samples contained viruses with an additional pair of cysteine residues in their V1 regions. For samples collected in Uganda, HIV-1 subtypes A, D and an A/D recombinant were recovered. CONCLUSION: An effective procedure is described for the isolation of HIV-1 env genes directly from patient samples, which has worked for A, B and D subtypes to date. The PCR primers can be utilized with other subtypes with the possible exception of subtype O viruses. Phylogenetic analyses revealed the potential importance of a G/C-rich region near the tat/rev splice site as a site of recombination. The sequences and translation products generated may be more relevant to disease progression in vivo and vaccine formulations than those obtained from viruses selected in long-term culture.

Development of human T-cell lymphotropic virus type I-associated adult T-cell leukemia/lymphoma during immunosuppressive treatment following renal transplantation.

Although it is recognized that there is an increased incidence of lymphoproliferative disorders among patients who have received immunosuppressive therapy following transportation, there have been few reports of adult T-cell leukemia/lymphoma (ATLL) developing in previously asymptomatic carriers of human T-cell lymphotropic virus type I (HTLV-I) who have undergone transplantation. We describe the development of such a tumor in a man who was HTLV-I-positive and received immunosuppressive treatment following renal transplantation. As the number of individuals in ethnic groups at risk for organ transplantation increases, it would seem prudent to screen such individuals for carriage of HTLV-I before transplantation and to follow them prospectively to confirm if transplantation and immunosuppression predispose to the development of ATLL.

HIV excretion patterns and specific antibody responses in body fluids.

HIV excretion patterns and specific antibody responses were evaluated in blood, semen, female genital secretions, saliva, and crevicular fluid. Samples were examined for infectious virus, viral antigens, viral nucleic acid, HIV specific IgG, IgA, anti-nef, and anti-p24. Viral load in peripheral blood appeared to increase with disease progression. The proportion of patients with antibody responses specific for nef and p24 was also lower among patients with more advanced disease. Infectious virus and viral antigens were detected infrequently and at lower levels in body fluids than in blood, which may reflect the presence of local antibodies. HIV nucleic acid was detected in some semen and saliva samples in the absence of infectious virus.