Resistance to Transmission

“It was in September that year [1989] that Joe Muriuki, a clerk with the Nairobi City Council, went for a HIV test because of some skin infection that refused to go and persistent night sweating that left him cold. But the news that awaited him was numbing. He was HIV positive. The worst was yet to come. Doctors predicted that it would be a matter of time before his wife, then three-weeks pregnant, also tested positive. In the light of those developments, they suggested that the Muriukis abort the foetus. Muriuki then started preparing for his death by packing his belongings to return to his rural home…“Those days, testing HIV positive was equated to a death sentence. It was a matter a months and...” Muriuki gestures helplessly. “You would be gone.”…Eighteen years on, Muriuki is convinced that one can live as healthy as others and he is a living testament of that resolve…Jane[his wife] tested negative but a prejudiced society found it hard to believe…An ever smiling Jane is the mother of three boys. Her last born, Eric Munyiri, the boy that doctors wanted terminated, was one of the top performers in the 2003 Kenya Certificate of Primary Education. “I had sought advice from a number of doctors who all felt that there was no need for me to give birth to a baby who would soon die,” Jane recalls.” But I rejected their advice and left everything to God.”…Jane, who was only 26 when Muriuki went public says, “Initially it was strange for me to be negative. I did not understand and thought maybe it was God’s will and therefore I decided to fully support my husband to overcome the social stigma or any unfairness he would encounter.”…After 18 years, Muriuki is not on ARVs, goes for periodic medical tests and generally keeps healthy by eating well. It’s called the spirit of life.

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“Repeated exposure to human immunodeficiency virus (HIV) does not always result in seroconversion...Nineteen subjects at risk for HIV infection [including 14 in 'stable relationships with HIV-infected sex partners] were CCR-5 genotyped and screened for virus-specific memory cytotoxic T lymphocytes (CTL). None had the delta-32CCR-5/delta-32CCR-5 genotype associated with HIV resistance. HIV-specific CTL were detected in 7 (41.1%) of 17 exposed uninfected subjects versus 0 of 14 seronegative subjects with no HIV risk factors.”

“To analyze whether HIV-specific mucosal immunity can coexist with HIV-specific systemic ccellular immunity in HIV-sexually exposed and seronegative individuals, we analyzed perhipheral blood mononuclear cells (PBMCs), urine, and cervical swabs in 16 heterosexual couples discordant for HIV status in serum [one HIV+, the other HIV-] and reporting multiple episodes of unprotected sex…HIV plasma viral load was undetectable in all the seronegative individuals. Length of exposure, time since last exposure, and CD4 counts in the HIV-seropositive partners, and CD4 counts [did not correlate with] the detection of HIV-specific immune responses in the seronegative exposed partners…Exposure to HIV does not inevitably result in infection.”

“A highly selected cohort of 24 HIV-1 seronegative subjects with histories of multiple high-risk sexual exposures to HIV-1 were studied. The cohort [included 7] homosexual men who reported sex with multiple HIV-1-infected partners, [5] homosexual men with predominantly a single HIV-1-infected partner, and [13] heterosexual individuals reporting sex predominantly with a single HIV-1-infected partner…Among the individuals reporting exposure to predominantly a single HIV-infected partner, most were in long-term relationships involving unprotected sexual intercourse over many years during which time several partners succumbed to AIDS. All subjects were HIV-1 negative by commercially available enzyme-linked immunsorbent assay (ELISA) tests and by diagnostic polymerase chain reaction (PCR)”

“[This study involved] a group of repeatedly exposed but persistently seronegative female prostitutes in The Gambia, West Africa…The seronegative women in this study have worked as prostitutes for more than five years, use condoms infrequently with clients and only rarely with their regular partners, and have a high incidence of other sexually transmitted diseases”

“An important advanced in the rational design of a prophylactic vaccine against HIV would be identification of people who have been exposed to HIV and generated an immune response, but not become persistently infected. A characteristic feature of the immune response to HIV is presence in healthy seropositive subjects of vigorous HIV-specific cytotoxic [cell killing] T-lymphocyte (CTL) activity…We describe the finding of HIV-specific CTL activity in a child born to an HIV-infected mother [and HIV antibody-positive at birth]; all standard markers of HIV infection in the child were negative by the age of 13 months [including antibody tests, antigen tests, PCR RNA and DNA]…if the child has never been infected it is difficult to explain the finding of HIV-specific CTL activity, which normally requires actively replicating virus for stimulation.”