Absence of HIV-1 Antibody Response in HIV Patients: What is the Foe, the Virus or the Host?

Diagnosis of HIV infection is mainly based on thedetection of specific antibodies by screening withcommercial enzyme immunoassays (EIA) or rapidtests, and further confirmation by Western blot. Themajor limitation of these tests is their inability toidentify infection during the “window periodâ€?, whenantibodies have still not been produced. In addition,infection with distant HIV variants such as groups Oor N may occasionally yield false-negative resultsusing some antibody tests. It is noteworthy that inthe last situation the problem is related to antibodydetection and not with antibody production. There isa third rare situation in which HIV infection can bemissed, represented by subjects in which HIV antibodyresponse is lacking despite detectable viremia.These cases have been a subject of intensivestudies in order to determine which factors are responsiblefor this lack of specific humoral immuneresponse.