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Transmission of the Monkey AIDS Virus to a Human

The origin of HIV-1 and HIV-2, the viruses that cause AIDS, has been the subject of much speculation. Although the origin of HIV-1 is murky, evidence has been mounting that HIV-2 may have originated as a monkey virus, known as simian immunodeficiency virus, or SIV. HIV-2 is transmitted sexually in humans and is less virulent in causing AIDS than HIV-1 and may be less transmissible. SIV and HIV-2 appear to be closely related both serologically and by DNA sequence. Analysis of DNA sequences has shown that some strains of SIV and HIV-2 are more closely related to each other than to other members of their families.

An unfortunate laboratory occurence has demonstrated that the transmission of SIV to humans is possible. A laboratory worker with severe hand eczema developed a positive antibody test for SIV and HIV-2 despite the clear absence of risk factors or exposure to infected persons. Subsequently, SIV was isolated from the worker's blood. The researcher had been handling clinical specimens from macaques infected with SIV; however, the researcher could not recall any direct exposure. The DNA sequence of the virus isolated from the researcher's blood was identical to the DNA sequence of the virus that the researcher had been working with.

Comment: This report documents that SIV can be directly transmitted to humans. The hypothesis that HIV-2 originated in monkeys has gained some support. Interestingly, the researcher has no clinical or laboratory evidence of AIDS and has maintained normal CD4 counts. Of particular note is that the researcher probably contracted the SIV infection by contact of infected fluid with eczematous skin. It is important to remember (and to remind our patients) that HIV-1 can be transmitted in this way as well.

— PA Bleicher

Published in Journal Watch Dermatology March 1, 1994

Citation(s):

Khabbaz RF et al. Brief report: Infection of a laboratory worker with simian immunodeficiency virus. N Engl J Med 1994 330 172-177.

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