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Human immunodeficiency virus antigenemia.

The article by Kessler et al 1 in this issue ofThe Journaldescribes the acute illness associated with human immunodeficiency virus (HIV) infection in four individuals. Of interest was the detection of HIV antigenemia during the course of this self-limited illness before enzyme-linked immunosorbent and Western blot assays for antibody to HIV became positive. The presence of circulating antigen thus helped to establish the diagnosis. Other investigators 2 have reported that HIV antigenemia precedes seroconversion in an unknown proportion of acutely infected individuals. The evidence available to date suggests that the circulating antigen contains the core protein of the HIV (p24) and possibly other epitopes of the virus, and that when antibody to the p24 component of the virus increases to measurable concentrations in serum or plasma, the antigen can no longer be detected. 3 In some individuals, months to years after infection, anti-p24 concentrations fall in association with