We recently discovered an amino acid-altering heterozygous mutation in codon 178 of the PRNP amyloid precursor gene in patients with familial Creutzfeldt-Jakob disease. This mutation is now shown to be associated with the occurrence of disease in 7 unrelated families of Western European origin, among which a total of 65 members are known to have died from Creutzfeldt-Jakob disease. The mutation was detected in each of 17 tested patients, including at least 1 affected member of each family, and in 16 of 36 of their first-degree relatives, but not in affected families with other mutations, patients with the nonfamilial form of the disease, or 83 healthy control individuals. Linkage analysis in two informative families yielded a lod score of 5.30, which, because no recombinants were found, strongly suggests that codon 178Asn is the actual disease mutation.

RNA sequences of five flaviviruses were detected by a modified polymerase chain reaction (PCR) that incorporated a reverse transcriptase and RNase inhibitor. Oligonucleotide primer pairs were synthesized to amplify sequences from St. Louis encephalitis (SLE), Japanese encephalitis (JBE), yellow fever (YF), dengue 2 (DEN-2), and dengue 4 (DEN-4) viruses. The amplified products were visualized as bands of appropriate size on ethidium bromide-stained agarose gels. The identity of these products was confirmed by restriction endonuclease cleavage to generate fragments of predicted lengths. The reverse-transcriptase PCR (RT-PCR) successfully amplified flavivirus sequences from cell cultures, frozen brain tissue, and formalin-fixed, paraffin-embedded brain tissue. The reactions were highly specific, and the method compared favorably to two conventional assays of viral infectivity. RT-PCR followed by PCR with nesting primers (N-PCR) was 1,000-fold more sensitive in detecting virus than classical infectivity titration by intracerebral inoculation of suckling mice and nearly 1,000-fold more sensitive than amplification of virus in cell culture followed by inoculation of mice.

An American family of English origin with an unusually early onset and long-duration form of Creutzfeldt-Jakob disease (CJD) had a heterozygous insert mutation in the region of repeating octapeptide coding sequences between codons 51 and 91 of the PRNP gene on chromosome 20. Affected members were 23 to 35 years old at the onset of illnesses that lasted from 4 to 13 years, yet experimental transmission of disease from the proband (11-year duration) produced a typically brief incubation period and duration of illness in each of three inoculated primates. Also, the PrP amyloid protein that accumulates in CJD brain was only barely detectable in extracted brain tissue from one case with massive spongiform change and was undetectable in another case with no spongiform change, perhaps because of epitope shielding by a configurational change in the protein induced by the mutation. Analysis of this and other families with similar inserts suggests that such mutations in the PRNP gene not only predispose to CJD, but also modify its phenotypic expression.

Twenty-seven chimpanzees inoculated with material presumed to contain human immunodeficiency virus (HIV) between June 1983 and February 1985 were studied. The animals were examined on four to six occasions between 1989 and 1992 for serologic, virologic, hematologic, immunophenotypic, as well as clinical signs of HIV infection and compared to five uninfected control animals. The 19 animals that had seroconverted within 244 days of inoculation remained antibody positive, whereas those that did not seroconvert within 244 days of inoculation remained antibody negative 6 to 8 years later. HIV antigen was demonstrated at least once in lymphocyte cultures from 12 of the 19 antibody positive chimpanzees during this period. Nested polymerase chain reaction amplified proviral DNA in lymphocytes from 14 of the 19 animals. No proviral DNA was detected in antibody-negative animals. Antibody titers were generally higher in animals from which virus was recovered in lymphocyte cultures [granulocyte-macrophage (GM) titer, 1:8427] compared to virus-negative animals (GM titer, 1:3608). Mean total white blood cell and lymphocyte subtype counts were similar in the HIV-infected animals and uninfected controls. The high antibody levels and Western blot profiles, over periods as long as 9 years in these chimpanzees, suggest continuous stimulation of the immune system by HIV antigen although virus was detected only sporadically in the peripheral blood. No illness suggestive of immunodeficiency was seen.