title: Rapid disease progression without seroconversion following primary human immunodeficiency virus type 1 infection--evidence for highly susceptible human hosts.
abstract: A patient is described who rapidly progressed from primary human immunodeficiency virus (HIV) type 1 infection to death without seroconversion but with consistently high plasma viremia. His asymptomatic sex partner had been HIV-1 seropositive for >8 years prior to transmission. Analysis of viral sequences from these subjects and controls confirmed the transmission event. Although the biologic properties of the patient's virus were unremarkable, he had poor functional immune responses to HIV and an HLA haplotype associated with rapid disease progression. The disparity between immune responses and clinical course in this transmission pair, coupled with infection with an unremarkable HIV-1 isolate, underscores the crucial importance of host factors in HIV-1 pathogenesis.
authors.affiliation: Division of Retrovirology, Walter Reed Army Institute of Research, and Henry M. Jackson Foundation, Rockville, Maryland 20850, USA.
authors.forename: N L
authors.initials: NL
authors.lastname: Michael
authors.forename: A E
authors.initials: AE
authors.lastname: Brown
authors.forename: R F
authors.initials: RF
authors.lastname: Voigt
authors.forename: S S
authors.initials: SS
authors.lastname: Frankel
authors.forename: J R
authors.initials: JR
authors.lastname: Mascola
authors.forename: K S
authors.initials: KS
authors.lastname: Brothers
authors.forename: M
authors.initials: M
authors.lastname: Louder
authors.forename: D L
authors.initials: DL
authors.lastname: Birx
authors.forename: S A
authors.initials: SA
authors.lastname: Cassol
mesh_terms: D000328:Adult; D018450:Disease Progression; D004198:Disease Susceptibility; D005814:Genes, Viral / Q000235:genetics; D015699:HIV Envelope Protein gp120 / Q000235:genetics; D015658:HIV Infections / Q000276:immunology / Q000821:virology*; D018023:HIV Seronegativity / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology / Q000302:isolation & purification / Q000502:physiology*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood; D015678:Viral Structural Proteins / Q000235:genetics; D014779:Virus Replication
chemical_list: D015699:HIV Envelope Protein gp120; D012367:RNA, Viral; D015678:Viral Structural Proteins