Drug resistance patterns, genetic subtypes, clinical features, and risk factors in military personnel with HIV-1 seroconversion.
BACKGROUND
Regular testing of military personnel identifies early HIV infection; this identification provides a sentinel cohort in which to describe the evolving molecular epidemiology of HIV-1 transmission.


OBJECTIVE
To describe the prevalence and epidemiologic correlates associated with the acquisition of non-subtype B and drug-resistant HIV infections.


METHODS
Cross-sectional study.


METHODS
Military referral hospital.


METHODS
95 military personnel with HIV-1 seroconversion.


METHODS
Self-reported questionnaire, CD4 cell counts, plasma HIV-1 RNA levels, and nucleic acid sequence analysis for drug-resistant mutations and HIV-1 genetic subtype.


RESULTS
95 patients were enrolled between February 1997 and February 1998. The likely geographic location of HIV-1 acquisition was overseas in 8% of patients, the United States in 68%, and either overseas or the United States in 24%. Seven patients (7.4%) had subtype E infection; the remainder had subtype B infection. Eight of 31 (26%) treatment-naive patients had mutations in the reverse transcriptase or protease gene associated with drug resistance.


CONCLUSIONS
The percentage of HIV-1 non-subtype B infection and antiretroviral drug-resistant mutations was relatively high in U.S. military personnel with recently acquired HIV-1 infection.
Brodine
S K
SK
Graduate School of Public Health, San Diego State University, California 92182-4162, USA.
Shaffer
R A
RA
Starkey
M J
MJ
Tasker
S A
SA
Gilcrest
J L
JL
Louder
M K
MK
Barile
A
A
VanCott
T C
TC
Vahey
M T
MT
McCutchan
F E
FE
Birx
D L
DL
Richman
D D
DD
Mascola
J R
JR
D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004352:Drug Resistance, Microbial / Q000235:genetics; D010450:Endopeptidases / Q000235:genetics; D005260:Female; D005838:Genotype; D054303:HIV Reverse Transcriptase / Q000235:genetics; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000235:genetics / Q000821:virology*; D015497:HIV-1 / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008889:Military Personnel; D009154:Mutation; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D011795:Surveys and Questionnaires
D012367:RNA, Viral; D054303:HIV Reverse Transcriptase; D010450:Endopeptidases