title: Drug resistance patterns, genetic subtypes, clinical features, and risk factors in military personnel with HIV-1 seroconversion.
abstract: 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.
authors.affiliation: Graduate School of Public Health, San Diego State University, California 92182-4162, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: Brodine
authors.forename: R A
authors.initials: RA
authors.lastname: Shaffer
authors.forename: M J
authors.initials: MJ
authors.lastname: Starkey
authors.forename: S A
authors.initials: SA
authors.lastname: Tasker
authors.forename: J L
authors.initials: JL
authors.lastname: Gilcrest
authors.forename: M K
authors.initials: MK
authors.lastname: Louder
authors.forename: A
authors.initials: A
authors.lastname: Barile
authors.forename: T C
authors.initials: TC
authors.lastname: VanCott
authors.forename: M T
authors.initials: MT
authors.lastname: Vahey
authors.forename: F E
authors.initials: FE
authors.lastname: McCutchan
authors.forename: D L
authors.initials: DL
authors.lastname: Birx
authors.forename: D D
authors.initials: DD
authors.lastname: Richman
authors.forename: J R
authors.initials: JR
authors.lastname: Mascola
mesh_terms: 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
chemical_list: D012367:RNA, Viral; D054303:HIV Reverse Transcriptase; D010450:Endopeptidases