title: Evolution and transmission of stable CTL escape mutations in HIV infection.
abstract: Increasing evidence indicates that potent anti-HIV-1 activity is mediated by cytotoxic T lymphocytes (CTLs); however, the effects of this immune pressure on viral transmission and evolution have not been determined. Here we investigate mother-child transmission in the setting of human leukocyte antigen (HLA)-B27 expression, selected for analysis because it is associated with prolonged immune containment in adult infection. In adults, mutations in a dominant and highly conserved B27-restricted Gag CTL epitope lead to loss of recognition and disease progression. In mothers expressing HLA-B27 who transmit HIV-1 perinatally, we document transmission of viruses encoding CTL escape variants in this dominant Gag epitope that no longer bind to B27. Their infected infants target an otherwise subdominant B27-restricted epitope and fail to contain HIV replication. These CTL escape variants remain stable without reversion in the absence of the evolutionary pressure that originally selected the mutation. These data suggest that CTL escape mutations in epitopes associated with suppression of viraemia will accumulate as the epidemic progresses, and therefore have important implications for vaccine design.
authors.affiliation: Partners AIDS Research Center, Massachusetts General Hospital and Division of AIDS, Harvard Medical School, Boston, Massachusetts 02114, USA. goulder@helix.mg.harvard.edu
authors.forename: P J
authors.initials: PJ
authors.lastname: Goulder
authors.forename: C
authors.initials: C
authors.lastname: Brander
authors.forename: Y
authors.initials: Y
authors.lastname: Tang
authors.forename: C
authors.initials: C
authors.lastname: Tremblay
authors.forename: R A
authors.initials: RA
authors.lastname: Colbert
authors.forename: M M
authors.initials: MM
authors.lastname: Addo
authors.forename: E S
authors.initials: ES
authors.lastname: Rosenberg
authors.forename: T
authors.initials: T
authors.lastname: Nguyen
authors.forename: R
authors.initials: R
authors.lastname: Allen
authors.forename: A
authors.initials: A
authors.lastname: Trocha
authors.forename: M
authors.initials: M
authors.lastname: Altfeld
authors.forename: S
authors.initials: S
authors.lastname: He
authors.forename: M
authors.initials: M
authors.lastname: Bunce
authors.forename: R
authors.initials: R
authors.lastname: Funkhouser
authors.forename: S I
authors.initials: SI
authors.lastname: Pelton
authors.forename: S K
authors.initials: SK
authors.lastname: Burchett
authors.forename: K
authors.initials: K
authors.lastname: McIntosh
authors.forename: B T
authors.initials: BT
authors.lastname: Korber
authors.forename: B D
authors.initials: BD
authors.lastname: Walker
mesh_terms: D000328:Adult; D002648:Child; D004279:DNA, Viral; D018450:Disease Progression; D018984:Epitopes, T-Lymphocyte / Q000235:genetics; D005260:Female; D015658:HIV Infections / Q000235:genetics / Q000276:immunology / Q000635:transmission* / Q000821:virology; D015497:HIV-1 / Q000235:genetics* / Q000276:immunology; D015796:HLA-B27 Antigen / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D009154:Mutation; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology*
chemical_list: D004279:DNA, Viral; D018984:Epitopes, T-Lymphocyte; D015796:HLA-B27 Antigen