Diverse HIV-1 subtypes and clinical, laboratory and behavioral factors in a recently infected US military cohort.
OBJECTIVE
To describe the demographics, risk behaviors, and HIV-1 subtypes in a large cohort of recently HIV-infected military personnel.


METHODS
Descriptive, cross-sectional study.


METHODS
US military personnel with recent HIV seroconversion from six medical referral centers were enrolled with a self-administered questionnaire, CD4 cell counts, syphilis and hepatitis B serologies, plasma viral RNA levels, and HIV-1 subtype nucleic acid sequencing.


RESULTS
Between February 1997 and May 2000, 520 patients were enrolled. Most [488 (94.3%)] were infected with HIV-1 subtype B. The most prevalent non-B subtype was a circulating recombinant form (CRF01_AE) [17 (61%)]; however, two pure subtypes (C and D), as well as CRF02_AG, CRF09_cpx and a BE recombinant were identified. The likely area of HIV-1 acquisition was the United States for 70% of the volunteers. At least three non-B subtype infections (two subtype C, one subtype CRF01_AE) were apparently acquired domestically. Risk behaviors and comorbid sexually transmitted diseases were reported during the seroconversion period. Volunteers with non-B subtype HIV infection were more likely to report heterosexual contacts [92% vs. 39%; odds ratio (OR), 10.0], including contacts with commercial sex workers (41% vs. 13%; OR, 4.9). The Roche Amplicor version 1.0 assay was less sensitive for non-B subtype infections than the Roche Amplicor version 1.5 assay.


CONCLUSIONS
There is a high prevalence and diversity of non-B HIV subtypes in this large cohort. Efficient diagnosis of acute primary HIV-1 infection was identified as a goal for prevention programs. Modifiable risk behaviors and target populations for intervention were identified.
Graduate School of Public Health, San Diego State University, San Diego, California 92182, USA.
Stephanie K
SK
Brodine
Monica J
MJ
Starkey
Richard A
RA
Shaffer
Stanley I
SI
Ito
Sybil A
SA
Tasker
Anthony J
AJ
Barile
Cindy L
CL
Tamminga
Kevin T
KT
Stephan
Naomi E
NE
Aronson
Susan L
SL
Fraser
Mark R
MR
Wallace
Scott A
SA
Wegner
John R
JR
Mascola
Francine E
FE
McCutchan
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000523:psychology / Q000821:virology*; D015497:HIV-1 / Q000145:classification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology; D015995:Prevalence; D012309:Risk-Taking; D012725:Sexual Behavior / Q000523:psychology; D014481:United States / Q000453:epidemiology