Infection with multiple human immunodeficiency virus type 1 variants is associated with faster disease progression.
Human immunodeficiency virus type 1 (HIV-1)-infected individuals develop a genetically diverse virus population over time, but often only a limited number of viral variants are transmitted from a chronic carrier to a newly infected person. Interestingly, many women but few men are infected by multiple HIV-1 variants from a single partner. To determine whether the complexity of the infecting virus population influences clinical outcome, we examined viral diversity in the HIV-1 envelope sequences present at primary infection in 156 women from Kenya for whom we had follow-up data on viral RNA levels and CD4 T-cell counts. Eighty-nine women had multiple viral genotypes, while 67 women had a single genotype at primary infection. Women who acquired multiple viral genotypes had a significantly higher viral load (median, 4.84 versus 4.64 log(10) copies/ml, P = 0.04) and a significantly lower CD4(+)-T-cell count (median, 416 versus 617 cells/mm(3), P = 0.01) 4 to 24 months after infection compared to women who were infected with a single viral genotype. These studies suggest that early HIV-1 genetic diversity is linked to faster disease progression.
Sagar
Manish
M
Divisions of Human Biology, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington 98109, USA.
Lavreys
Ludo
L
Baeten
Jared M
JM
Richardson
Barbra A
BA
Mandaliya
Kishorchandra
K
Chohan
Bhavna H
BH
Kreiss
Joan K
JK
Overbaugh
Julie
J
D001483:Base Sequence; D017931:DNA Primers; D018450:Disease Progression; D005838:Genotype; D015658:HIV Infections / Q000503:physiopathology / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D013045:Species Specificity; D019562:Viral Load
D017931:DNA Primers