title: Evolution of HIV-1 in an HLA-B*57-positive patient during virologic escape.
abstract: Elite suppressors maintain normal CD4(+) T cell counts and viral loads of <50 copies of human immunodeficiency virus type 1 (HIV-1) RNA per milliliter of plasma without antiviral therapy. We report here a case of virologic escape in a human leukocyte antigen (HLA)-B*57-positive patient shortly after seroconversion. This escape was associated with the development of mutations in 2 HLA-B*57-restricted CD8(+) T cell Gag epitopes, reversion of the drug-resistance mutation M184V, and reversion of a novel polymorphism in Vpu. The present study suggests that control of viral replication in elite suppressors may be due to HIV-1-specific CD8(+) T cells and, in some cases, mutations that have subtle effects on viral fitness.
authors.affiliation: Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
authors.forename: Justin R
authors.initials: JR
authors.lastname: Bailey
authors.forename: Haili
authors.initials: H
authors.lastname: Zhang
authors.forename: Barbara W
authors.initials: BW
authors.lastname: Wegweiser
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Yang
authors.forename: Laura
authors.initials: L
authors.lastname: Herrera
authors.forename: Aima
authors.initials: A
authors.lastname: Ahonkhai
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Williams
authors.forename: Robert F
authors.initials: RF
authors.lastname: Siliciano
authors.forename: Joel N
authors.initials: JN
authors.lastname: Blankson
mesh_terms: D000328:Adult; D019943:Amino Acid Substitution / Q000235:genetics; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D004252:DNA Mutational Analysis; D024882:Drug Resistance, Viral / Q000235:genetics; D018984:Epitopes, T-Lymphocyte / Q000235:genetics; D019143:Evolution, Molecular; D015683:Gene Products, gag / Q000235:genetics; D016679:Genome, Viral / Q000235:genetics*; D015658:HIV Infections / Q000235:genetics / Q000276:immunology* / Q000821:virology*; D015497:HIV-1 / Q000235:genetics* / Q000302:isolation & purification; D015235:HLA-B Antigens / Q000235:genetics*; D054298:Human Immunodeficiency Virus Proteins; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D020125:Mutation, Missense; D012367:RNA, Viral / Q000235:genetics*; D054334:Viral Regulatory and Accessory Proteins / Q000235:genetics; D000086082:Viroporin Proteins
chemical_list: D018984:Epitopes, T-Lymphocyte; D015683:Gene Products, gag; D015235:HLA-B Antigens; D054298:Human Immunodeficiency Virus Proteins; D012367:RNA, Viral; D054334:Viral Regulatory and Accessory Proteins; C103707:HLA-B57 antigen; C514859:vpu protein, Human immunodeficiency virus 1; D000086082:Viroporin Proteins