title: Disease progression due to dual infection in an HLA-B57-positive asymptomatic long-term nonprogressor infected with a nef-defective HIV-1 strain.
abstract: We describe the case of an HLA-B57-positive long-term nonprogressor in whom we previously showed that PBMCs accumulated HIV-1 subtype B proviruses defective in the env gene. After more than 10 years of control of infection, plasma viremia increased progressively, with a concomitant loss of CD4(+) T cells. By phylogenetic analyses of env, nef, vif, and gag sequences obtained at different time points, we suggest here that this patient was initially infected by a putatively attenuated nef-defective variant and that loss of control was due to superinfection with a fully competent virus belonging to the same clade B. At the time of superinfection, its plasma was unable to efficiently neutralize the superinfecting virus and moderate Gag-specific CD8(+) T-cell responses were observed. This suggests the limited capacity of even a long-lasting natural infection with a nef-deficient HIV-1 strain to elicit immune responses able to prevent and control superinfection with a virus of the same clade.
authors.affiliation: Université François-Rabelais, Inserm U966 & CHRU de Tours, 37032 Tours, France. braibant@med.univ-tours.fr
authors.forename: Martine
authors.initials: M
authors.lastname: Braibant
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.forename: Assia
authors.initials: A
authors.lastname: Samri
authors.forename: Henri
authors.initials: H
authors.lastname: Agut
authors.forename: Brigitte
authors.initials: B
authors.lastname: Autran
authors.forename: Francis
authors.initials: F
authors.lastname: Barin
mesh_terms: D000595:Amino Acid Sequence; D001483:Base Sequence; D005786:Gene Expression Regulation / Q000502:physiology; D015658:HIV Infections / Q000821:virology*; D020276:HIV Long-Term Survivors; D015497:HIV-1 / Q000235:genetics*; D015235:HLA-B Antigens / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D010802:Phylogeny; D015163:Superinfection / Q000821:virology*; D013997:Time Factors; D054311:nef Gene Products, Human Immunodeficiency Virus / Q000737:chemistry / Q000235:genetics* / Q000378:metabolism
chemical_list: D015235:HLA-B Antigens; C103707:HLA-B57 antigen; D054311:nef Gene Products, Human Immunodeficiency Virus