title: Analysis of HIV Diversity in HIV-Infected Black Men Who Have Sex with Men (HPTN 061).
abstract: BACKGROUND
  HIV populations often diversify in response to selective pressures, such as the immune response and antiretroviral drug use. We analyzed HIV diversity in Black men who have sex with men who were enrolled in the HIV Prevention Trials Network 061 study.
  
  
  METHODS
  A high resolution melting (HRM) diversity assay was used to measure diversity in six regions of the HIV genome: two in gag, one in pol, and three in env. HIV diversity was analyzed for 146 men who were HIV infected at study enrollment, including three with acute infection and 13 with recent infection (identified using a multi-assay algorithm), and for 21 men who seroconverted during the study. HIV diversification was analyzed in a paired analysis for 62 HIV-infected men using plasma samples from the enrollment and 12-month (end of study) visits.
  
  
  RESULTS
  Men with acute or recent infection at enrollment and seroconverters had lower median HRM scores (lower HIV diversity) than men with non-recent infection in all six regions analyzed. In univariate analyses, younger age, higher CD4 cell count, and HIV drug resistance were associated with lower median HRM scores in multiple regions; ARV drug detection was marginally associated with lower diversity in the pol region. In multivariate analysis, acute or recent infection (all six regions) and HIV drug resistance (both gag regions) were associated with lower median HRM scores. Diversification in the pol region over 12 months was greater for men with acute or recent infection, higher CD4 cell count, and lower HIV viral load at study enrollment.
  
  
  CONCLUSIONS
  HIV diversity was significantly associated with duration of HIV infection, and lower gag diversity was observed in men who had HIV drug resistance. HIV pol diversification was more pronounced in men with acute or recent infection, higher CD4 cell count, and lower HIV viral load.
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Iris
authors.initials: I
authors.lastname: Chen
authors.affiliation: Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
authors.forename: Gordon
authors.initials: G
authors.lastname: Chau
authors.affiliation: Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America.
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: William
authors.initials: W
authors.lastname: Clarke
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Marzinke
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cummings
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Autumn
authors.initials: A
authors.lastname: Breaud
authors.affiliation: Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, Maryland, United States of America.|Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Oliver
authors.initials: O
authors.lastname: Laeyendecker
authors.affiliation: Mervyn M. Dymally School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, California, United States of America.
authors.forename: Sheldon D
authors.initials: SD
authors.lastname: Fields
authors.affiliation: Science Facilitation Department, FHI 360, Durham, North Carolina, United States of America.
authors.forename: Sam
authors.initials: S
authors.lastname: Griffith
authors.affiliation: Bridge HIV, San Francisco Department of Public Health, San Francisco, California, United States of America.
authors.forename: Hyman M
authors.initials: HM
authors.lastname: Scott
authors.affiliation: Department of Family Medicine, University of California Los Angeles, Los Angeles, California, United States of America.
authors.forename: Steven
authors.initials: S
authors.lastname: Shoptaw
authors.affiliation: Department of Global Health, Emory University Rollins School of Public Health, Atlanta, Georgia, United States of America.
authors.forename: Carlos
authors.initials: C
authors.lastname: Del Rio
authors.affiliation: Department of Epidemiology and Biostatistics, Milken Institute School of Public Health at The George Washington University, Washington, District of Columbia, United States of America.
authors.forename: Manya
authors.initials: M
authors.lastname: Magnus
authors.affiliation: Department of Medicine, Harlem Hospital, Columbia University, Mailman School of Public Health, New York, New York, United States of America.
authors.forename: Sharon
authors.initials: S
authors.lastname: Mannheimer
authors.affiliation: Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America.
authors.forename: Hong-Van
authors.initials: HV
authors.lastname: Tieu
authors.affiliation: School of Social Welfare, University at Albany, State University of New York, Albany, New York, United States of America.
authors.forename: Darrell P
authors.initials: DP
authors.lastname: Wheeler
authors.affiliation: The Fenway Institute, Fenway Health, Boston, Massachusetts, United States of America.|Infectious Disease Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America.|Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.affiliation: Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, New York, United States of America.
authors.forename: Beryl A
authors.initials: BA
authors.lastname: Koblin
authors.affiliation: Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.
authors.forename: Susan H
authors.initials: SH
authors.lastname: Eshleman
mesh_terms: D000328:Adult; D001741:Black or African American; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D014644:Genetic Variation; D006678:HIV / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents