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1 July 2007

Volume 196, Number 1
The Journal of Infectious Diseases 2007;196:50–55
© 2007 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2007/19601-0010$15.00
DOI: 10.1086/518515
BRIEF REPORT

Evolution of HIV‐1 in an HLA‐B*57–Positive Patient during Virologic Escape

Justin R. Bailey,1

Haili Zhang,1

Barbara W. Wegweiser,1

Hung‐Chih Yang,1

Laura Herrera,1

Aima Ahonkhai,1

Thomas M. Williams,3,4

Robert F. Siliciano,1,2 and

Joel N. Blankson1

1Department of Medicine, Johns Hopkins School of Medicine, and 2Howard Hughes Medical Institute, Baltimore, Maryland; 3Department of Pathology, University of New Mexico, and 4TriCore Reference Laboratories, Albuquerque

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.

Received 13 December 2006; accepted 1 February 2007; electronically published 17 May 2007.

Reprints or correspondence: Dr. Joel Blankson, Broadway Research Bldg., Rm. 880, Johns Hopkins University School of Medicine, 733 N. Broadway, Baltimore, MD 21205 ().

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Online publication date: 1-Feb-2009.
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Yefei Han, Jun Lai, Patricia Barditch-Crovo, Joel E Gallant, Thomas M Williams, Robert F Siliciano, Joel N Blankson. (2008) The role of protective HCP5 and HLA-C associated polymorphisms in the control of HIV-1 replication in a subset of elite suppressors. AIDS 22:4, 541-544
Online publication date: 1-Mar-2008.
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James I Mullins, Morgane Rolland, Todd M Allen. (2008) Viral evolution and escape during primary human immunodeficiency virus-1 infection: implications for vaccine design. Current Opinion in HIV and AIDS 3:1, 60-66
Online publication date: 1-Feb-2008.
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  • Potential conflicts of interest: none reported.

    Financial support: National Institutes of Health (grant K08 AI51191‐04); Howard Hughes Medical Institute.

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