HIV-1 Variation Prior to Seroconversion in Men Who Have Sex with Men: Analysis of Acute/Early HIV Infection in the MACS

Geoffrey S. Gottlieb, Laura Heath, David C. Nickle, Kim G. Wong, Stephanie E. Leach, Benjamin Jacobs, Surafel Gezahegne,
Angélique B van 't Wout, Lisa P. Jacobson, Joseph B. Margolick, James I. Mullins

Division of Allergy & Infectious Diseases, Departments of Medicine and Microbiology, School of Medicine, University of Washington;
Department of Epidemiology and Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

Understanding the characteristics of human immunodeficiency virus (HIV) necessary for infection in a new host is a critical goal for acquired immunodeÞciency syndrome (AIDS) research. We studied the characteristics of HIV-1 envelope genes in 38 men in the Multicenter AIDS Cohort Study cohort before seroconversion. We found a range of diversity (0.2%Ð5.6% [median, 0.86%]), V1-V2 loop length (58Ð93 aa), and potential N-linked glycosylation sites (n = 2Ð9 ). However, at least 46% of the men had replicating virus that appeared to have been derived from a single viral variant. Nearly all variants were predicted to be CCR5 tropic. We found no correlation between these viral characteristics and the HIV outcomes of time to clinical AIDS or death and/or a CD4 cell count <200 cells/μL.