PMID- 19093810
OWN - NLM
STAT- MEDLINE
DCOM- 20090123
LR  - 20211020
IS  - 1537-6591 (Electronic)
IS  - 1058-4838 (Print)
IS  - 1058-4838 (Linking)
VI  - 48
IP  - 2
DP  - 2009 Jan 15
TI  - Contribution of immunological and virological factors to extremely severe primary 
      HIV type 1 infection.
PG  - 229-38
LID - 10.1086/595704 [doi]
AB  - BACKGROUND: During acute human immunodeficiency virus (HIV) infection, high viral 
      loads and the induction of host immune responses typically coincide with the 
      onset of clinical symptoms. However, clinically severe presentations during acute 
      HIV type 1 (HIV-1) infection, including AIDS-defining symptoms, are unusual. 
      METHODS: Virus isolates were tested for clade, drug susceptibility, coreceptor 
      use, and growth rate in 2 case reports of sexual transmission of HIV-1 infection. 
      Human leukocyte antigen (HLA) genotype was determined, and HIV-1-specific 
      cytotoxic T lymphocyte responses to an overlapping peptide set spanning the 
      entire HIV clade A and clade B proteome were assayed. RESULTS: The viruses 
      isolated in the 2 unrelated case reports of severe primary HIV-1 infection showed 
      R5/X4 dual-mixed tropism, belonged to clade B and CRF02-AG, and were highly 
      replicative in peripheral blood mononuclear cell culture. Impaired humoral 
      responses were paralleled by a profound absence of HIV-1-specific cytotoxic T 
      lymphocyte responses to the entire viral proteome in the 2 case reports. In 1 
      case report for which the virus source was available, there was a remarkable HLA 
      similarity between the 2 patients involved in the transmission event, because 3 
      of 4 HLA-A and HLA-B alleles had matched HLA supertype for both patients. 
      CONCLUSIONS: The data suggest that concurrence of viral and host factors 
      contributes to the clinical severity of primary HIV-1 infection and that patients 
      infected with highly replicative, dual-tropic viruses are more prone to develop 
      AIDS-defining symptoms during acute infection if they are unable to mount humoral 
      and cellular HIV-1-specific immune responses. The presence of concordant HLA 
      supertypes might facilitate the preferential transmission of HLA-adapted viral 
      variants, further accelerating disease progression.
FAU - Dalmau, Judith
AU  - Dalmau J
AD  - irsiCaixa Foundation, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
FAU - Puertas, Maria Carmen
AU  - Puertas MC
FAU - Azuara, Marta
AU  - Azuara M
FAU - Marino, Ana
AU  - Marino A
FAU - Frahm, Nicole
AU  - Frahm N
FAU - Mothe, Beatriz
AU  - Mothe B
FAU - Izquierdo-Useros, Nuria
AU  - Izquierdo-Useros N
FAU - Buzon, Maria Jose
AU  - Buzon MJ
FAU - Paredes, Roger
AU  - Paredes R
FAU - Matas, Lourdes
AU  - Matas L
FAU - Allen, Todd M
AU  - Allen TM
FAU - Brander, Christian
AU  - Brander C
FAU - Rodrigo, Carlos
AU  - Rodrigo C
FAU - Clotet, Bonaventura
AU  - Clotet B
FAU - Martinez-Picado, Javier
AU  - Martinez-Picado J
LA  - eng
GR  - R01 AI054178/AI/NIAID NIH HHS/United States
GR  - R01 AI054178-05/AI/NIAID NIH HHS/United States
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Clin Infect Dis
JT  - Clinical infectious diseases : an official publication of the Infectious Diseases 
      Society of America
JID - 9203213
RN  - 0 (HIV Antibodies)
RN  - 0 (HLA Antigens)
RN  - 0 (Receptors, HIV)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cells, Cultured
MH  - Female
MH  - Genotype
MH  - HIV Antibodies/blood
MH  - HIV Infections/*immunology/pathology/*virology
MH  - HIV-1/*classification/genetics/growth & development/isolation & purification
MH  - HLA Antigens/genetics
MH  - Humans
MH  - Leukocytes, Mononuclear/virology
MH  - Male
MH  - Receptors, HIV/analysis
MH  - T-Lymphocytes, Cytotoxic/*immunology
PMC - PMC2806184
MID - NIHMS166521
EDAT- 2008/12/20 09:00
MHDA- 2009/01/24 09:00
PMCR- 2010/01/15
CRDT- 2008/12/20 09:00
PHST- 2008/12/20 09:00 [entrez]
PHST- 2008/12/20 09:00 [pubmed]
PHST- 2009/01/24 09:00 [medline]
PHST- 2010/01/15 00:00 [pmc-release]
AID - 10.1086/595704 [doi]
PST - ppublish
SO  - Clin Infect Dis. 2009 Jan 15;48(2):229-38. doi: 10.1086/595704.