Abstract
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.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Amino Acid Substitution / genetics
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CD4-Positive T-Lymphocytes / immunology
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CD8-Positive T-Lymphocytes / immunology
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DNA Mutational Analysis
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Drug Resistance, Viral / genetics
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Epitopes, T-Lymphocyte / genetics
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Evolution, Molecular*
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Gene Products, gag / genetics
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Genome, Viral / genetics*
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HIV Infections / genetics
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HIV Infections / immunology*
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HIV Infections / virology*
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HIV-1 / genetics*
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HIV-1 / isolation & purification
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HLA-B Antigens / genetics*
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Human Immunodeficiency Virus Proteins
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Humans
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Male
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Molecular Sequence Data
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Mutation, Missense
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RNA, Viral / genetics*
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Viral Regulatory and Accessory Proteins / genetics
Substances
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Epitopes, T-Lymphocyte
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Gene Products, gag
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HLA-B Antigens
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HLA-B57 antigen
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Human Immunodeficiency Virus Proteins
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RNA, Viral
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Viral Regulatory and Accessory Proteins
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vpu protein, Human immunodeficiency virus 1