Regional spread of HIV-1 M subtype B in middle-aged patients by random env-C2V4 region sequencing

Abstract

A transmission cluster of HIV-1 M:B was identified in 11 patients with a median age of 52 (range 26-65) in North-East Germany by C2V4 region sequencing of the env gene of HIV-1, who-except of one-were not aware of any risky behaviour. The 10 male and 1 female patients deteriorated immunologically, according to their information made available, within 4 years after a putative HIV acquisition. Nucleic acid sequence analysis showed a R5 virus in all patients and in 7 of 11 a crown motif of the V3 loop, GPGSALFTT, which is found rarely. Analysis of formation of this cluster showed that there is still a huge discrepancy between awareness and behaviour regarding HIV transmission in middle-aged patients, and that a local outbreak can be detected by nucleic acid analysis of the hypervariable env region.

Fig. 1

Phylogenetic tree of the nucleic acid sequences of 177 HIV’s, including some reference sequences for comparative analysis of the HIV-1 group B sequences of the patients of the described cluster, drawn with the Mega 4 program. As may be seen in the lower part of the tree, marked with the red square, the cluster is formed by the 11 sequences (HGW1–11) and separated from all other sequences analysed in Greifswald (FLI), München (MVP) and Frankfurt (FFM). Roughly the position of subtype B strains (bow on the right), and of subtypes A, A/E and F (dashed lines) are given; the position of the 3 group O strains is indicated with a double line on the left upper end of the tree