Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Switzerland.
Clin Infect Dis. 2011 Dec;53(12):1271-9. doi: 10.1093/cid/cir725. Epub 2011 Oct 12.
In the context of sexual transmission of human immunodeficiency virus type 1 (HIV-1), current findings suggest that the mucosal barrier is the major site of viral selection, transforming the complex inoculum to a small, homogeneous founder virus population. We analyzed HIV-1 transmission in relation to viral and host characteristics within the Zurich primary HIV-1 infection study.
Clonal HIV-1 envelope sequences (on average 16 clones/patient) were isolated from the first available plasma samples during the early phase of infection from 145 patients with primary HIV-1 infection. Phylogenetic and tropism analyses were performed. Differences of viral diversities were investigated in association with several parameters potentially influencing HIV-1 transmission, eg, concomitant sexually transmitted infections (STIs) and mode of transmission.
Median viral diversity within env C2-V3-C3 region was 0.39% (range 0.04%-3.23%). Viral diversity did not correlate with viral load, but it was slightly correlated with the duration of infection. Neither transmission mode, gender, nor STI predicted transmission of more heterogeneous founder virus populations that were found in 16 of 145 patients (11%; diversity >1%). Only 2 patients (1.4%) were assuredly infected with CXCR4-tropic HIV-1 within a R5/X4-tropic--mixed population, as revealed and confirmed using several genotypic prediction algorithms and phenotypic assays.
Our findings suggest that transmission of multiple HIV-1 variants might be a complex process that is not dependent on mucosal factors alone. CXCR4-tropic viruses can be sexually transmitted in rare instances, but their clinical relevance remains to be determined.
在人类免疫缺陷病毒 1 型（HIV-1）的性传播中，目前的研究结果表明，黏膜屏障是病毒选择的主要部位，将复杂的接种物转化为一小部分、同质的原始病毒群体。我们分析了苏黎世原发性 HIV-1 感染研究中与病毒和宿主特征相关的 HIV-1 传播。
从 145 例原发性 HIV-1 感染患者早期阶段的首次可用血浆样本中，平均每个患者分离出 16 个克隆的 HIV-1 包膜序列。进行了系统发育和嗜性分析。在考虑到几个可能影响 HIV-1 传播的参数（例如同时发生的性传播感染和传播模式）的情况下，研究了病毒多样性的差异。
env C2-V3-C3 区域内的中位数病毒多样性为 0.39%（范围 0.04%-3.23%）。病毒多样性与病毒载量无关，但与感染持续时间有轻微相关性。传播模式、性别或性传播感染均不能预测更具异质性的原始病毒群体的传播，145 例患者中有 16 例（11%；多样性>1%）发现了这种情况。只有 2 例（1.4%）患者在 R5/X4-混合种群中肯定感染了 CXCR4 嗜性 HIV-1，这是使用几种基因型预测算法和表型测定证实的。
我们的研究结果表明，多种 HIV-1 变体的传播可能是一个复杂的过程，不仅仅依赖于黏膜因素。CXCR4 嗜性病毒在极少数情况下可能通过性传播，但它们的临床相关性仍有待确定。
