Oka S, Ida S, Shioda T, Takebe Y, Kobayashi N, Shibuya Y, Ohyama K, Momota K, Kimura S, Shimada K
Department of Infectious Diseases, University of Tokyo, Japan.
AIDS Res Hum Retroviruses. 1994 Mar;10(3):271-7. doi: 10.1089/aid.1994.10.271.
We encountered a case of HIV-1 infection in a previously healthy man, which was characterized by rapid progression to AIDS and death within 7 months in association with high levels of antigenemia throughout the clinical course and no humoral immune response for at least 6 months. Genetic changes of the third variable domain (V3) of the envelope gene of HIV-1 in serum samples were analyzed at four time points during his rapid clinical course. The nucleotide changes were confined to a maximum of three substitutions among 105 nucleotides of the V3 region. A major population of the viral clones in this patient showed one amino acid substitution from aspartic acid (a negatively charged amino acid) to lysine (a positively charged amino acid) at position 30 from the first cysteine of the V3 loop. This substitution was thought to be associated with phenotypic changes, and viruses with this sequence in the V3 region had a strong syncytium-inducing ability in MT-4 cells. It appears that the lack of a humoral immune response accelerated disease progression in our patient and a genetic change that appeared to produce a phenotypic change occurred at an early stage of the disease.
我们遇到了一例HIV-1感染病例，患者此前身体健康，其特点是在7个月内迅速发展为艾滋病并死亡，整个临床过程中抗原血症水平很高，且至少6个月没有体液免疫反应。在其快速临床病程的四个时间点分析了血清样本中HIV-1包膜基因第三可变区（V3）的基因变化。核苷酸变化最多局限于V3区域105个核苷酸中的三个替换。该患者的主要病毒克隆群体在V3环第一个半胱氨酸起第30位处显示一个氨基酸从天冬氨酸（带负电荷的氨基酸）替换为赖氨酸（带正电荷的氨基酸）。这种替换被认为与表型变化有关，V3区域具有该序列的病毒在MT-4细胞中具有很强的合胞体诱导能力。看来缺乏体液免疫反应加速了我们患者的疾病进展，并且在疾病早期就出现了似乎产生表型变化的基因改变。
