17th International AIDS Conference Mexico City, Mexico - August 13 - 18, 2008

HIGH LEVEL OF STRAIN DIVERSITY IN HIV-1 INFECTED PATIENTS AT A CLINICAL SITE IN LONDON

Int Conf AIDS. 2008 Aug 13-18;17 Abstract No. MOAA0204

J. Hackett Jr. ¹, V. Holzmayer¹, P. Hay², P. Swanson¹, A. Adebiyi², P. Rice², N. Marlowe³, S.G. Devare^1
1Abbott Diagnostics, Abbott Park, United States; ²St George's Hospital, London, United Kingdom; ³Celera, Alameda, United States

BACKGROUND: HIV-1 is characterized by extensive genetic diversity. Phylogenetic analysis has revealed three distinct lineages or groups of HIV-1 (M, O and N) and distinct subtypes designated as A-K. Recombination has resulted in further complexity with 37 circulating recombinant forms (CRF) currently recognized. In Western Europe, subtype B predominates, but increasing numbers of infections with non-B and recombinant strains are being observed. In this study, we investigate the extent of HIV-1 diversity within the patients attending the Courtyard Clinic at St. George’s Hospital in London.

METHODS: Plasma and whole blood were collected from 139 patients considered at risk for infection with non-subtype B strains. Subtype was determined by sequence/phylogenetic analysis of three genomic regions, gag p24, pol integrase and env gp41. The ViroSeq(tm) HIV-1 Genotyping System (Celera, Alameda, CA) was performed on 86 specimens. Viral loads were measured using the Abbott RealTime™ HIV-1 assay with the m2000sp™ automated sample preparation instrument (Abbott Molecular, Des Plaines, IL) and the Versant HIV-1 RNA 3.0 assay (bDNA; Siemens, Berkeley, CA).

RESULTS: Phylogenetic analysis revealed that 117 (84%) patients were infected with non-subtype B strains. These included 35 A, 45 C, 11 D, 1 CRF01_AE, 6 CRF02_AG, 2 CRF06_cpx and 17 unique recombinant viruses. The unique recombinants based on gag/pol/env included: 1 G/A/A, 4 D/D/A, 3 A/A/D, 1 D/A/A, 1 G/U/A, 2 D/G/A, 1 U/G/G, 1 A/02/06, 1 02/G/G, 1 02/02/A, and 1 U/U/D. ViroSeq genotyping was successful on 83 of 86 specimens with RealTime HIV-1 viral loads ranging from 1.79 to 6.18 log₁₀ copies/ml.

CONCLUSIONS: A remarkably high level of HIV-1 genetic diversity was observed at this London site reflecting epidemiologic links with 21 countries (16 African) outside U.K. The continued evolution and redistribution of HIV-1 strains has important implications for diagnostic and patient monitoring technologies.

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2008-08-13
MOAA0204

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