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      Slow immunological progression in HIV-1 CRF07_BC-infected injecting drug users

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          Abstract

          Human immunodeficiency virus type 1 (HIV-1) circulating recombinant form (CRF) 07_BC has caused serious HIV-1 epidemics among injecting drug users (IDUs) in East Asia. Little is known about the characteristics of the virus and its impact on disease progression among the infected individuals. In this study, we compared immunological progression between 423 IDUs infected with CRF07_BC and 194 men who have sex with men (MSM) with primary subtype B infection, and a representative full-length CRF07_BC molecular clone, pCRF07_BC, was constructed to characterize the virus. We found that IDUs infected with CRF07_BC had significantly slower immunological progression in the Cox proportional hazards model (hazard ratio: 0.30; 95% confidence interval: 0.13–0.69; P=0.004). The constructed recombinant CRF07_BC viruses had a reduced processing of the Gag/Gag-Pol polyproteins, a decreased incorporation of Vpr in the virus particle, tethering of virus particles on the plasma membrane and decreased virus growth kinetics. These phenotypes are related to the unique 7-amino acid deletion in the p6 of CRF07_BC, since complementation of the 7-amino acid in pCRF07_BC could improve the defective phenotypes. In summary, compared with MSM infected with HIV-1 subtype B, IDUs infected with CRF07_BC had slower immunological progression, which is likely correlated with interference of virus particle maturation by the 7-amino acid deletion in p6.

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          Human immunodeficiency virus type 1 viral protein R (Vpr) arrests cells in the G2 phase of the cell cycle by inhibiting p34cdc2 activity.

          J. He, S. Choe, R. Walker … (1995)
          The Vpr accessory gene product of human immunodeficiency virus types 1 and 2 and simian immunodeficiency virus is believed to play a role in permitting entry of the viral core into the nucleus of nondividing cells. A second role for Vpr was recently suggested by Rogel et al. (M. E. Rogel, L. I. Wu, and M. Emerman, J. Virol. 69:882-888, 1995), who showed that Vpr prevents the establishment in vitro of chronically infected HIV producer cell lines, apparently by causing infected cells to arrest in the G2/M phase of the cell cycle. In cycling cells, progression from G2 to M phase is driven by activation of the p34cdc2/cyclin B complex, an event caused, in part, by dephosphorylation of two regulatory amino acids of p34cdc2 (Thr-14 and Tyr-15). We show here that Vpr arrests the cell cycle in G2 by preventing the activation of the p34cdc2/cyclin B complex. Vpr expression in cells caused p34cdc2 to remain in the phosphorylated, inactive state, p34cdc2/cyclin B complexes immunoprecipitated from cells expressing Vpr were almost completely inactive in a histone H1 kinase assay. Coexpression of a constitutively active mutant p34cdc2 molecule with Vpr relieved the G2 arrest. These findings strongly suggest that Vpr arrests cells in G2 by preventing the activation of the p34cdc2/cyclin B complex that is required for entry into M phase. In vivo, Vpr might, by preventing p34cdc2 activation, delay or prevent apoptosis of infected cells. This would increase the amount of virus each infected cell produced.
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            Influence of combinations of human major histocompatibility complex genes on the course of HIV-1 infection.

            R.A. Kaslow, M. Carrington, R Apple … (1996)
            Major histocompatibility complex (MHC) genes (HLA in humans) regulate the immune response to foreign antigens. Molecular and serologic techniques were used to identify products of HLA class I, class II and transporter (TAP) genes (also part of the MHC) in homosexual seroconverters to human immunodeficiency virus type 1 (HIV-1). Comprehensive statistical analysis produced an HLA profile that predicted time from HIV-1 infection to the onset of AIDS. The profile was developed in a cohort of 139 men and evaluated in a second unrelated cohort of 102 men. In the evaluation cohort, the profile discriminated a sixfold difference between groups with the shortest and longest times to AIDS (P = 0.001). These findings support current theory about control of antigen processing by HLA genes and have implications for immunopathogenesis of HIV-1 and other infections.
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              Predictors of disease progression in HIV infection: a review

              Simone E Langford, Jintanat Ananworanich, David Cooper (2007)
              During the extended clinically latent period associated with Human Immunodeficiency Virus (HIV) infection the virus itself is far from latent. This phase of infection generally comes to an end with the development of symptomatic illness. Understanding the factors affecting disease progression can aid treatment commencement and therapeutic monitoring decisions. An example of this is the clear utility of CD4+ T-cell count and HIV-RNA for disease stage and progression assessment. Elements of the immune response such as the diversity of HIV-specific cytotoxic lymphocyte responses and cell-surface CD38 expression correlate significantly with the control of viral replication. However, the relationship between soluble markers of immune activation and disease progression remains inconclusive. In patients on treatment, sustained virological rebound to >10 000 copies/mL is associated with poor clinical outcome. However, the same is not true of transient elevations of HIV RNA (blips). Another virological factor, drug resistance, is becoming a growing problem around the globe and monitoring must play a part in the surveillance and control of the epidemic worldwide. The links between chemokine receptor tropism and rate of disease progression remain uncertain and the clinical utility of monitoring viral strain is yet to be determined. The large number of confounding factors has made investigation of the roles of race and viral subtype difficult, and further research is needed to elucidate their significance. Host factors such as age, HLA and CYP polymorphisms and psychosocial factors remain important, though often unalterable, predictors of disease progression. Although gender and mode of transmission have a lesser role in disease progression, they may impact other markers such as viral load. Finally, readily measurable markers of disease such as total lymphocyte count, haemoglobin, body mass index and delayed type hypersensitivity may come into favour as ART becomes increasingly available in resource-limited parts of the world. The influence of these, and other factors, on the clinical progression of HIV infection are reviewed in detail, both preceding and following treatment initiation.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Microbes Infect
                Journal ID (iso-abbrev): Emerg Microbes Infect
                Title: Emerging Microbes & Infections
                Publisher: Nature Publishing Group
                ISSN (Electronic): 2222-1751
                Publication date (Print): December 2013
                Publication date (Electronic): 11 December 2013
                Publication date PMC-release: 1 December 2013
                Volume: 2
                Issue: 12
                Page: e83
                Affiliations
                [1 ]Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine , Taipei, Taiwan
                [2 ]Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University , Kaohsiung, Taiwan
                [3 ]Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch , Yun-Lin, Taiwan
                [4 ]Departments of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei, Taiwan
                [5 ]Department of Internal Medicine, Far Eastern Memorial Hospital , New Taipei City, Taiwan
                [6 ]Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei, Taiwan
                Author notes
                [*]

                These authors contributed equally to this work.

                Article
                Publisher Item ID: emi201383
                DOI: 10.1038/emi.2013.83
                PMC ID: 3880871
                PubMed ID: 26038447
                SO-VID: cfd54762-d00c-426d-8953-6378b5d2ad33
                Copyright © Copyright © 2013 Shanghai Shangyixun Cultural Communication Co., Ltd
                License:

                This work is licensed under the Creative Commons Attribution-NonCommercial-No Derivative Works 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/3.0/

                History
                Date received : 31 July 2013
                Date revision received : 21 October 2013
                Date accepted : 14 November 2013
                Categories
                Subject: Original Article

                Keywords: disease progression,men who have sex with men,growth kinetics,hiv subtype,injecting drug use,primary hiv infection
                Data availability:
                Keywords: disease progression, men who have sex with men, growth kinetics, hiv subtype, injecting drug use, primary hiv infection

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