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Journal of Virology, June 2009, p. 6020-6028, Vol. 83, No. 12
0022-538X/09/$08.00+0     doi:10.1128/JVI.02664-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Monotypic Human Immunodeficiency Virus Type 1 Genotypes across the Uterine Cervix and in Blood Suggest Proliferation of Cells with Provirus{triangledown}

Marta E. Bull,1,2 Gerald H. Learn,2 Scott McElhone,1 Jane Hitti,2 David Lockhart,2 Sarah Holte,2,3 Joan Dragavon,2 Robert W. Coombs,2 James I. Mullins,2 and Lisa M. Frenkel1,2*

Seattle Children's Hospital Research Institute,1 University of Washington,2 Fred Hutchinson Cancer Research Center, Seattle, Washington3

Received 27 December 2008/ Accepted 26 March 2009

Understanding the dynamics and spread of human immunodeficiency virus type 1 (HIV-1) within the body, including within the female genital tract with its central role in heterosexual and peripartum transmission, has important implications for treatment and vaccine development. To study HIV-1 populations within tissues, we compared viruses from across the cervix to those in peripheral blood mononuclear cells (PBMC) during effective and failing antiretroviral therapy (ART) and in patients not receiving ART. Single-genome sequences of the C2-V5 region of HIV-1 env were derived from PBMC and three cervical biopsies per subject. Maximum-likelihood phylogenies were evaluated for differences in genetic diversity and compartmentalization within and between cervical biopsies and PBMC. All subjects had one or more clades with genetically identical HIV-1 env sequences derived from single-genome sequencing. These sequences were from noncontiguous cervical biopsies or from the cervix and circulating PBMC in seven of eight subjects. Compartmentalization of virus between genital tract and blood was observed by statistical methods and tree topologies in six of eight subjects, and potential genital lineages were observed in two of eight subjects. The detection of monotypic sequences across the cervix and blood, especially during effective ART, suggests that cells with provirus undergo clonal expansion. Compartmentalization of viruses within the cervix appears in part due to viruses homing to and/or expanding within the cervix and is rarely due to unique viruses evolving within the genital tract. Further studies are warranted to investigate mechanisms producing monotypic viruses across tissues and, importantly, to determine whether the proliferation of cells with provirus sustain HIV-1 persistence in spite of effective ART.

* Corresponding author. Mailing address: Seattle Children's Hospital Research Institute, 1900 Ninth Ave., Seattle, WA 98101-1304. Phone: (206) 987-5140. Fax: (206) 884-7311. E-mail: lfrenkel{at}u.washington.edu

{triangledown} Published ahead of print on 1 April 2009.

Journal of Virology, June 2009, p. 6020-6028, Vol. 83, No. 12
0022-538X/09/$08.00+0     doi:10.1128/JVI.02664-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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