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Molecular analysis of HIV strains from a cluster of worker infections in the
adult film industry, Los Angeles, 2004.
AIDS 2006;20(6):923-928.
Brooks JT, Robbins KE, Youngpairoj AS, Taylor MM, Daar ES, Rotblatt H, Kerndt
PR, Kalish ML.
Abstract
OBJECTIVES: In April 2004, 13 susceptible women were exposed to a single acutely
HIV-1-infected man while employed to perform various sex acts for the production
of adult films; three women were subsequently found to have acquired HIV
infection (23% attack rate). As part of the investigation of this infection
cluster, we evaluated whether viral strains collected from infected individuals
were significantly related. METHODS: We determined nucleotide sequences from
the C2V3C3 and gp41 region of env and the p17 region of gag in viruses from
the three infected individuals from whom specimens were available. We then
compared these sequences phylogenetically to comparable sequences from available
reference strains. Genotypic and phenotypic antiretroviral drug resistance
was determined for plasma virus from the male index case and one female contact
at a separate commercial laboratory. RESULTS: The env and gag sequences of
the HIV strains from the male index case and two of the infected women were
100% similar. Genotyping of the male index case's virus identified 12 mutations,
which represented known naturally occurring polymorphisms in the subtype
B consensus sequence that are not associated with antiretroviral drug resistance.
Genotyping of the virus from the female contact identified 10 mutations,
all of which were shared by the virus from the male index case. Phenotyping
demonstrated that both viruses were susceptible to all antiretroviral drugs
tested. CONCLUSION: Molecular and virological data strongly support the epidemiological
conclusion that these women were infected with an identical strain of HIV
through occupational exposure to an individual with an acute HIV infection.