Stephanie K. Brodine, MD; Richard A. Shaffer, PhD; Monica J. Starkey, MPH; Sybil A. Tasker, MD; Joyce L. Gilcrest, RN; Mark K. Louder; Anthony Barile, MD; Thomas C. VanCott, PhD; Maryanne T. Vahey, PhD; Francine E. McCutchan, PhD; Deborah L. Birx, MD; Douglas D. Richman, MD; John R. Mascola, MD
Disclaimer: The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the U.S. Government.
Acknowledgments: The authors thank the military personnel who contributed to the objectives of this study and whose input will be incorporated into a military-specific HIV/STD prevention program. They also thank Brit Christofferson for technical assistance and database management; Stan Ito for programming and data analyses; Cathy Siwek, Eric Sanders-Buell, and Chris Ettore for laboratory assistance; and Mark Wallace, John McNeil, and Craig Hendrix for manuscript review.
Grant Support: In part by Cooperative Agreement DAMD17-93-V 3004 between the U.S. Army Medical Research and Materiel Command, Fort Detrick, Maryland, and the Henry M. Jackson Foundation for the Advancement of Military Medicine, Rockville, Maryland, and Army Reimbursable Work Unit #6816. Dr. Richman was supported by grants AI 27670, AI 38858, AI 36214 (Center for AIDS Research), and grant AI 29164 from the National Institutes of Health. Dr. Richman was also supported by the Research Center for AIDS and HIV Infection of the San Diego Veterans Affairs Medical Center.
Requests for Reprints: Stephanie K. Brodine, MD, Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, College of Health and Human Services, 5500 Campanile Drive, San Diego, CA 92182-4162. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, email@example.com.
Current Author Addresses: Dr. Brodine: Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, College of Health and Human Services, 5500 Campanile Drive, San Diego, CA 92182-4162.
Dr. Shaffer: Naval Health Research Center, Division of Clinical Epidemiology, Box 85122, San Diego, CA 92186.
Ms. Starkey: Naval Health Research Center, 271 Catalina Boulevard, Building 304, San Diego, CA 92152.
Dr. Tasker and Ms. Gilcrest: Naval Medical Center San Diego, Infectious Diseases, 34800 Bob Wilson Drive, Box 575, San Diego, CA 92134-5000.
Mr. Louder: Henry M. Jackson Foundation, 13 Taft Court, Suite 200, Rockville, MD 20850.
Dr. Barile: HIV Clinical Research Program, National Naval Medical Center, 8901 Wisconsin Avenue, Special Immunology Clinic, Bethesda, MD 20889.
Dr. VanCott: Henry M. Jackson Foundation, 13 Taft Court, Suite 200, Rockville, MD 20850.
Dr. Vahey: Division of Retrovirology, Walter Reed Army Institute of Research, 1600 East Gude Drive, Rockville, MD 20850.
Dr. McCutchan: Henry M. Jackson Foundation, Global Molecular Epidemiology Program, 1 Taft Court, Suite 250, Rockville, MD 20850.
Dr. Birx: Division of Retrovirology, Walter Reed Army Institute of Research, 13 Taft Court, Suite 200, Rockville, MD 20850.
Dr. Richman: San Diego Veterans Affairs Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161.
Dr. Mascola: Division of Retrovirology, Walter Reed Army Institute of Research, 1 Taft Court, Suite 250, Rockville, MD 20850.
Regular testing of military personnel identifies early HIV infection; this identification provides a sentinel cohort in which to describe the evolving molecular epidemiology of HIV-1 transmission.
To describe the prevalence and epidemiologic correlates associated with the acquisition of non-subtype B and drug-resistant HIV infections.
Military referral hospital.
95 military personnel with HIV-1 seroconversion.
Self-reported questionnaire, CD4 cell counts, plasma HIV-1 RNA levels, and nucleic acid sequence analysis for drug-resistant mutations and HIV-1 genetic subtype.
95 patients were enrolled between February 1997 and February 1998. The likely geographic location of HIV-1 acquisition was overseas in 8% of patients, the United States in 68%, and either overseas or the United States in 24%. Seven patients (7.4%) had subtype E infection; the remainder had subtype B infection. Eight of 31 (26%) treatment-naive patients had mutations in the reverse transcriptase or protease gene associated with drug resistance.
The percentage of HIV-1 non-subtype B infection and antiretroviral drug-resistant mutations was relatively high in U.S. military personnel with recently acquired HIV-1 infection.
Table 1. Characteristics and Risk Exposures of Military Personnel with HIV-1 Seroconversion
Table 2. Drug-Resistant Mutations in Eight Treatment-Naive Patients
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Brodine SK, Shaffer RA, Starkey MJ, Tasker SA, Gilcrest JL, Louder MK, et al. Drug Resistance Patterns, Genetic Subtypes, Clinical Features, and Risk Factors in Military Personnel with HIV-1 Seroconversion. Ann Intern Med. 1999;131:502–506. doi: 10.7326/0003-4819-131-7-199910050-00004
Download citation file:
Published: Ann Intern Med. 1999;131(7):502-506.
HIV, Infectious Disease.
Results provided by:
Copyright © 2019 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use