HIV Type 1 Envelope Sequences from Seroconverting Patients in Barbados

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Abstract
Because of the prevalence of leptospirosis in Barbados, patients who present to the hospital with febrile illnesses are routinely screened for Leptospira infection and their sera are stored for future reference. While the majority of patients are infected with Leptospira, some are not. Since some symptoms of acute HIV-1 illness are similar to those of leptospirosis, patient records were reviewed to identify patients whose clinical symptoms may have been due to HIV-1 infection. 10 HIV-1-positive patients originally hospitalized during 1990-94 were identified whose medical histories suggested the occurrence of acute HIV-1 illness at the time of Leptospira testing. Stored sera from those patients were then tested for the presence of HIV-1 p24 antigen and by Western blotting. Evidence of acute HIV-1 infection was considered to be a positive p24 test or a characteristic Western blot profile occurring at or shortly before the time of seropositivity for HIV-1 antibody. The authors determined the sequence of viral RNA from the 12 remaining sera samples from 8 patients, including paired samples drawn at 3- or 4-day intervals from 4 people. The Barbados patient variants aligned more closely with HIV-1 clade B reference strains than with the other subtypes. 2 variants, however, align separately from the classic B subtype and somewhat closer to variants from clades A and C. The Venezuelan isolate, although different from the patient sequences, is also separate from the other B variants.