(Journal of Leukocyte Biology. 2000;68:324-330.)
© 2000
by Society for Leukocyte Biology
Co-receptor usage was more predictive than NSI/SI phenotype for HIV replication in macrophages: is NSI/SI phenotyping sufficient?
Janet L. Lathey*,
Donald Brambilla
,
Maureen M. Goodenow
,
Mostafa Nokta
,
Suraiya Rasheed||,
Edward B. Siwak¶,
James W. Bremer**,
Diana D. Huang**,
Yanjie Yi
,
Patricia S. Reichelderfer
and
Ronald G. Collman
,1
* Department of Pediatrics, University of California San Diego, La Jolla, California;
New England Research Institutes, Watertown, Massachusetts;
Department of Pathology, University of Florida, Gainsville, Florida;
Department of Internal Medicine, University of Texas, Medical Branch, Galveston, Texas;
|| Department of Pathology, University of Southern California, Los Angeles, California;
¶ Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas;
** Department of Immunology/Microbiology, Rush Medical College, Chicago, Illinois;

Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania, Philadelphia, Pennsylvania; and

National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
Correspondence: Janet L. Lathey, Ph.D., Pediatric Infectious Diseases, University of California, San Diego, 9500 Gilman Dr. #0672, La Jolla, CA 92093-0672. E-mail: jlathey{at}uesd.edu
 |
ABSTRACT
|
|---|
A monocyte-derived macrophage (MDM) culture assay was used to define
the replication kinetics of HIV isolates. Ten-day-old MDMs were
infected with HIV. Supernatants were collected and assayed for HIV p24
on days 3, 7, 10, and 14 post-infection (PI). In this assay, SF162
(macrophage tropic, NSI) produced increasing amounts of HIV p24 antigen
with increasing time in culture. BRU (nonmacrophage tropic, SI)
infection resulted in low levels of HIV p24 antigen with no increase in
production during the culture period. A panel of 12 clinical isolates
was evaluated. All isolates produced detectable levels of HIV p24
antigen in MDMs. However, the NSI viruses had significantly higher
log10 HIV p24 antigen values at all times PI
(P < 0.01). Co-receptor usage was determined for all
12 isolates (8 NSI and 4 SI). All SI isolates used CXCR4 for entry; two
used CXCR4 only, one used CXCR4, CCR5, and CCR3, and one was a mixture
of two isolates using CXCR4 and CCR5. None of the NSI viruses used
CXCR4 for entry. All used CCR5 as their predominant co-receptor. Of the
eight NSI isolates, three used CCR5 only, two used CCR5 and CCR2b, one
used CCR5 and CCR3, and one used CCR5, CCR3, and CCR2b.
Log10 HIV p24 antigen production on day 14 PI for viruses
that used CCR5+CCR3 (3.79 + 1.40) was greater than for viruses
that used CCR5+CCR2b (3.22 + 1.55) or CCR5 (3.32 + 1.49), and
all were greater than those that used CXCR4 only (1.69 + 0.28),
regardless of SI phenotype (P < 0.05). Thus, in these
primary isolates, macrophage tropism and replication kinetics were
closely linked to CCR5 utilization, whereas SI capacity was closely
linked to CXCR4 utilization. Furthermore, viruses, which could use CCR5
and CCR3 for entry, had a replication advantage in macrophages,
regardless of SI phenotype.
Key Words: macrophage tropism viral phenotype HIV co-receptors HIV replication kinetics
 |
INTRODUCTION
|
|---|
Host and viral factors during HIV infection play a role in
determining disease progression and the way in which an individual
responds to anti-retroviral therapy. One viral factor, which has been
evaluated, is viral tropism. Historically, HIV isolates have been
classified as either syncytium-inducing (SI), T-tropic, or
nonsyncytium-inducing (NSI), macrophage tropic. Viruses with SI
phenotype generally demonstrated rapid growth kinetics, cytopathicity
for T cells, and lacked the ability to grow in macrophages. In
contrast, viruses of the NSI phenotype usually grow more slowly, are
not cytopathic for T cells, and replicate in macrophages. The presence
of an SI phenotype has been associated with disease progression even
during anti-retroviral therapy. Conversely, the presence and
maintenance of the NSI phenotype has been associated with reduced
disease progression and asymptomatic disease [1
, 2
]. However, 50% of
adult individuals that progress to AIDS have circulating virus with an
NSI phenotype [3
, 4
], and rapid disease progression can occur in
infants and children from whom only NSI viruses were isolated [5
]. In
addition, the assumption has been that a switch from SI back to NSI
during antiretroviral treatment would result in a positive response to
therapy (i.e., reduced chance of disease progression). However, this
was not true for ACTG 175. There was no significant difference in
disease progression between individuals who maintained the SI phenotype
and those that switched from SI back to NSI [6
]. Thus, it is possible
that losing the SI phenotype does not necessarily indicate a switch
back to a macrophage-tropic less-cytopathic phenotype. This was
demonstrated in PACTG 138, which included four detectable conversions
from SI to NSI between baseline and week 56132 [7
]. Of those four NSI
isolates, only two demonstrated macrophage tropism. For the remaining
two cases, neither the baseline SI nor the post-treatment NSI isolates
were able to replicate in macrophages. Thus, a virus conversion back to
NSI does not automatically indicate a change in tropism. As a further
complication to defining tropism, dual tropic viruses have been
isolated. The dual tropic activity of one such virus, 89.6, has been
attributed to expanded co-receptor usage [8
]. Taken together, these
data suggest more stringent criteria than SI/NSI may be necessary to
define HIV tropism. Here we investigate replication kinetics in
macrophages and viral co-receptor usage for their abilities to define
viral tropism.
 |
MATERIALS AND METHODS
|
|---|
Viral stocks
The prototypic viral strains, HIV-1 SF162 and HIV-1 BRU, were
obtained from the AIDS Research and Reference Reagent Program (Ogden
BioServices, Rockville, MD). They were biologically cloned by limiting
dilution culture: HIV-1 SF162 in macrophages and HIV-1 BRU in
lymphocytes by Robert Buckheit at the Frederick Research Center
(Frederick, MD). The 12 clinical isolates were selected randomly from a
panel of 25 isolates generated during the course of ACTG virology
studies using standard methods. The cloned viruses, as well as the 12
clinical isolates, were grown, titered, and phenotyped by the NIAID
Virology Quality Assurance Laboratory at Rush Medical College (Chicago,
IL).
Viral culture
Viral stocks of cloned viruses and viral isolates were grown and
titered in peripheral blood mononuclear cells (PBMC). PBMC were
separated by Ficoll-Hypaque density centrifugation and cultured for
13 days in medium (RPMI-1640 with glutamine, penicillin [100 U/ml]/streptomycin [100 g/ml], and 20% FBS) containing PHA (2.5
µg/ml) and 3% interleukin-2 (IL-2). On day of infection, media were
removed and 1 ml of supernatant viral samples were added to 10 million
PBMC. After 1 h, 9 ml of medium, which contained 5% IL-2, was
added to each sample. Half of the media were replaced on days 3, 10,
and 17 PI. On days 7 and 14, 10 million PHA-stimulated PBMC were added
and medium volume was doubled (concentration maintained at 1 million
cells/ml). Supernatant harvested on day 21 was titered by limiting
dilution culture on PHA-stimulated PBMC. TCID50 was
calculated by the method of Spearman-Karber.
Macrophage isolation and culture
Macrophage cultures were performed according to the consensus
protocol of the Pediatric AIDS Clinical Trials Group. PBMC were
separated by Ficoll-Hypaque density centrifugation. After two washes
with PBS, PBMC were suspended at a concentration of 2.5 x
106/ml in RPMI-1640 with glutamine and penicillin (100
U/ml)/streptomycin (100 g/ml) (medium) and plated at 1 ml per well in
24-well plates. After 1 h, 1 ml of medium containing 20% FBS was
added (10% FBS final concentration). After 3 days, half of the medium
with 10% FBS was replaced in each well. After 7 days of culture, cells
(macrophages) were vigorously washed three times with PBS. Macrophages
were cultured and additional 3 days, then infected with either HIV-1
isolates or prototype viral strains. At this time, the cells were
95100% esterase positive. Supernatants were harvested on days 3, 7,
10, and 14 from duplicate wells and assayed for HIV-1 p24 antigen by
ELISA. Macrophage cultures were set up in three independent
laboratories for SF162/BRU comparison and four laboratories for all
other comparisons. The cloned prototype viral strains (SF162 and BRU)
were included as controls in all experiments.
Viral phenotype assay
Syncytium induction was determined by use of MT-2 cells [9
].
Viral isolates that replicated in PBMC, as determined by p24 antigen
production, and formed syncytia on MT-2 cells were considered to be SI.
Viral isolates that replicated in PBMC and did not form syncytia on
MT-2 cells were considered NSI.
Co-receptor assay
Co-receptor usage was determined on the basis of entry into
quail QT6 cells that were cotransfected with CD4 and CCR5, CXCR4, CCR2b
or CCR3. One day after transfection, cells were infected with 3000
TCID50 of Dnase-treated virus and then lysed 2 days later.
Cell lysates were amplified by PCR using primers directed at conserved
LTR sequences that detect early viral reverse transcription products,
followed by Southern blot with an oligonucleotide probe. Details of
this assay, primers, and probe have been described previously [8
].
Controls included cells transfected with CD4 alone, heat inactivated
virus, and prototype HIV-1 strains with established patterns of
co-receptor use. Definite co-receptor use was considered viral entry
clearly detected in three of three replicate experiments, whereas
detection in one or two of three replicates was considered intermediate
use.
Genotype analysis
The V3 loop of the ENV gene was sequenced using either DNA from
infected PBMC culture pellets or virion RNA from culture supernatants.
DNA from pellets was prepared by cell lysis as described in the DAIDS
Virology Manual [9
]. Sequencing templates were then generated by PCR
amplification using nested primers described by Simmonds et al. [10
].
The outer primers +6957 and -7381 and the inner primers +7009 and
-7331 were used. Viral RNA was extracted using the Nuclisens Isolation
kit (Organon-Teknika, Durham, NC). The RNA was reversed-transcribed
using AMV-RT and random hexamers (Promega, Madison, WI). The cDNA was
then amplified using the PE Biosystems (Foster City, CA) XL PCR Kit by
kit instructions with 250 pM primers MSF12 and MSR5 [11
]. A 1.5-kb
product was made under the conditions described above for +6957/-7381
from these amplicons but using primers env 1
(5'TCACAGTHTATTATGGGGTACCTGT) and env 2 (5'ATAATTGTCTGGCCTGTACCGTCA).
Sequencing templates were then generated using the +6957/-7381 and
+7009/-7331 protocols described above. Sequencing reactions were
performed using the ABI Prism Big Dye Terminator Cycle Sequencing Ready
Reaction Kit (PE Biosystems) according to kit instructions using +7009
and -7331 as overlapping sequencing primers. Data were analyzed using
ABI Prism software, DNA Sequencing Analysis 3.0, Factura 2.0, and Auto
Assembler 2.0. Nucleic acid sequences were translated and amino acid
sequences aligned and compared.
Statistical analysis
The HIV p24 antigen values were transformed to base 10
logarithms and the transformed duplicate values were averaged before
data analysis. Values that were <10 pg/ml were set at 1 pg/ml before
log transformation. Two-way analysis of variance (ANOVA) was used to
compare average HIV p24 antigen levels at each time point among
isolates, controlling for laboratory, and to compare changes from day 3
among isolates, again controlling for laboratory. This approach was
also used to compare HIV p24 antigen levels at each time point and
changes since day 3 in SI and NSI viruses and in groups of isolates
defined by co-receptor use. Interactions between laboratory and
isolate, between laboratory and type (SI vs. NSI), and between
laboratory and co-receptor class were included in the initial models to
determine if results varied over laboratories. No statistically
significant variation among laboratories was identified, so the
interactions were removed form the final models.
 |
RESULTS
|
|---|
Replication of prototypic NSI and SI viral strains in macrophages
To determine the replication pattern for typical NSI and SI
viruses in macrophages, 12,500 TCID50 of HIV-1 SF162 (NSI)
and HIV-1 BRU (SI) were used to infect macrophages in three independent
laboratories. Although there was variation among the laboratories in
actual log10 HIV p24 antigen values, which resulted in lack
of significance, the mean values were higher for SF162 at all time
points (Fig. 1) . To normalize for the difference in levels of HIV p24 antigen measured
among the labs, the change from baseline (day 3) in log10
HIV p24 antigen was calculated for each viral strain (Fig. 1) . The
change from base line was constant at day 7, 10, and 14 PI for HIV-1
BRU. Conversely, the change from baseline was increasing at each time
point for SF162. The difference between the two reached significance by
day 14 (P = 0.05). Thus, the NSI, but not the SI, virus
demonstrated increasing replication kinetics in macrophages.

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Figure 1. Replication patterns in macrophages of prototype strains and clinical
isolates. A) SF162 vs. BRU, n = 3 assays.
B) NSI clinical isolates [8
] vs. SI clinical isolates [4
],
n = 4 assays of each isolate. Left,
Mean ± SD log10 HIV p24, P value is given
in parenthesis for difference between SF162 and BRU or NSI and SI for
day 3, 7, 10, and 14 PI. Right, Mean ± SD
log10 change from baseline for days 7, 10, 14
(log10 HIV p24 antigen for day 7, 10, or 14 PI
log10 HIV p24 antigen for 3). P value is given
in parenthesis for difference between SF162 and BRU or NSI and SI for
day 7, 10, and 14.
|
|
Replication of NSI versus SI isolates in macrophages
To determine whether clinical isolates behaved like the prototype
HIV strains, twelve clinical isolates (four SI and eight NSI) were
evaluated for replication kinetics in macrophages in four independent
laboratories. Macrophages were infected with 7500 TCID50 of
each isolate and the prototype SI and NSI viruses. Log10
HIV p24 antigen production was measured at 3, 7, 10, and 14 days PI. At
all time points, the mean log10 HIV p24 antigen values for
the NSI isolates were greater than those for the SI isolates
(P < 0.01) (Fig.1)
. However, the pattern of
log10 HIV p24 antigen production was similar for the SI and
NSI viruses with both increasing over time. This was demonstrated by
the lack of difference in change from baseline (day 3 PI) for all days
PI between the NSI and SI isolates (Fig. 1)
. In addition, when the mean
log10 HIV p24 antigen values for day 14 PI were evaluated
for the individual clinical isolates, there was a continuum of HIV p24
antigen levels. All isolates retained some ability to replicate in
macrophages with no distinct cutoff between SI and NSI isolates (Table 1)
. Thus, although there was a difference in the total log10
HIV p24 antigen production between NSI and SI clinical isolates, there
was no difference in the growth kinetics in macrophages, nor was there
a HIV p24 antigen cutoff that separated NSI from SI isolates.
Genetic analysis of isolates
Because the clinical isolates were not cloned, it was possible
that the viral stocks contained multiple instead of single isolates.
Multiple isolates might explain the inability to differentiate SI from
NSI isolates. The envelope regions of the isolates and the prototype
viruses were sequenced by PCR (Table 1)
. Of the 12 isolates, only one
(#051) was a mixture of two isolates. NSI/SI phenotype was confirmed by
net positive charge analysis of V3 loops. All SI viruses had a charge
of
6. The sample with two isolates contained one SI (charge =
+6) and one NSI (charge = +3). Thus, the lack of difference in
replication kinetics between NSI and SI isolates could not totally be
explained by the presence of mixed isolates.
Co-receptor usage of isolates
Multiple co-receptor usage by the isolates might also help explain
the lack of difference for replication in macrophages. Co-receptor
usage was determined for all 12 isolates and the 2 prototype viruses
(Table 1) . All NSI viruses used at least CCR5. No NSI isolates used
CXCR4 for entry. Use of CXCR4 was exclusively associated with SI
viruses. Two SI isolates could also use CCR5 in addition to CXCR4. One
of these was the mixed isolate. The other could also use CCR3. The two
SI viruses with multiple co- receptor usage did have a higher level of
HIV p24 antigen production than the two that used only CXCR4. Thus,
multiple co-receptor usage could be associated with the lack of
difference in replication kinetics in macrophages between NSI and SI
isolates.
Association of co-receptor usage with replication in macrophages
It is possible that co-receptor usage is more predictive of viral
replication in macrophages than NSI/SI phenotype. To determine whether
co-receptor usage was related to replication kinetics in macrophages,
the 12 clinical isolates (TCID50 = 7,500) were used to
infect macrophages in four independent laboratories. Supernatants were
collected and assayed for HIV p24 antigen on days 3, 7, 10, and 14.
Isolates were divided into four groups according to co-receptor
usage (Fig. 2)
. Group 1 included all isolates that use CCR3 regardless of
other co-receptor usage (n = 3; 1 CCR5+CCR3,
NSI; 1 CCR5+CCR2b+CCR3, NSI; 1 CCR5+CXCR4+CCR3, SI). Group 2 included
isolates tht use CCR2b and CCR5 (n = 2; 2 NSI). Group 3
included isolates that used only CCR5 (n = 4; 4 NSI).
Group 4 included isolates that used only CXCR4 (n = 2;
2 SI). The sample that was a mixture of two isolates was excluded.
Isolates that used CCR3 with any combination of co-receptors produced
the highest levels of HIV p24 antigen at all time points. There was
little to no difference in the levels of HIV p24 antigen produced by
isolates that used CCR5 with or without CCR2b. The lowest level of HIV
p24 antigen production was observed from group 4, the isolates that
only used CXCR4. The level of p24 production in the CXCR4-only group
was significantly lower at all time points than all other groups
(P < 0.05). Thus, isolates that used CCR4 had the
least ability to replicate in macrophages, whereas isolates that used
CCR3 and CCR5, including the isolate that was SI and used CXCR4,
replicated to the highest level.

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Figure 2. Replication patterns in macrophages of co-receptor groups, CCR3 (3)
includes CCR3 plus any other receptor, CCR2b (2) includes CCR2b plus
CCR5, CCR5 (4) includes only CCR5, and CXCR4 (2) includes only CXCR4,
means ± SD are plotted, n = 4 assays of each
isolate. For all time points, the mean log10 HIV p24
antigen values for CXCR4 were significantly different from all other
groups, P < 0.05.
|
|
Effect of CCR3 at varying infectious doses
To determine if input viral concentration determined the effect
observed for isolates able to use CCR3, macrophages were infected with
various TCID50 ranging from 500 to 7,500 in four
independent laboratories. Supernatants were collected and assayed for
HIV p24 antigen on days 3, 7, 10, and 14. Isolates were divided into
four groups depending on TCID50: group 1, 501748; group
2, 18792007; group 3, 30074765; group 4, 7,500. Groups 13
contained one CCR3-using isolate each. HIV p24 antigen levels are shown
for day 10 PI (Table 2)
. This is the point in Figure 2
where the replication curve started to
flatten. Data from day 10 PI in Figure 2
is shown for comparison. In
each case, the isolates that could use CCR3 produced higher levels of
HIV p24 than any isolates in its own group. In addition, the isolates
that used only CXCR4 produced the least HIV p24 antigen. Thus, use of
CCR3 with CCR5 could predict a high level of HIV p24 antigen
production, whereas use of only CXCR4 predicted a low level of HIV p24
antigen production in macrophages.
 |
DISCUSSION
|
|---|
The macrophage culture system developed by the Macrophage Tropism
Viral Kinetics Team for the Pediatric AIDS Clinical Trials Group was
used to examine the relationship of NSI/SI phenotype and replication in
macrophages. A prototypic NSI strain HIV-1 SF162 replicates with
increasing replication kinetics (increased HIV p24 antigen production
over time). Conversely, a prototypic SI strain HIV-1 BRU replicated
with a flat kinetic replication curve (HIV p24 antigen did not increase
after day 3 PI). The separation, however, was not observed when
clinical isolates of the NSI and SI phenotypes were evaluated. Although
NSI isolates had a greater level of production of HIV p24 antigen,
isolates of both the NSI and SI phenotype had increasing replication
kinetics. Because 11/12 isolates were a single virus population, this
did not appear to be related to multiple population viral stocks. Many
of the isolates, however, did have the ability to use multiple
co-receptors for entry. CXCR4 usage was exclusively associated with SI
viruses. However, SI viruses, which could use CCR5 and CCR3 in addition
to CXCR4, had a replication advantage in macrophages over viruses that
used CXCR4 alone. CCR3-using CCR5 viruses also appeared to have a
replication advantage over CCR5 viruses that could not use CCR3.
Several aspects of the primary isolate macrophage-replication patterns
were notable. In contrast to the T-tropic X4 prototype strain BRU, both
CXCR4-restricted primary isolates replicated in macrophages, based on
HIV p24 antigen levels that increased over time (Table 1
and Figs. 1
2
). This result is consistent with recent studies showing that CXCR4 is
a functional co-receptor on macrophages for some primary isolates
[12
13
14
15
]. However, the peak antigen levels reached by the
CXCR4-restricted strains were modest compared with those produced by
isolates that used CCR5, which emphasizes that for these strains CCR5
is a more efficient pathway for macrophage infection than CXCR4.
Primary HIV-1 isolates are typically grouped as M-tropic/NSI versus
T-tropic/SI. Among these isolates, however, CXCR4 use was tightly
associated with the SI phenotype regardless of other co-receptors used,
and CCR5 use was associated with greater replication in macrophages
regardless of CXCR4 use. Thus, whereas M-tropic and NSI phenotypes are
frequently co-associated, these results show that the phenotypes of SI
versus NSI, and efficient versus inefficient macrophage infection, are
independently governed by the use of distinct co-receptors and should
not be considered reciprocal features of the same phenotype. In
contrast, replication in transformed cell lines (the T-tropic
phenotype) and syncytia formation in MT-2 cells (the SI phenotype) are
both determined by CXCR4 utilization, so these two biological
characteristics are both phenotypically and mechanistically linked. A
previous report [16
] correlates number of basic amino acid
substitutions in V3 with SI/NSI phenotype. In our study, SI viruses
display a higher net positive charge than NSI viruses. Furthermore, a
high V3 charge was closely associated with CXCR4 utilization rather
than with lack of CCR5 use, because the mean V3 charge was 6.3 for
isolates restricted to CXCR4, 6.0 for CXCR4/CCR5 isolates, and 3 for
strains that used CCR5 with or without other non-CXCR4 co-receptors.
Our data, then, suggest that the V3 charge is related directly to CXCR4
utilization and that factors in addition to V3 charge distribution may
impact CCR5 usage.
We found that isolates that used CCR3 in addition to CCR5 had the
highest levels of replication in macrophages. However, it is unlikely
that these strains replication advantage is a result of entry into
macrophages through CCR3 in addition to CCR5, because little if any
CCR3 is expressed by macrophages [17
, 18
], and macrophages that lack
CCR5 cannot be infected by HIV-1 isolates that use CCR3 [19
]. In
addition, we did not observe any CCR3 expression on the macrophages
grown using this protocol (data not shown). Instead, it is more likely
that co-utilization of CCR3 is a marker for some other factor such as
more efficient CCR5 utilization. Use of CCR3 in addition to CCR5
indicates that a viral envelope can use a range of related co-receptor
structures. This might reflect a more "fusogenic" envelope
glycoprotein or might be associated with more efficient use of CCR5 if
there are conformational variations or post-translational modifications
of CCR5 in primary cells that limit use by isolates that are more
restricted to specific structure.
In this study we observed that NSI/SI phenotype was not an adequate
predictor of HIV replication in macrophages or complete co-receptor
usage. The range in viral replication patterns we have observed is
supported by a previous report by Simmons et al. [20
]. They described a
continuum of relative levels of HIV p24 antigen production from
clinical isolates grown in macrophages. In addition, there are clinical
situations that have required additional evaluations beyond NSI/SI
phenotyping. These include the areas of transmission and disease
progression. In one such study by Yu et al. [21
] of 12 seroconverters,
3 were thought to be infected by SI viruses based on NSI/SI
phenotyping. However, after genotypic and macrophage culture analysis,
two of three viruses were found to be dual tropic and the third a mixed
population of SI and NSI variants. Thus, NSI/SI phenotyping had given
an incomplete picture.
Transmission of HIV from mother to infant is an area complicated by
viral phenotype issues. Infants are most often infected with NSI
viruses. However, a low percentage of mothers with NSI viruses actually
transmit HIV to their infants [22
]. In addition, mothers with SI
viruses who transmit usually transmit NSI viruses to their infants.
Thus, phenotyping alone is not a good predictor of transmission. In
studies that looked at only qualitative growth (replication positive or
negative) in macrophages, there were no differences in the ability of
viruses from transmitters or nontransmitters, whether SI or NSI, to
replicate in macrophages. Most were capable of replication in
macrophages [23
24
25
]. This is similar to our results observed with the
panel of isolates described in this report; all were capable of some
level of replication in macrophages. However, when the macrophage
replication kinetics of isolates from transmitters and nontransmitters
were evaluated differences were observed. Lathey et al. [23
] showed
that isolates taken at delivery from transmitters compared wth
nontransmitters had increasing replication kinetics in macrophages
(0.65 ± 0.21 vs. 0.07 ± 0.11 log10 HIV p24
antigen increase between days 11 and 15 PI, respectively). Of these
80%, four of five of the transmitter isolates had increases of
log10 HIV p24 antigen
0.5 log10
compared with only 17% (1/12) of nontransmitters. Thus, for
mother-to-infant transmission, NSI phenotype or qualitative growth in
macrophages could not differentiate transmitters from nontransmitters.
However, the replication kinetics in macrophages were predictive of
transmission.
Viral phenotype issues also complicate disease progression studies. The
SI phenotype has been associated with progression to AIDS, however,
50% of individuals can progress to AIDS with only NSI isolates [3
, 4
].
In a study by Blaak et al. [26
] isolates from long-term survivors (LTS)
and progressors were all NSI isolates, however, they could be
differentiated when they were examined for replication kinetics in
vitro. Early in the course of infection, viruses from 5/7 LTS and 3/3
progressors had a low replicative rate. Late in infection, only viruses
from 4/7 LTS remained with a low replicative rate. However, all
viruses, including the high-replicating viruses, remained NSI. Thus,
individuals with NSI viruses early in disease retained NSI viruses late
in disease, but the replication rate of the NSI viruses had increased.
In addition, at the time of isolation of viruses with high replicative
rate in vitro, high levels of HIV RNA in serum were observed in vivo.
This suggests that changes in replication kinetics of NSI isolates that
are observed in vitro may be associated with viral load in vivo. This
association could not have been made from simply NSI/SI phenotyping,
because all viruses were NSI.
In summary, we have shown that NSI/SI phenotyping is not sufficient for
the prediction of replication of HIV isolates in macrophages or
predicting co-receptor usage of dual tropic isolates. Co-receptor usage
is predictive of growth in macrophages with viruses using only CXCR4
having the lowest level of replication. However, there is a range of
levels of replication by viruses using CCR5, with the addition of
CCR3-increasing viral replication in macrophages. For clinical
evaluations, it may be necessary to do some combination of viral growth
kinetics and co-receptor analyses in addition to NSI/SI phenotyping.
 |
ACKNOWLEDGEMENTS
|
|---|
We would like to thank the Virology Committee of the Pediatric AIDS
Clinical Trials Group for supporting this project. We would like to
acknowledge David Polstra and Tom Giesler of the Virology Quality
Assurance Program, Rush Medical College, Susanna Lamers of Gene Genie,
and Rodney Trout of UCSD for technical assistance.
The following grant support was used in part for this project:
SSS-97PVCL01 and SSS-97PICL04 (J. L. L.), NO-AI-35712 and
NO-AI-85354 (D. B., J. W. B., D. D. H.),
HD-32259, HL-58005, AI-39015 (M. M. G.), Rasheed Research
Fund at USC School of Medicine (S. R.), AACTG Immunology Support
Laboratory at UTMB (M. N.), Eugene B. Casey Foundation at Baylor
College of Medicine (E. B. S.), and AI-35502 (R. G. C.).
 |
FOOTNOTES
|
|---|
1 For the Macrophage Tropic Viral Kinetic Team (MTVK), Pediatric AIDS Clinical Trials Group (PACTG), NIAID. 
 |
REFERENCES
|
|---|
-
Schuitemaker, H., Koot, M., Kootstra, N.A., Dercksen, M. W., de Goode, R. E. Y., Van Strenwijk, R. P., Lange, J. M. A., Eeftink Schattenkerk, J. K. M., Miedema, F., Tersmette, M. (1992) Biological phenotype of human immunodeficiency virus type 1 clones at different stages of infection: progression of disease is associated with a shift from monocytotropic to T-cell-tropic populations J. Virol. 66,1354-1360[Abstract/Free Full Text]
-
. AIDS Clinical Trails Group Protocol 175 TeamLathey, J. L., Hughes, M. D., Fiscus, S. A., Pi, T., Jackson, J. B., Rasheed, S., Elbeik, T., Reichman, R., Japour, A., DAquila, R. T., Scott, W., Griffith, B. P., Hammer, S. M., Katzenstein, D. A. (1998) Variability and prognostic values of virologic and CD4 cell measures in human immunodeficiency virus type 1-infected patients with 200-500 CD4 cells/mm3 (ACTG 175) J. Infect. Dis. 177,617-624[Medline]
-
Tersmette, M., Lange, J. M. A., de Goode, R. E. Y., de Wolf, F., Eeftink-Schattenkerk, J. K. M., Schellekens, P. Th. A., Coutinho, R. A., Huisman, J. G., Goutsmit, J., Miedema, F. (1989) Association between biological properties of human immunodeficiency virus variants and risk for AIDS and AIDS mortality Lancet 1,983-985[Medline]
-
Richman, D. D., Bozzette, S. A. (1994) The impact of syncytium-inducing phenotype of human immunodeficiency virus on disease progression J. Infect. Dis. 169,968-974[Medline]
-
Spencer, L. T., Ogino, M. T., Dankner, W. M., Spector, S. A. (1994) Clinical significance of human immunodeficiency virus type 1 phenotypes in infected children J. Infect. Dis. 169,491-495[Medline]
-
. AIDS Clinical Trails Group Protocol 175 TeamFiscus, S., Hughes, M. D., Lathey, J. L., Pi, T., Jackson, J. B., Rasheed, S., Elbeik, T., Reichman, R., Japour, A., Byington, R., Scott, W., Griffith, B. P., Katzenstein, D. A., Hammer, S. M. (1998) Changes in virologic markers as predictors of CD4 cell decline and progression of disease in human immunodeficiency virus type 1-infected adults treated with nucleosides J. Infect. Dis. 177,625-633[Medline]
-
Viani, R. M., Smith, I. L., Spector, S. A. (1998) Human immunodeficiency virus type 1 phenotypes in children with advanced disease treated with long-term zalcitabine J. Infect. Dis. 177,565-570[Medline]
-
Doranz, B. J., Rucker, J., Yi, Y., Smyth, R. J., Samson, M., Peiper, S. C., Parmentier, M., Collman, R. G., Doms, R. W. (1996) A dual-tropic primary HIV-1 isolate that uses fusin and the beta-chemokine receptors CKR-5, CKR-3, and CKR-2b as fusion cofactors Cell 85,1149-1158[Medline]
-
. US Department of Health and Human Services (1994) ACTG virology manual for HIV laboratories NIH Publication 94-3828 SIA-1-SIA-3 Bethesda, MD..
-
Simmonds, P., Balfe, P., Ludlum, C.A., Bishop, J. O., Brown, A. J. L. (1990) Analysis of sequence diversity in hypervariable regions of the external glycoprotein of human immunodeficiency virus type 1 J. Virol. 64,5840-5850[Abstract/Free Full Text]
-
Salminen, M. O., Koch, C., Sanders-Buel, E., Ehrenberg, P. K., Michael, N. L., Carr, J. K., Burke, D. S., McCutchan, F. E. (1995) Recovery of virtually full-length HIV-1 provirus of diverse subtypes from primary virus cultures using the polymerase chain reaction Virol 213,80-86
-
Yi, Y., Rana, S., Turner, J. D., Gaddis, N., Collman, R. G. (1998) CXCR-4 expressed by primary macrophages and supports CCR5-independent infection by dual-tropic but not T-tropic isolates of human immunodeficiency virus type 1 J. Virol. 72,772-777[Abstract/Free Full Text]
-
Yi, Y., Isaacs, S. N., Williams, D. A., Frank, I., Schols, D., DeClercq, E., Kolson, D. L., Collman, R. G. (1999) Role of CXCR4 in cell-cell fusion and infection of monocyte-derived macrophages by primary human immunodeficiency virus type 1 (HIV-1) strains: two distinct mechanisms of HIV-1 dual tropism J. Virol. 73,7117-7125[Abstract/Free Full Text]
-
Simmons, G., Reeves, J. D., McKnight, A., Dejucq, N., Hibbitts, S., Power, C. A., Aarons, E., Schols, D., DeClercq, E., Proudfoot, A. E., Clapham, P. R. (1998) CXCR4 as a functional coreceptor for human immunodeficiency virus type 1 infection of primary macrophages J. Virol. 72,8453-8457[Abstract/Free Full Text]
-
Verani, A., Pesenti, E., Polo, S., Tresoldi, E., Scarlatti, G., Lusso, P., Siccardi, A.G., Vercelli, D. (1998) CXCR4 is a functional coreceptor for infection of human macrophages by CXCR4-dependent primary HIV-1 isolates J. Immunol. 161,2084-2088[Abstract/Free Full Text]
-
Milich, L., Margolin, B., Swanstorm, R. (1993) V3 loop of the human immunodeficiency virus type 1 env protein: Interpreting sequence variability J. Virol. 67,5623-5634[Abstract/Free Full Text]
-
Sica, A., Saccani, A., Borsatti, A., Power, C. A., Wells, T. N., Luini, W., Sozzani, S., Mantovani, A. (1997) Bacterial lipopolysaccharide rapidly inhibits expression of C-C chemokine receptors in human monocytes J. Exp. Med. 185,969-974[Abstract/Free Full Text]
-
Naif, H. M., Li, S., Alali, M., Sloane, A., Wu, L., Kelly, M., Lynch, G., Lloyd, A., Cunningham, A. L. (1998) CCR5 expression correlates with susceptibility of maturing monocytes to human immunodeficiency virus type 1 infection J. Virol. 72,830-836[Abstract/Free Full Text]
-
Rana, S., Besson, G., Cook, D. G., Rucker, J., Smyth, R. J., Yi, Y., Turner, J. D., Guo, H. H., Du, J. G., Peiper, S. C., Lavi, E., Samson, M., Libert, F., Liesnard, C., Vassart, G., Doms, R. W., Parmentier, M., Collman, R. G. (1997) Role of CCR5 in infection of primary macrophages and lymphocytes by macrophage-tropic strains of human immunodeficiency virus: resistance to patient-derived and prototype isolates resulting from the dccr5 mutation J. Virol. 71,3219-3227[Abstract]
-
Simmons, G., Wilkinson, D., Reeves, J. D., Dittmar, M. T., Beddows, S., Weber, J., Carnegie, G., Desselberger, U., Gray, P. W., Weiss, R. A., Clapham, P. R. (1998) Primary, syncytium-inducing human immunodeficiency virus type 1 isolates are dual-tropic and most can use either Lestr or CCR5 as coreceptors for virus entry J. Virol. 70,8355-8360[Abstract]
-
Yu, X., Wang, Z., Vlahov, D., Markham, R. B., Farzadegan, H., Margolick, J. B. (1998) Infection with dual-tropic human immunodeficiency virus type 1 variants associated with rapid total T cell decline and disease progression in injection drug users J. Infect. Dis. 178,388-396[Medline]
-
Bryson, Y. J. (1996) Perinatal HIV-1 transmission: recent advances and therapeutic interventions AIDS 10(S3),S33-S42
-
Lathey, J. L., Tsou, J., Brinker, K., Hsia, K., Meyer, W. A., Spector, S. A. (1999) Lack of autologous neutralizing antibody to human immunodeficiency virus type-1 (HIV-1) and macrophage tropism are associated with mother-to-infant transmission J. Infect. Dis. 180,344-350[Medline]
-
Ometto, L., Zanotto, C., Maccabruni, A., Caselli, D., Truscia, D., Giaquinto, C., Ruga, E., Chieco-Bianchi, L., De Rossi, A. (1995) Viral phenotype and host-cell susceptibility to HIV-1 infection as risk factors for mother-to-child HIV-1 transmission AIDS 9,427-434[Medline]
-
Kliks, S., Wara, D. W., Landers, D.V., Levy, J. A. (1994) Features of HIV-1 that could influence maternal-child transmission JAMA 272,467-474[Abstract]
-
Blaak, H., Brouwer, M., Ran, L. J., de Wolf, F., Schuitemaker, H. (1998) In vitro replication kinetics of human immunodeficiency virus type 1 (HIV-1) variants in relation to virus load in long-term survivors of HIV-1 infection J. Infect. Dis. 177,600-610[Medline]
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