Diverse HIV-1 subtypes and clinical, laboratory and behavioral factors in a recently infected US military cohort

Stephanie K. Brodine*, Monica J. Starkey, Richard A. Shaffer, Stanley I. Ito, Sybil A. Tasker, Anthony J. Barile, Cindy L. Tamminga, Kevin T. Stephan, Naomi E. Aronson, Susan L. Fraser, Mark R. Wallace, Scott A. Wegner, John R. Mascola, Francine E. McCutchan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


Objective: To describe the demographics, risk behaviors, and HIV-1 subtypes in a large cohort of recently HIV-infected military personnel. Design: Descriptive, cross-sectional study. Methods: US military personnel with recent HIV seroconversion from six medical referral centers were enrolled with a self-administered questionnaire, CD4 cell counts, syphilis and hepatitis B serologies, plasma viral RNA levels, and HIV-1 subtype nucleic acid sequencing. Results: Between February 1997 and May 2000, 520 patients were enrolled. Most [488 (94.3%)] were infected with HIV-1 subtype B. The most prevalent non-B subtype was a circulating recombinant form (CRF01_AE) [17 (61%)]; however, two pure subtypes (C and D), as well as CRF02_AG, CRF09_cpx and a BE recombinant were identified. The likely area of HIV-1 acquisition was the United States for 70% of the volunteers. At least three non-B subtype infections (two subtype C, one subtype CRF01_AE) were apparently acquired domestically. Risk behaviors and comorbid sexually transmitted diseases were reported during the seroconversion period. Volunteers with non-B subtype HIV infection were more likely to report heterosexual contacts [92% vs. 39%; odds ratio (OR), 10.0], including contacts with commercial sex workers (41% vs. 13%; OR, 4.9). The Roche Amplicor version 1.0 assay was less sensitive for non-B subtype infections than the Roche Amplicor version 1.5 assay. Conclusion: There is a high prevalence and diversity of non-B HIV subtypes in this large cohort. Efficient diagnosis of acute primary HIV-1 infection was identified as a goal for prevention programs. Modifiable risk behaviors and target populations for intervention were identified.

Original languageEnglish
Pages (from-to)2521-2527
Number of pages7
Issue number17
StatePublished - 21 Nov 2003
Externally publishedYes


  • Cross-sectional study
  • Epidemiology
  • HIV-1
  • Hiv-1 subtypes
  • Risk factors
  • Seroconversion
  • US military


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