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HIV escape mutations do not always survive transmission
  By David Douglas
NEW YORK (Reuters Health) - HIV mutations that arise in order to escape cytotoxic T-lymphocyte (CTL) recognition do not necessarily lead to significant evolution of the virus at the population level, researchers report in the February 8th advance online edition of Nature Medicine.
As senior investigator Dr. Philip Goulder told Reuters Health, although "the virus may seek to evade the immune response by mutation within one particular individual, transmission of such a mutant virus into another individual who expresses a different immune response may result in reversion of the virus back to its original sequence."
Dr. Goulder of the University of Oxford, UK and colleagues came to this conclusion following a study of 300 patients with chronic HIV infection. The team found that an escape mutation that arose in HLAB57/5801-positive subjects reverted to wild-type after transmission to subjects negative for these alleles.
However, a second escape mutation within the epitope did survive transmission.
Nevertheless, continued Dr. Goulder, the findings show that "HIV is not inexorably evolving to evade all the immune responses we as a population direct against it."
The finding has relevance for the development of an AIDS vaccine, the researcher noted. "The responses that revert after transmission may indeed be the very ones that are best associated with successful containment of HIV and that will continue to be relevant to vaccine design well into the future."
Nature Med 2004;163:36-42.


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