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Medline Plus Health Information
*High Risk Pregnancy
*Infections and Pregnancy
The Journal of Immunology, 1999, 162: 4796-4800.
Copyright © 1999 by The American Association of Immunologists

Persistent HIV-1-Specific CTL Clonal Expansion Despite High Viral Burden Post In Utero HIV-1 Infection1

Christian Brander2,*, Philip J. R. Goulder*, Katherine Luzuriaga{dagger}, Otto O. Yang*, Kelly E. Hartman*, Norman G. Jones*, Bruce D. Walker* and Spyros A. Kalams*

* AIDS Research Center and Infectious Disease Unit, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129; and {dagger} Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA 01605

To address the issue of clonal exhaustion in humans, we monitored HLA class I-restricted, epitope-specific CTL responses in an in utero HIV-1-infected infant from 3 mo through 5 years of age. Serial functional CTL precursor assays demonstrated persistent, vigorous, and broadly directed HIV-1 specific CTL activity with a dominant response against an epitope in HIV-1 Gag-p17 (SLYNTVATL, aa 77–85). A clonal CTL response directed against the immunodominant, HLA-A*0201-restricted epitope was found to persist over the entire observation period, as shown by TCR analysis of cDNA libraries generated from PBMC. The analysis of autologous viral sequences did not reveal any escape mutations within the targeted epitope, and viral load measurement indicated ongoing viral replication. Furthermore, inhibition of viral replication assays indicated that the epitope was properly processed from autologous viral protein. These data demonstrate that persistent exposure to high levels of viral Ag does not necessarily lead to clonal exhaustion and that epitope-specific clonal CTL responses induced within the first weeks of life can persist for years without inducing detectable viral escape variants.




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