A1 Signature pattern and phylogenetic analysis of full-length env genes in 20 hemophiliacs infected with Korean subclade of HIV-1 subtype B
Twenty patients with hemophilia (HP) were diagnosed with HIV-1, one to two years after exposure to domestic clotting factor IX (DCF), in 1989–90. Previous analysis of pol and vif genes confirmed that HIV-1 transmission to 20 HPs occurred through infusion of DCF. In this study, we determined full-length env gene sequences (about 2,550 bp) in 21 HPs, three plasma donors whose plasma were used in DCF production, and 45 local controls. The env gene from frozen stored sera obtained 1–3 years after diagnosis as well as from samples collected years after infection, was amplified by RT-PCR, and subjected to direct sequencing. Phylogenetic analysis revealed that all sequences were subtype B, with 109 sequences from 64 patients (20 HPs, 3 serum donors, 41 local controls, LCs) belonging to the Korean subclade (KSB) and 13 sequences from 5 patients (1HP infected outside Korea, 4 LCs) not in the KSB. Sequences of the env gene from donors O and P plus the 20 HPs comprised two subclusters within KSB. In addition, signature pattern analysis revealed signature nucleotides at 45 positions between the HPs and LCs (P < 0.05). Surprisingly, specific signature nucleotides positions were conserved 100% in clusters O and P only (at 4 and 1 positions, respectively) with none in LCs. Within both clusters, sequence identity was high. These results are consistent with our previous conclusion that these 20 HPs were infected with viruses in the DCF used for treatment. In addition, we found that there are 25 signature pattern residues in amino acids in env gene of KSB distinct from subtype B.