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 Blood, 1 November 2007, Vol. 110, No. 9, pp. 3143-3149.
Prepublished online as a Blood First Edition Paper on August 10, 2007; DOI 10.1182/blood-2007-04-086314.

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HEMATOPOIESIS

Infection of hematopoietic progenitor cells by HIV-1 subtype C, and its association with anemia in southern Africa

Andrew D. Redd1, Ava Avalos2, and Max Essex1

1 Harvard School of Public Health AIDS Initiative, Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, and Botswana-Harvard Partnership for HIV Education and Training, Gaborone, Botswana; 2 Infectious Disease Care Clinic, Princess Marina Hospital, Gaborone, Botswana

Reports from southern Africa, an area in which human immunodeficiency virus type 1 (HIV-1) infection is caused almost exclusively by subtype C (HIV-1C), have shown increased rates of anemia in HIV-infected populations compared with similar acquired immunodeficiency syndrome (AIDS) patients in the United States, an area predominantly infected with subtype B (HIV-1B). Recent findings by our group demonstrated a direct association between HIV-1 infection and hematopoietic progenitor cell health in Botswana. Therefore, using a single-colony infection assay and quantitative proviral analysis, we examined whether HIV-1C could infect hematopoietic progenitor cells (HPCs) and whether this phenotype was associated with the higher rates of anemia found in southern Africa. The results show that a significant number of HIV-1C, but not HIV-1B, isolates can infect HPCs in vitro (P < .05). In addition, a portion of HIV-1C–positive Africans had infected progenitor cell populations in vivo, which was associated with higher rates of anemia in these patients (P < .05). This represents a difference in cell tropism between 2 geographically separate and distinct HIV-1 subtypes. The association of this hematotropic phenotype with higher rates of anemia should be considered when examining anti-HIV drug treatment regimens in HIV-1C–predominant areas, such as southern Africa.


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