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Author
- Smithgall, Thomas E4
- Wu, Li4
- Kim, Baek3
- Aghasadeghi, Mohammad Reza2
- Allahbakhshi, Elham2
- Chong, Huihui2
- Cui, Sheng2
- Ding, Xiaohui2
- Emert-Sedlak, Lori A2
- Engelman, Alan N2
- Fan, Yan2
- Hao, Caili2
- Kim, Dong-Hyun2
- Koneru, Pratibha C2
- Kvaratskhelia, Mamuka2
- Schinazi, Raymond F2
- Skowronski, Jacek2
- Wang, Xiaojun2
- Zheng, Yong-Hui2
- Abdel-Mohsen, Mohamed1
- Abe, Makoto1
- Ahmed, Shubbir1
- Ahn, Jinwoo1
- Ahn, Koree W1
- Akpamagbo, Yao1
Keyword
- viral replication10
- virus entry8
- infection7
- membrane fusion7
- viral protein7
- protein-protein interaction6
- SAM domain and HD domain-containing protein 1 (SAMHD1)6
- AIDS5
- antiviral agent5
- HIV-15
- infectious disease5
- dimerization4
- inhibitor4
- macrophage4
- restriction factor4
- bimolecular fluorescence complementation (BiFC)3
- dNTPase3
- drug resistance3
- HIV-1 Nef3
- retrovirus3
- DNA replication2
- E3 ubiquitin ligase2
- histone deacetylase (HDAC)2
- HIV-1 production2
Microbiology
59 Results
- MicrobiologyOpen Access
Nef homodimers down-regulate SERINC5 by AP-2–mediated endocytosis to promote HIV-1 infectivity
Journal of Biological ChemistryVol. 295Issue 46p15540–15552Published online: September 1, 2020- Ryan P. Staudt
- Thomas E. Smithgall
Cited in Scopus: 11SERINC5 is a multipass intrinsic membrane protein that suppresses HIV-1 infectivity when incorporated into budding virions. The HIV-1 Nef virulence factor prevents viral incorporation of SERINC5 by triggering its down-regulation from the producer cell membrane through an AP-2–dependent endolysosomal pathway. However, the mechanistic basis for SERINC5 down-regulation by Nef remains elusive. Here we demonstrate that Nef homodimers are important for SERINC5 down-regulation, trafficking to late endosomes, and exclusion from newly synthesized viral particles. - JBC ReviewsOpen Access
Structure, function, and inhibitor targeting of HIV-1 Nef-effector kinase complexes
Journal of Biological ChemistryVol. 295Issue 44p15158–15171Published online: August 29, 2020- Ryan P. Staudt
- John J. Alvarado
- Lori A. Emert-Sedlak
- Haibin Shi
- Sherry T. Shu
- Thomas E. Wales
- and others
Cited in Scopus: 15Antiretroviral therapy has revolutionized the treatment of AIDS, turning a deadly disease into a manageable chronic condition. Life-long treatment is required because existing drugs do not eradicate HIV-infected cells. The emergence of drug-resistant viral strains and uncertain vaccine prospects highlight the pressing need for new therapeutic approaches with the potential to clear the virus. The HIV-1 accessory protein Nef is essential for viral pathogenesis, making it a promising target for antiretroviral drug discovery. - MicrobiologyOpen Access
A novel HIV-1 inhibitor that blocks viral replication and rescues APOBEC3s by interrupting vif/CBFβ interaction
Journal of Biological ChemistryVol. 295Issue 43p14592–14605Published online: August 19, 2020- Sizhu Duan
- Shiqi Wang
- Yanan Song
- Nan Gao
- Lina Meng
- Yanxin Gai
- and others
Cited in Scopus: 6HIV remains a health challenge worldwide, partly because of the continued development of resistance to drugs. Therefore, it is urgent to find new HIV inhibitors and targets. Apolipoprotein B mRNA-editing catalytic polypeptide-like 3 family members (APOBEC3) are important host restriction factors that inhibit HIV-1 replication by their cytidine deaminase activity. HIV-1 viral infectivity factor (Vif) promotes proteasomal degradation of APOBEC3 proteins by recruiting the E3 ubiquitin ligase complex, in which core-binding factor β (CBFβ) is a necessary molecular chaperone. - Molecular Bases of DiseaseOpen Access
Modification of lipid rafts by extracellular vesicles carrying HIV-1 protein Nef induces redistribution of amyloid precursor protein and Tau, causing neuronal dysfunction
Journal of Biological ChemistryVol. 295Issue 38p13377–13392Published online: July 30, 2020- Michael Ditiatkovski
- Nigora Mukhamedova
- Dragana Dragoljevic
- Anh Hoang
- Hann Low
- Tatiana Pushkarsky
- and others
Cited in Scopus: 12HIV-associated neurocognitive disorders (HANDs) are a frequent outcome of HIV infection. Effective treatment of HIV infection has reduced the rate of progression and severity but not the overall prevalence of HANDs, suggesting ongoing pathological process even when viral replication is suppressed. In this study, we investigated how HIV-1 protein Nef secreted in extracellular vesicles (exNef) impairs neuronal functionality. ExNef were rapidly taken up by neural cells in vitro, reducing the abundance of ABC transporter A1 (ABCA1) and thus cholesterol efflux and increasing the abundance and modifying lipid rafts in neuronal plasma membranes. - MicrobiologyOpen Access
Super-rapid quantitation of the production of HIV-1 harboring a luminescent peptide tag
Journal of Biological ChemistryVol. 295Issue 37p13023–13030Published online: July 20, 2020- Seiya Ozono
- Yanzhao Zhang
- Minoru Tobiume
- Satoshi Kishigami
- Kenzo Tokunaga
Cited in Scopus: 18In studies of HIV-1, virus production is normally monitored by either a reverse transcriptase assay or a p24 antigen capture ELISA. However, these assays are costly and time-consuming for routine handling of a large number of HIV-1 samples. For example, sample dilution is always required in the ELISA procedure to determine p24 protein levels because of the very narrow range of detectable concentrations in this assay. Here, we establish a novel HIV-1 production assay system to solve the aforementioned problems by using a recently developed small peptide tag called HiBiT. - MicrobiologyOpen Access
The African natural product knipholone anthrone and its analogue anthralin (dithranol) enhance HIV-1 latency reversal
Journal of Biological ChemistryVol. 295Issue 41p14084–14099Published online: August 11, 2020- Khumoekae Richard
- Cole Schonhofer
- Leila B. Giron
- Jocelyn Rivera-Ortiz
- Silven Read
- Toshitha Kannan
- and others
Cited in Scopus: 3A sterilizing or functional cure for HIV is currently precluded by resting CD4+ T cells that harbor latent but replication-competent provirus. The “shock-and-kill” pharmacological ap-proach aims to reactivate provirus expression in the presence of antiretroviral therapy and target virus-expressing cells for elimination. However, no latency reversal agent (LRA) to date effectively clears viral reservoirs in humans, suggesting a need for new LRAs and LRA combinations. Here, we screened 216 compounds from the pan-African Natural Product Library and identified knipholone anthrone (KA) and its basic building block anthralin (dithranol) as novel LRAs that reverse viral latency at low micromolar concentrations in multiple cell lines. - MicrobiologyOpen Access
The viral protein U (Vpu)-interacting host protein ATP6V0C down-regulates cell-surface expression of tetherin and thereby contributes to HIV-1 release
Journal of Biological ChemistryVol. 295Issue 21p7327–7340Published online: April 14, 2020- Abdul A. Waheed
- Maya Swiderski
- Ali Khan
- Ariana Gitzen
- Ahlam Majadly
- Eric O. Freed
Cited in Scopus: 3Host proteins with antiviral activity have evolved as first-line defenses to suppress viral replication. The HIV-1 accessory protein viral protein U (Vpu) enhances release of the virus from host cells by down-regulating the cell-surface expression of the host restriction factor tetherin. However, the exact mechanism of Vpu-mediated suppression of antiviral host responses is unclear. To further understand the role of host proteins in Vpu's function, here we carried out yeast two-hybrid screening and identified the V0 subunit C of vacuolar ATPase (ATP6V0C) as a Vpu-binding protein. - Molecular Bases of DiseaseOpen Access
Pro-515 of the dynamin-like GTPase MxB contributes to HIV-1 inhibition by regulating MxB oligomerization and binding to HIV-1 capsid
Journal of Biological ChemistryVol. 295Issue 19p6447–6456Published online: March 26, 2020- Fengwen Xu
- Fei Zhao
- Xiaoxiao Zhao
- Di Zhang
- Xiaoman Liu
- Siqi Hu
- and others
Cited in Scopus: 2Interferon-regulated myxovirus resistance protein B (MxB) is an interferon-induced GTPase belonging to the dynamin superfamily. It inhibits infection with a wide range of different viruses, including HIV-1, by impairing viral DNA entry into the nucleus. Unlike the related antiviral GTPase MxA, MxB possesses an N-terminal region that contains a nuclear localization signal and is crucial for inhibiting HIV-1. Because MxB previously has been shown to reside in both the nuclear envelope and the cytoplasm, here we used bioinformatics and biochemical approaches to identify a nuclear export signal (NES) responsible for MxB's cytoplasmic location. - Signal TransductionOpen Access
HIV-1 Nef dimers short-circuit immune receptor signaling by activating Tec-family kinases at the host cell membrane
Journal of Biological ChemistryVol. 295Issue 15p5163–5174Published online: March 6, 2020- Wing Fai Li
- Manish Aryal
- Sherry T. Shu
- Thomas E. Smithgall
Cited in Scopus: 10The HIV-1 virulence factor Nef promotes high-titer viral replication, immune escape, and pathogenicity. Nef interacts with interleukin-2–inducible T-cell kinase (Itk) and Bruton's tyrosine kinase (Btk), two Tec-family kinases expressed in HIV-1 target cells (CD4 T cells and macrophages, respectively). Using a cell-based bimolecular fluorescence complementation assay, here we demonstrate that Nef recruits both Itk and Btk to the cell membrane and induces constitutive kinase activation in transfected 293T cells. - MicrobiologyOpen Access
The C-terminal domain of feline and bovine SAMHD1 proteins has a crucial role in lentiviral restriction
Journal of Biological ChemistryVol. 295Issue 13p4252–4264Published online: February 19, 2020- Chu Wang
- Kaikai Zhang
- Lina Meng
- Xin Zhang
- Yanan Song
- Ying Zhang
- and others
Cited in Scopus: 4SAM and HD domain-containing protein 1 (SAMHD1) is a host factor that restricts reverse transcription of lentiviruses such as HIV in myeloid cells and resting T cells through its dNTP triphosphohydrolase (dNTPase) activity. Lentiviruses counteract this restriction by expressing the accessory protein Vpx or Vpr, which targets SAMHD1 for proteasomal degradation. SAMHD1 is conserved among mammals, and the feline and bovine SAMHD1 proteins (fSAM and bSAM) restrict lentiviruses by reducing cellular dNTP concentrations. - MicrobiologyOpen Access
The lipid membrane of HIV-1 stabilizes the viral envelope glycoproteins and modulates their sensitivity to antibody neutralization
Journal of Biological ChemistryVol. 295Issue 2p348–362Published online: November 22, 2019- Hamid Salimi
- Jacklyn Johnson
- Manuel G. Flores
- Michael S. Zhang
- Yunxia O'Malley
- Jon C. Houtman
- and others
Cited in Scopus: 26The envelope glycoproteins (Envs) of HIV-1 are embedded in the cholesterol-rich lipid membrane of the virus. Chemical depletion of cholesterol from HIV-1 particles inactivates their infectivity. We observed that diverse HIV-1 strains exhibit a range of sensitivities to such treatment. Differences in sensitivity to cholesterol depletion could not be explained by variation in Env components known to interact with cholesterol, including the cholesterol-recognition motif and cytoplasmic tail of gp41. - MicrobiologyOpen Access
Viral protein X reduces the incorporation of mutagenic noncanonical rNTPs during lentivirus reverse transcription in macrophages
Journal of Biological ChemistryVol. 295Issue 2p657–666Published online: December 5, 2019- Adrian Oo
- Dong-Hyun Kim
- Raymond F. Schinazi
- Baek Kim
Cited in Scopus: 1Unlike activated CD4+ T cells, nondividing macrophages have an extremely small dNTP pool, which restricts HIV-1 reverse transcription. However, rNTPs are equally abundant in both of these cell types and reach much higher concentrations than dNTPs. The greater difference in concentration between dNTPs and rNTPs in macrophages results in frequent misincorporation of noncanonical rNTPs during HIV-1 reverse transcription. Here, we tested whether the highly abundant SAM domain– and HD domain–containing protein 1 (SAMHD1) deoxynucleoside triphosphorylase in macrophages is responsible for frequent rNTP incorporation during HIV-1 reverse transcription. - MicrobiologyOpen Access
Facile autofluorescence suppression enabling tracking of single viruses in live cells
Journal of Biological ChemistryVol. 294Issue 50p19111–19118Published online: November 6, 2019- Yen-Cheng Chen
- Chetan Sood
- Ashwanth C. Francis
- Gregory B. Melikyan
- Robert M. Dickson
Cited in Scopus: 4Live cell fluorescence imaging is the method of choice for studying dynamic processes, such as nuclear transport, vesicular trafficking, and virus entry and egress. However, endogenous cellular autofluorescence masks a useful fluorescence signal, limiting the ability to reliably visualize low-abundance fluorescent proteins. Here, we employed synchronously amplified fluorescence image recovery (SAFIRe), which optically alters ground versus photophysical dark state populations within fluorescent proteins to modulate and selectively detect their background-free emission. - Protein Structure and FoldingOpen Access
Structural and biophysical characterizations of HIV-1 matrix trimer binding to lipid nanodiscs shed light on virus assembly
Journal of Biological ChemistryVol. 294Issue 49p18600–18612Published online: October 22, 2019- R. Elliot Murphy
- Alexandra B. Samal
- Jiri Vlach
- Vicente Mas
- Peter E. Prevelige
- Jamil S. Saad
Cited in Scopus: 16During the late phase of the HIV-1 replication cycle, the viral Gag polyproteins are targeted to the plasma membrane for assembly. The Gag-membrane interaction is mediated by binding of Gag’s N-terminal myristoylated matrix (MA) domain to phosphatidylinositol 4,5-bisphosphate (PI(4,5)P2). The viral envelope (Env) glycoprotein is then recruited to the assembly sites and incorporated into budding particles. Evidence suggests that Env incorporation is mediated by interactions between Gag’s MA domain and the cytoplasmic tail of the gp41 subunit of Env (gp41CT). - Editors' PicksOpen Access
Nucleic acid–induced dimerization of HIV-1 Gag protein
Journal of Biological ChemistryVol. 294Issue 45p16480–16493Published online: September 30, 2019- Huaying Zhao
- Siddhartha A.K. Datta
- Sung H. Kim
- Samuel C. To
- Sumit K. Chaturvedi
- Alan Rein
- and others
Cited in Scopus: 7HIV-1 Gag is a highly flexible multidomain protein that forms the protein lattice of the immature HIV-1 virion. In vitro, it reversibly dimerizes, but in the presence of nucleic acids (NAs), it spontaneously assembles into virus-like particles (VLPs). High-resolution structures have revealed intricate details of the interactions of the capsid (CA) domain of Gag and the flanking spacer peptide SP1 that stabilize VLPs, but much less is known about the assembly pathway and the interactions of the highly flexible NA-binding nucleocapsid (NC) domain. - ArticleOpen Access
ANP32A and ANP32B are key factors in the Rev-dependent CRM1 pathway for nuclear export of HIV-1 unspliced mRNA
Journal of Biological ChemistryVol. 294Issue 42p15346–15357Published online: August 23, 2019- Yujie Wang
- Haili Zhang
- Lei Na
- Cheng Du
- Zhenyu Zhang
- Yong-Hui Zheng
- and others
Cited in Scopus: 14The nuclear export receptor CRM1 is an important regulator involved in the shuttling of various cellular and viral RNAs between the nucleus and the cytoplasm. HIV-1 Rev interacts with CRM1 in the late phase of HIV-1 replication to promote nuclear export of unspliced and single spliced HIV-1 transcripts. However, other cellular factors involved in the CRM1-dependent viral RNA nuclear export remain largely unknown. Here, we demonstrate that ANP32A and ANP32B mediate the export of unspliced or partially spliced viral mRNA via interactions with Rev and CRM1. - ArticleOpen Access
The anti-parasitic drug suramin potently inhibits formation of seminal amyloid fibrils and their interaction with HIV-1
Journal of Biological ChemistryVol. 294Issue 37p13740–13754Published online: July 25, 2019- Suiyi Tan
- Jin-Qing Li
- Hongyan Cheng
- Zhaofeng Li
- Yan Lan
- Ting-Ting Zhang
- and others
Cited in Scopus: 8Seminal amyloid fibrils are made up of naturally occurring peptide fragments and are key targets for the development of combination microbicides or antiviral drugs. Previously, we reported that the polysulfonic compound ADS-J1 is a potential candidate microbicide that not only inhibits HIV-1 entry, but also seminal fibrils. However, the carcinogenic azo moieties in ADS-J1 preclude its clinical application. Here, we screened several ADS-J1–like analogs and found that the antiparasitic drug suramin most potently inhibited seminal amyloid fibrils. - MicrobiologyOpen Access
Two-long terminal repeat (LTR) DNA circles are a substrate for HIV-1 integrase
Journal of Biological ChemistryVol. 294Issue 20p8286–8295Published online: April 10, 2019- Clémence Richetta
- Sylvain Thierry
- Eloise Thierry
- Paul Lesbats
- Delphine Lapaillerie
- Soundasse Munir
- and others
Cited in Scopus: 3Integration of the HIV-1 DNA into the host genome is essential for viral replication and is catalyzed by the retroviral integrase. To date, the only substrate described to be involved in this critical reaction is the linear viral DNA produced in reverse transcription. However, during HIV-1 infection, two-long terminal repeat DNA circles (2-LTRcs) are also generated through the ligation of the viral DNA ends by the host cell’s nonhomologous DNA end-joining pathway. These DNAs contain all the genetic information required for viral replication, but their role in HIV-1’s life cycle remains unknown. - MicrobiologyOpen Access
HIV-1 anchor inhibitors and membrane fusion inhibitors target distinct but overlapping steps in virus entry
Journal of Biological ChemistryVol. 294Issue 15p5736–5746Published online: January 29, 2019- Dirk Eggink
- Ilja Bontjer
- Steven W. de Taeye
- Johannes P.M. Langedijk
- Ben Berkhout
- Rogier W. Sanders
Cited in Scopus: 16HIV-1 entry into cells is mediated by the envelope glycoprotein (Env) and represents an attractive target for therapeutic intervention. Two drugs that inhibit HIV entry are approved for clinical use: the membrane fusion-inhibitor T20 (Fuzeon, enfuvirtide) and the C-C chemokine receptor type 5 (CCR5) blocker maraviroc (Selzentry). Another class of entry inhibitors supposedly target the fusion peptide (FP) and are termed anchor inhibitors. These include the VIRIP peptide and VIRIP derivatives such as VIR165, VIR353, and VIR576. - Methods and ResourcesOpen Access
Cell–cell and virus–cell fusion assay–based analyses of alanine insertion mutants in the distal α9 portion of the JRFL gp41 subunit from HIV-1
Journal of Biological ChemistryVol. 294Issue 14p5677–5687Published online: February 8, 2019- Mizuki Yamamoto
- Qingling Du
- Jiping Song
- Hongyun Wang
- Aya Watanabe
- Yuetsu Tanaka
- and others
Cited in Scopus: 14Membrane fusion is the first essential step in HIV-1 replication. The gp41 subunit of HIV-1 envelope protein (Env), a class I fusion protein, achieves membrane fusion by forming a structure called a six-helix bundle composed of N- and C-terminal heptad repeats. We have recently shown that the distal portion of the α9 helix in the C-terminal heptad repeat of X4-tropic HXB2 Env plays a critical role in the late-stage membrane fusion and viral infection. Here, we used R5-tropic JRFL Env and constructed six alanine insertion mutants, 641+A to 646+A, in the further distal portion of α9 where several glutamine residues are conserved (the number corresponds to the position of the inserted alanine in JRFL Env). - MicrobiologyOpen Access
HIV-1 envelope proteins up-regulate N6-methyladenosine levels of cellular RNA independently of viral replication
Journal of Biological ChemistryVol. 294Issue 9p3249–3260Published online: January 7, 2019- Nagaraja Tirumuru
- Li Wu
Cited in Scopus: 22N6-methyladenosine (m6A) modification of HIV-1 RNA regulates viral replication and protein expression. The m6A modification is regulated by two groups of cellular proteins named writers and erasers that add or remove m6A, respectively. HIV-1 infection of CD4+ T-cells increases m6A levels of cellular mRNA, but the underlying mechanism is unknown. Here, we show that HIV-1 infection of CD4+ primary T-cells or Jurkat cells significantly increases m6A levels of cellular RNA independently of viral replication. - Developmental BiologyOpen Access
Benzolactam-related compounds promote apoptosis of HIV-infected human cells via protein kinase C–induced HIV latency reversal
Journal of Biological ChemistryVol. 294Issue 1p116–129Published online: November 9, 2018- Kouki Matsuda
- Takuya Kobayakawa
- Kiyoto Tsuchiya
- Shin-ichiro Hattori
- Wataru Nomura
- Hiroyuki Gatanaga
- and others
Cited in Scopus: 19Latency-reversing agents (LRAs) are considered a potential strategy for curing cells of HIV-1 infection. Certain protein kinase C (PKC) activators have been previously reported to be LRAs because they can reverse HIV latency. In the present study, we examined the activities of a panel of benzolactam derivatives against cells latently infected with HIV. Using determination of p24 antigen in cell supernatants or altered intracellular GFP expression to measure HIV reactivation from latently infected cells along with a cytotoxicity assay, we found that some of the compounds exhibited latency-reversing activity, which was followed by enhanced release of HIV particles from the cells. - MicrobiologyOpen Access
Molecular mechanism of HIV-1 resistance to sifuvirtide, a clinical trial–approved membrane fusion inhibitor
Journal of Biological ChemistryVol. 293Issue 33p12703–12718Published online: June 21, 2018- Danwei Yu
- Xiaohui Ding
- Zixuan Liu
- Xiyuan Wu
- Yuanmei Zhu
- Huanmian Wei
- and others
Cited in Scopus: 16Host cell infection with HIV-1 requires fusion of viral and cell membranes. Sifuvirtide (SFT) is a peptide-based HIV-1 fusion inhibitor approved for phase III clinical trials in China. Here, we focused on characterizing HIV-1 variants highly resistant to SFT to gain insight into the molecular resistance mechanism. Three primary substitutions (V38A, A47I, and Q52R) located at the inhibitor-binding site of HIV-1's envelope protein (Env) and one secondary substitution (N126K) located at the C-terminal heptad repeat region of the viral protein gp41, which is part of the envelope, conferred high SFT resistance and cross-resistance to the anti-HIV-1 drug T20 and the template peptide C34. - MicrobiologyOpen Access
N6-Methyladenosine–binding proteins suppress HIV-1 infectivity and viral production
Journal of Biological ChemistryVol. 293Issue 34p12992–13005Published online: July 5, 2018- Wuxun Lu
- Nagaraja Tirumuru
- Corine St. Gelais
- Pratibha C. Koneru
- Chang Liu
- Mamuka Kvaratskhelia
- and others
Cited in Scopus: 59The internal N6-methyladenosine (m6A) modification of cellular mRNA regulates post-transcriptional gene expression. The YTH domain family proteins (YTHDF1–3 or Y1–3) bind to m6A-modified cellular mRNAs and modulate their metabolism and processing, thereby affecting cellular protein translation. We previously reported that HIV-1 RNA contains the m6A modification and that Y1–3 proteins inhibit HIV-1 infection by decreasing HIV-1 reverse transcription activity. Here, we investigated the mechanisms of Y1–3–mediated inhibition of HIV-1 infection in target cells and the effect of Y1–3 on viral production levels in virus-producing cells. - MicrobiologyOpen Access
PTAP motif duplication in the p6 Gag protein confers a replication advantage on HIV-1 subtype C
Journal of Biological ChemistryVol. 293Issue 30p11687–11708Published online: May 17, 2018- Shilpee Sharma
- Prabhu S. Arunachalam
- Malini Menon
- Viswanath Ragupathy
- Ravi Vijaya Satya
- Joshua Jebaraj
- and others
Cited in Scopus: 9HIV-1 subtype C (HIV-1C) may duplicate longer amino acid stretches in the p6 Gag protein, leading to the creation of an additional Pro–Thr/Ser–Ala–Pro (PTAP) motif necessary for viral packaging. However, the biological significance of a duplication of the PTAP motif for HIV-1 replication and pathogenesis has not been experimentally validated. In a longitudinal study of two different clinical cohorts of select HIV-1 seropositive, drug-naive individuals from India, we found that 8 of 50 of these individuals harbored a mixed infection of viral strains discordant for the PTAP duplication.