Relationship between V3 genotype, biologic phenotype, tropism, and coreceptor use for primary isolates of human immunodeficiency virus type 1

Objectives: The predictive value of positively charged amino acids at posit ions 11 and 25 within the V3 loop region of the human immunodeficiency viru s type 1 (HIV-1) envelope gene for the syncytium-inducing (SI) phenotype wa s assessed. Study Design/Methods: Sequencing was performed on DNA extracted from primar y peripheral blood mononuclear cells (PB-MCs) and complementary DNA (cDNA) prepared from serial viral isolates from 10 HIV-1-seropositive subjects. Pr oviral DNA sequencing was also performed on biologic clones from most of th ese subjects. Results: Positive charge at position 11 and/or 25 in 257 isolate cDNA, PBMC DNA, and biologic clone PBMC DNA sequences was compared with 69 phenotypic determinations, of which 62.3% were SL V3 genotype was 51.2% sensitive and 85.8% specific for the SI phenotype, with positive and negative predictive values of 62.8% and 79.0%, respectively. Cellular tropism failed to correl ate with V3 genotype, coreceptor use, or biologic phenotype. Exclusive use of CCR5 was associated with the nonsyncytium-inducing (NSI) phenotype. Over all, V3 loop charge was higher in SI than in NSI isolates (5.01 and 3.78, r espectively; p = 0.0211). Conclusions: The predictive power of SI phenotype from V3 genotype is relat ively weak, especially in a low SI prevalence population. The direct measur ement of viral phenotype, cellular tropism, and coreceptor use in HIV-1 iso lates is essential for accurate biologic characterization.