Molecular Investigation of Human Immunodeficiency Virus (HIV) Infection in a Patient of an HIV-Infected Surgeon

Abstract

Recall of patients who had been treated by a human immunodeficiency virus (HIV)-infected surgeon uncovered 1 previously unknown HIV-seropositive person. Nucleotide sequencing of the gag gene and maximum likelihood phylogenetic analysis were used to investigate the relationships among sequences from the surgeon, the patient, and an anonymous blood donor from whom the patient had received blood products. The likelihoods of all possible pathways of transmission linking these persons were estimated. On these data, transmission from the surgeon to the patient was significantly less likely than from the blood donor to the patient. It is concluded that none of the recalled patients were infected by the surgeon.

Molecular Characterization of Human Immunodeficiency Virus Type 1 and Hepatitis C Virus in Paid Blood Donors and Injection Drug Users in China

“…The PCR primer-binding sites for both HIV-1 and HCV were based on the published sequences of geographical variants and were as highly conserved as possible. The primer sequences used for the p17 and C2-V3 regions of HIV-1 have been published (11,39,40). The primer pair used to amplify the HCV 5ЈNCR was previously described by Chan et al (7), while those for the E1/E2 region are Lqz187 (antisense primer, 5Ј-CCYACBACMACDGGGCTNGGDGTGAARC ARTA, used in both the first-and second-round amplifications [ambiguous nucleotides are expressed in International Union of Applied and Pure Chemistry nomenclature]), Lqz188 (first-round sense primer, 5Ј-CAYCGBATGGCHTGG GAYATGATGATGAA), and Lqz189 (second-round sense primer, 5Ј-TGGGA YATGATGATGAAYTGGTC).…”

Phylogenetically resolving epidemiologic linkage

“…Another criminal investigation involving a Swedish rapist was investigated and became the first case settled in court (6). Subsequently, many other similar criminal cases occurred around the world (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). In all of these cases, phylogenetic reconstruction of transmission events was central to the evidence of guilt.…”

Source identification in two criminal cases using phylogenetic analysis of HIV-1 DNA sequences

“…For example, the Centers for Disease Control and Prevention investigated the contention that a second Florida dentist infected 24 patients during invasive procedures and rejected the a priori hypothesis of suspected transmission based on phylogenetic analysis (19). Similarly, molecular evidence dismissed the assertion that a Baltimore surgeon (20) and a UK obstetrician/gynecologist (21) infected their respective patients while providing care. These studies establish an important touchstone of objectivity for the use of phylogenetic methods in providing strong support for or against allegations of suspected HIV-1 transmission events.…”