© The Rockefeller University Press, 0022-1007/1997/2/621/ $5.00
The Journal of Experimental Medicine, Volume 185, Number 4, February 17, 1997 621-628
Change in Coreceptor Use Correlates with Disease Progression in HIV-1–Infected Individuals
Ruth I. Connor,
Kristine E. Sheridan,
Daniel Ceradini,
Sunny Choe, and
Nathaniel R. Landau
From the Aaron Diamond AIDS Research Center and The Rockefeller University, New York, 10016
Recent studies have identified several coreceptors that are required for fusion and entry of Human Immunodeficiency Virus type 1 (HIV-1) into CD4+ cells. One of these receptors, CCR5, serves as a coreceptor for nonsyncytium inducing (NSI), macrophage-tropic strains of HIV-1, while another, fusin or CXCR-4, functions as a coreceptor for T cell line–adapted, syncytiuminducing (SI) strains. Using sequential primary isolates of HIV-1, we examined whether viruses using these coreceptors emerge in vivo and whether changes in coreceptor use are associated with disease progression. We found that isolates of HIV-1 from early in the course of infection predominantly used CCR5 for infection. However, in patients with disease progression, the virus expanded its coreceptor use to include CCR5, CCR3, CCR2b, and CXCR-4. Use of CXCR-4 as a coreceptor was only seen with primary viruses having an SI phenotype and was restricted by the env gene of the virus. The emergence of variants using this coreceptor was associated with a switch from NSI to SI phenotype, loss of sensitivity to chemokines, and decreasing CD4+ T cell counts. These results suggest that HIV-1 evolves during the course of infection to use an expanded range of coreceptors for infection, and that this adaptation is associated with progression to AIDS.
Address correspondence to Ruth I. Connor, Aaron Diamond AIDS Research Center and The Rockefeller University, 455 First Ave., 7th Floor, New York, NY 10016.
1Abbreviations used in this paper: HOS.CD4, human osteosarcoma cells expressing human CD4; NSI, nonsyncytium-inducing; SI, syncytium-inducing; TCID50, 50% tissue culture infectious dose; TCLA, T cell line–adapted.

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78: 12022-12029
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Kitchen, C. M. R., Philpott, S., Burger, H., Weiser, B., Anastos, K., Suchard, M. A.
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Schweighardt, B., Roy, A.-M., Meiklejohn, D. A., Grace, E. J. II, Moretto, W. J., Heymann, J. J., Nixon, D. F.
(2004). R5 Human Immunodeficiency Virus Type 1 (HIV-1) Replicates More Efficiently in Primary CD4+ T-Cell Cultures Than X4 HIV-1. J. Virol.
78: 9164-9173
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Nishimura, Y., Igarashi, T., Donau, O. K., Buckler-White, A., Buckler, C., Lafont, B. A. P., Goeken, R. M., Goldstein, S., Hirsch, V. M., Martin, M. A.
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Kenakin, T.
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Pastore, C., Ramos, A., Mosier, D. E.
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Brainard, D. M., Tharp, W. G., Granado, E., Miller, N., Trocha, A. K., Ren, X.-H., Conrad, B., Terwilliger, E. F., Wyatt, R., Walker, B. D., Poznansky, M. C.
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Reeves, J. D., Miamidian, J. L., Biscone, M. J., Lee, F.-H., Ahmad, N., Pierson, T. C., Doms, R. W.
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78: 5476-5485
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Hoshino, Y., Tse, D. B., Rochford, G., Prabhakar, S., Hoshino, S., Chitkara, N., Kuwabara, K., Ching, E., Raju, B., Gold, J. A., Borkowsky, W., Rom, W. N., Pine, R., Weiden, M.
(2004). Mycobacterium tuberculosis-Induced CXCR4 and Chemokine Expression Leads to Preferential X4 HIV-1 Replication in Human Macrophages. J. Immunol.
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Stalmeijer, E. H. B., van Rij, R. P., Boeser-Nunnink, B., Visser, J. A., Naarding, M. A., Schols, D., Schuitemaker, H.
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Kuhmann, S. E., Pugach, P., Kunstman, K. J., Taylor, J., Stanfield, R. L., Snyder, A., Strizki, J. M., Riley, J., Baroudy, B. M., Wilson, I. A., Korber, B. T., Wolinsky, S. M., Moore, J. P.
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Pollakis, G., Abebe, A., Kliphuis, A., Chalaby, M. I. M., Bakker, M., Mengistu, Y., Brouwer, M., Goudsmit, J., Schuitemaker, H., Paxton, W. A.
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Audige, A., Schlaepfer, E., Bonanomi, A., Joller, H., Knuchel, M. C., Weber, M., Nadal, D., Speck, R. F.
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Jacobson, J. M., Israel, R. J., Lowy, I., Ostrow, N. A., Vassilatos, L. S., Barish, M., Tran, D. N. H., Sullivan, B. M., Ketas, T. J., O'Neill, T. J., Nagashima, K. A., Huang, W., Petropoulos, C. J., Moore, J. P., Maddon, P. J., Olson, W. C.
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Igarashi, T., Donau, O. K., Imamichi, H., Dumaurier, M.-J., Sadjadpour, R., Plishka, R. J., Buckler-White, A., Buckler, C., Suffredini, A. F., Lane, H. C., Moore, J. P., Martin, M. A.
(2003). Macrophage-Tropic Simian/Human Immunodeficiency Virus Chimeras Use CXCR4, Not CCR5, for Infections of Rhesus Macaque Peripheral Blood Mononuclear Cells and Alveolar Macrophages. J. Virol.
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Trkola, A., Kuster, H., Leemann, C., Ruprecht, C., Joos, B., Telenti, A., Hirschel, B., Weber, R., Bonhoeffer, S., Gunthard, H. F.
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Vogel, T. U., Reynolds, M. R., Fuller, D. H., Vielhuber, K., Shipley, T., Fuller, J. T., Kunstman, K. J., Sutter, G., Marthas, M. L., Erfle, V., Wolinsky, S. M., Wang, C., Allison, D. B., Rud, E. W., Wilson, N., Montefiori, D., Altman, J. D., Watkins, D. I.
(2003). Multispecific Vaccine-Induced Mucosal Cytotoxic T Lymphocytes Reduce Acute-Phase Viral Replication but Fail in Long-Term Control of Simian Immunodeficiency Virus SIVmac239. J. Virol.
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Jensen, M. A., Li, F.-S., van 't Wout, A. B., Nickle, D. C., Shriner, D., He, H.-X., McLaughlin, S., Shankarappa, R., Margolick, J. B., Mullins, J. I.
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Yi, Y., Singh, A., Shaheen, F., Louden, A., Lee, C., Collman, R. G.
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Campbell, T. B., Schneider, K., Wrin, T., Petropoulos, C. J., Connick, E.
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Kunstman, K. J., Puffer, B., Korber, B. T., Kuiken, C., Smith, U. R., Kunstman, J., Stanton, J., Agy, M., Shibata, R., Yoder, A. D., Pillai, S., Doms, R. W., Marx, P., Wolinsky, S. M.
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Chang, T. L.-Y., Chang, C.-H., Simpson, D. A., Xu, Q., Martin, P. K., Lagenaur, L. A., Schoolnik, G. K., Ho, D. D., Hillier, S. L., Holodniy, M., Lewicki, J. A., Lee, P. P.
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Harouse, J. M., Buckner, C., Gettie, A., Fuller, R., Bohm, R., Blanchard, J., Cheng-Mayer, C.
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Roscic-Mrkic, B., Fischer, M., Leemann, C., Manrique, A., Gordon, C. J., Moore, J. P., Proudfoot, A. E. I., Trkola, A.
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Chang, T. L.-Y., Francois, F., Mosoian, A., Klotman, M. E.
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Willey, S. J., Reeves, J. D., Hudson, R., Miyake, K., Dejucq, N., Schols, D., Clercq, E. D., Bell, J., McKnight, A., Clapham, P. R.
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Dehghani, H., Puffer, B. A., Doms, R. W., Hirsch, V. M.
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Jekle, A., Keppler, O. T., De Clercq, E., Schols, D., Weinstein, M., Goldsmith, M. A.
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Kumar, S., Kwei, G. Y., Poon, G. K., Iliff, S. A., Wang, Y., Chen, Q., Franklin, R. B., Didolkar, V., Wang, R. W., Yamazaki, M., Chiu, S.-H. L., Lin, J. H., Pearson, P. G., Baillie, T. A.
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Ketas, T. J., Frank, I., Klasse, P. J., Sullivan, B. M., Gardner, J. P., Spenlehauer, C., Nesin, M., Olson, W. C., Moore, J. P., Pope, M.
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Lin, G., Baribaud, F., Romano, J., Doms, R. W., Hoxie, J. A.
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Hsu, M., Harouse, J. M., Gettie, A., Buckner, C., Blanchard, J., Cheng-Mayer, C.
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