HIV-1 Gag Evolution in Recently Infected HLA-B57 Patients with Low Level Viremia

We studied viral evolution in five HLA-B*57 patients recently infected with HIV-1. Escape mutations in HLA-B*57-restricted Gag epitopes were present at study entry in all patients but were not associated with significant increases in viremia. Conversely, no new escape mutations in HLA-B*57-restricted epitopes or known compensatory mutations were detected in patients who experienced significant increases in viremia. Thus the development of escape mutations alone does not determine virologic outcome in recently infected HLA-B*57 patients.