Long-read deep sequencing reveals high rates of multilineage transmission and rapid viral population changes in acute HIV infection

J James I. Mullins W Wenjie Deng E Elena E. Giorgi (Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center) C Craig A. Magaret M Morgane Rolland (U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research) T Tanmoy Bhattacharya D Dylan H. Westfall (Infectious Disease Division, Fred Hutchinson Cancer Center) A Anna E. J. Yssel R Roger E. Bumgarner B Ben Murrell T Thumbi Ndung’u (Human Immunodeficiency Virus, Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal) M Merlin L. Robb R Raabya Rossenkhan P Paul T. Edlefsen K Krista L. Dong L Lennie Chen A Asanda Gwashu-Nyangiwe H Hong Zhao R Ruwayhida Thebus N Nonkululeko Ndabambi B Bruna Galvao F Fredrick Sawe S Sorachai Nitayaphan T Talita York D David Matten H Hugh Murrell A Alec P. Pankow M Michal Juraska J James Ludwig J John Hural M Myron S. Cohen L Lawrence Corey (Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center) M M. Juliana McElrath (Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center) P Peter B. Gilbert C Carolyn Williamson

Abstract

Abstract Understanding the selective forces acting upon HIV early in infection is crucial to design prevention strategies. By leveraging deep sequencing and the short diagnostic intervals of the FRESH and RV217 cohorts between the last-negative and first-positive RNA tests (median 4 days), we captured a precise and early snapshot of acute HIV infection. The frequency of multiple transmitted viruses of 37% in these as well as placebo recipients from the AMP trials (NCT02716675 and NCT02568215) was higher than previously published, with the true frequency likely to be higher. The relative abundance of lineages fluctuated substantially over time in two-thirds of the multilineage infections, generating uncertainty in identifying the specific viruses that were transmitted and founding the infection. At the population level, viral populations exhibited limited diversity and selection on the Gag and Env proteins at the earliest times examined, with sites inferred to be undergoing negative selection most evident. These data may help explain vaccination failures and provide new targets for prevention.

Article Details

Volume / Issue Vol. 17, Issue 1
Published May 25, 2026
ISSN 2041-1723
Publisher Nature Portfolio

Journal Info

Nature Communications

Nature Portfolio

ISSN: 2041-1723 Open Access Life Sciences

Authors (35)

J

James I. Mullins

W

Wenjie Deng

E

Elena E. Giorgi

Vaccine and Infectious Diseases Division, Fred Hutchinson Cancer Center

C

Craig A. Magaret

M

Morgane Rolland

U.S. Military HIV Research Program, Center for Infectious Disease Research, Walter Reed Army Institute of Research

T

Tanmoy Bhattacharya

D

Dylan H. Westfall

Infectious Disease Division, Fred Hutchinson Cancer Center

A

Anna E. J. Yssel

R

Roger E. Bumgarner

B

Ben Murrell

T

Thumbi Ndung’u

Human Immunodeficiency Virus, Pathogenesis Programme, Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu-Natal

M

Merlin L. Robb

R

Raabya Rossenkhan

P

Paul T. Edlefsen

K

Krista L. Dong

L

Lennie Chen

A

Asanda Gwashu-Nyangiwe

H

Hong Zhao

R

Ruwayhida Thebus

N

Nonkululeko Ndabambi

B

Bruna Galvao

F

Fredrick Sawe

S

Sorachai Nitayaphan

T

Talita York

D

David Matten

H

Hugh Murrell

A

Alec P. Pankow

M

Michal Juraska

J

James Ludwig

J

John Hural

M

Myron S. Cohen

L

Lawrence Corey

Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center

M

M. Juliana McElrath

Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center

P

Peter B. Gilbert

C

Carolyn Williamson