R5 HIV-1 with efficient DC-SIGN use is not selected for early after birth in vertically infected children.

Binding of HIV to C-type lectin receptors may either result in enhanced trans-infection of T cells or virus degradation. We have investigated the efficacy of HIV-1 utilization of Dendritic Cell-Specific Intercellular adhesion molecule-3-Grabbing Non-integrin (DC-SIGN), a C-type lectin receptor, in the setting of intrauterine or intrapartum mother-to-child transmission. Viruses isolated from HIV-1 infected mothers, at delivery, and from their vertically infected children, early after birth and later in disease, were analysed for use of DC-SIGN, binding and ability to mediate trans-infection. DC-SIGN-use of the child's early virus tended to be reduced as compared with the corresponding maternal isolate. Furthermore, the children's late isolate displayed enhanced DC-SIGN utilization compared with the corresponding early virus. These results were also supported in head-to-head competition assays and suggest that HIV-1 variants displaying efficient DC-SIGN-use are not selected for during intrauterine or intrapartum mother-to-child transmission. However, viruses with increased DC-SIGN-use may evolve later in paediatric HIV-1 infections.