Infections following repeated, low-dose (RLD), mucosal S(H)IV exposures of macaques are used to model sexual HIV exposures for biomedical prevention testing. Different susceptibilities among animals can complicate study designs. In rhesus macaques, TRIM5 alleles Q, CypA, and TFP, are resistance factors for infection with some S(H)IV strains, but not for SIVmac239 due to its capsid properties. SIVmac239-derived SHIVSF162P3 has been demonstrated to reproducibly infect mucosally in vaginal and rectal RLD models. To further test the suitability of SHIVSF162P3 for RLD models, we studied the influence of TRIM5 genotype on susceptibility to rectal RLD infection and on plasma viremia by analyzing 43 male Indian rhesus macaques from control arms of completed studies. The median number of exposures required for infection was: 3 (Q/Q, n=4) (TRIM5 alleles, number of macaques, respectively); 4 (Q/CypA, n=7), 3 (TFP/Q, n=15); 3 (TFP/TFP, n=15); 2 (TFP/CypA, n=2); TRIM5CypA/CypA was not represented in our study. Median peak viremia (log10 viral copies/mL) in infected animals was: 7.4 (Q/Q, n=4); 7.2 (Q/CypA, n=6), 7.3 (TFP/Q, n=13); 7.1 (TFP/TFP, n=15); 6.5 (TFP/CypA; n=2). Neither susceptibility nor peak viremia were significantly different (log-rank test, Kruskal Wallis test, respectively). Rhesus macaques' susceptibility to RLD SHIVSF162P3 is independent of TRIM5 TFP, CypA, and Q alleles, with the limitation that the power to detect any impact of CypA/CypA and TFP/CypA genotypes was nonexistent or low, due to absence or infrequency, respectively. The finding that TRIM5 alleles do not restrict mucosal infection or ensuing replication rates suggests that SHIVSF162P3 is indeed suitable for RLD experimentation.

Thalassemia is an inherited genetic disorder requiring multiple transfusions to treat anemia caused by low hemoglobin levels. Thus, thalassemia patients are at risk for infection with blood-borne pathogens, including human T-cell lymphotropic viruses (HTLV) that are transmitted by transfusion of cellular blood products. Here, we examined the prevalence of HTLV among 234 US thalassemia patients using sera collected in 2008. Sera were tested for antibodies to HTLV-1/2 using EIA and a confirmatory Western blot (WB) that differentiates between HTLV-1 and HTLV-2. Demographic and clinical information were collected at study enrollment, including HIV and HCV status. Three patients (1.3%) were WB-positive; two were HTLV-1 and one could not be serotyped as HTLV-1/2. All three HTLV-positive persons were HIV-1 and one was HCV seropositive. The HTLV seroprevalence was higher than that of HIV-1 (0.85%) and lower than HCV (18.8%) in this population. All three patients (ages 26-46 years) were diagnosed with beta-thalassemia shortly after birth and have since been receiving multiple transfusions annually. Two of the HTLV-positive patients confirmed receiving transfusions before HTLV blood screening was implemented in 1988. We identified a substantial HTLV-1 seroprevalence in US thalassemia patients that is much greater than that seen in blood donors. Our findings highlight the importance of HTLV testing of patients with thalassemia and other diseases requiring multiple transfusions, especially in recipients of unscreened transfusions. In addition, appropriate counseling and follow-up of HTLV-infected patients is warranted.