High frequency of grossly deleted nef genes in HIV-1 infected long-term slow progressors treated with Korean red ginseng

To investigate the association between Korean red ginseng (KRG) intake in HIV-1 infected patients and the occurrence of grossly deleted nef genes (g Delta nef), we characterized nef genes in 10 long-term slow progressors (LTSP) infected with HIV-1 subtype B and 34 control patients. LTSP was defined by the annual decrease in CD4 T cells being less than 20/mu l over 10 years in the absence of antiretroviral therapy. They were treated with KRG for a prolonged period. Nef genes were amplified from peripheral blood mononuclear cells (PBMC) using nested PCR and the products were sequenced directly. It was observed that the patients CD4 T cell counts decreased from 444 +/- 207/mu l to 294 +/- 177/mu l over 136 23 months of KRG intake. This corresponds to an annual decrease in the level of CD4 T cells of 13.3/mu l. A total of 479 nef genes were amplified from 137 PBMC samples. Nine out of the 10 patients, 47 (34.3%) out of the 137 samples, and 90 out of the 479 genes revealed g Delta nef. The deletion extended outside the nef gene in 25 g Delta nef obtained from 6 patients. The proportion of samples with gAnef (343%) was significantly, higher than 4.8% in control patients (P < 0.001). In addition, it significantly increased as the duration of KRG intake prolongs (P < 0.01). These data suggest that the occurrence of gAnef might be associated with long-term intake of KRG.