A gastroenterologist was found guilty of attempted second-degree murder after he injected his ex-girlfriend with blood or blood products obtained from HIV type 1 (HIV-1)-infected patients under his care. Phylogenetic analyses of sequences of HIV-1 were admitted and used as evidence in the case, which represents the first use of phylogenetic analysis in a criminal court case in the United States. Phylogenetic analyses of HIV-1 env reverse transcriptase and DNA sequences isolated from the victim, the sick, and a sample of the local population of HIV-1-positive individuals showed the victim's HIV-1 sequence both are more closely related and intertwined Within a lineage consisting of the patient's HIV-1 sequences.
That finding of paraphyly of the patient's sequence was consistent with the direction of transmission from patient to the victim. Analysis of the victim's sequences of the viral reverse transcriptase proved compatible with the genotypes known mutations that confer resistance to AZT, similar to those found in the genotype of the patient. Prior creation of the patient and the victim as a suspected transmission pair provided a clear phylogenetic hypothesis for testing. All phylogenetic models, and examined two genes strongly supports the close relationship between HIV-1, the sequences of the patient and the victim.
Resample blood of suspected transmission pair of sequencing and independent provided by the different laboratories a precaution against error in the laboratory.
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