Digalactoside (gal␣-1-4 gal) structures of the lipopolysaccharide (LPS) of Haemophilus influenzae are implicated in virulence. A confounding factor is that tetranucleotide repeats within the lic2A, lgtC, and lex2 genes mediate phase-variable expression of the digalactosides. By deleting these repeats, we constructed recombinant strains of RM153 constitutively expressing either one or two LPS digalactosides. Expression of two digalactosides, rather than one, was associated with increased virulence of H. influenzae in vivo.Lipopolysaccharide (LPS) is one of the major virulence determinants of the human pathogen Haemophilus influenzae. The number of hexoses and phosphate groups replacing the triheptose (HepI to HepIII) backbone ( Fig. 1) is variable within any strain owing to high-frequency translational switching (phase variation) of LPS genes containing repeat tracts. Phase-variable LPS genes include lic2A and lgtC, which are involved in the assembly of gal␣-1-4 gal into the oligosaccharide extensions from the conserved triheptose backbone (7, 10), and lex2, which is involved in completion of the HepIattached diglucoside acceptor for this digalactoside ( Fig. 1) (4). The investigation of the association between digalactoside expression on H. influenzae LPS and virulence has relied on the monoclonal antibody (MAb) 4C4 for detecting the expression of the digalactoside (1, 2, 12, 13). The findings from these studies have been difficult to interpret because of the confounding factor of phase variation and the different numbers and locations of the digalactoside on oligosaccharide extensions in different strains (7,17,18).Recently, it has been shown that MAb 4C4 binds digalactosides that are part of the extensions from both HepI and HepII of the triheptose LPS backbone (Fig. 1) (4, 5). A type b clinical strain, RM153, used in previous virulence studies (9, 16), typically generates LPS molecules containing only four hexose sugars (17), depending on whether lic2A, lgtC, or lex2 is out of frame (4,7,10). This is in contrast to the related strain RM7004, which has up to nine hexose sugars in its LPS due to these three loci being predominantly in frame (Fig. 1). Knowing the LPS structure, the genes required for digalactoside assembly, and the fact that tetranucleotide repeats mediate phase variation, we constructed recombinant strains of RM153 in which variable expression of digalactosides was eliminated by removing the repeat tracts located within each of these genes. Briefly, two isogenic strains were constructed by transformation (6) using appropriate chromosomal DNA or plasmid constructs in which the repeats had been deleted for lic2A (8), lex2 (5), or lgtC. All three genes were constitutively expressed in the first strain, RM153lic2AϩtlgtCϩlex2ϩk, to facilitate expression of two digalactosides, while in the second strain, RM153lic2AϩtlgtCϩlex2Ϫk, lex2 was mutated such that only a single digalactoside in the extension from HepII was expressed (Fig.