Abstract
BackgroundAcquisition of more than one strain of human immunodeficiency virus type 1 (HIV-1) has been reported to occur both during and after primary infection, but the risks and repercussions of dual and superinfection are incompletely understood. In this study, we evaluated a longitudinal cohort of chronically HIV-infected men who were sexual partners to determine if individuals acquired their partners' viral strains.MethodologyOur cohort of HIV-positive men consisted of 8 couples that identified themselves as long-term sexual partners. Viral sequences were isolated from each subject and analyzed using phylogenetic methods. In addition, strain-specific PCR allowed us to search for partners' viruses present at low levels. Finally, we used computational algorithms to evaluate for recombination between partners' viral strains.Principal Findings/ConclusionsAll couples had at least one factor associated with increased risk for acquisition of new HIV strains during the study, including detectable plasma viral load, sexually transmitted infections, and unprotected sex. One subject was dually HIV-1 infected, but neither strain corresponded to that of his partner. Three couples' sequences formed monophyletic clusters at the entry visit, with phylogenetic analysis suggesting that one member of the couple had acquired an HIV strain from his identified partner or that both had acquired it from the same source outside their partnership. The 5 remaining couples initially displayed no evidence of dual infection, using phylogenetic analysis and strain-specific PCR. However, in 1 of these couples, further analysis revealed recombinant viral strains with segments of viral genomes in one subject that may have derived from the enrolled partner. Thus, chronically HIV-1 infected individuals may become superinfected with additional HIV strains from their seroconcordant sexual partners. In some cases, HIV-1 superinfection may become apparent when recombinant viral strains are detected.
Highlights
Data from case reports and cohort studies have established that infection with more than one strain of human immunodeficiency virus type 1 (HIV-1)– termed dual infection– does occur
The phenomena of HIV-1 dual and superinfection have been reported in a variety of risk groups, including men who have sex with men (MSM), heterosexual women, infants, and injection drug users (IDU) [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23], and are relevant to HIV clinical care, epidemiology, and the design of prevention strategies
Research on dual and superinfection is pertinent to the development of preventive approaches, as it is clear that in some instances HIVpositive individuals are vulnerable to repeated infection with other viral strains
Summary
Data from case reports and cohort studies have established that infection with more than one strain of human immunodeficiency virus type 1 (HIV-1)– termed dual infection– does occur. Dual infection encompasses both co-infection, acquisition of two separate viral strains during primary infection, and superinfection, acquisition of one or more viral strains after seroconversion. Acquisition of more than one strain of human immunodeficiency virus type 1 (HIV-1) has been reported to occur both during and after primary infection, but the risks and repercussions of dual and superinfection are incompletely understood. We evaluated a longitudinal cohort of chronically HIV-infected men who were sexual partners to determine if individuals acquired their partners’ viral strains
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