RESUMO
Infection with two strains of HIV-1 has implications for understanding HIV transmission and vaccine development; however, frequency and pathogenic consequences of dual infection are unknown. We assessed 64 patients for dual infection with heteroduplex mobility assay, viral sequencing, and phylogenetic methods. HIV disease outcomes were available in 34 patients. Five of these with AIDS endpoints had dual infection with HIV-1: four were cases of coinfection and one was superinfection. In all five, time from seroconversion to clinical AIDS or to CD4+ T-cell count less than 200 cells per microL was very rapid (<3.4 and <3.1 years, respectively). Our findings should prompt larger studies to assess the effect of dual infection at the population level.
Assuntos
Síndrome da Imunodeficiência Adquirida/diagnóstico , Infecções por HIV/diagnóstico , HIV-1/isolamento & purificação , Síndrome da Imunodeficiência Adquirida/sangue , Síndrome da Imunodeficiência Adquirida/virologia , Adulto , Ensaio de Amplificação de Sinal de DNA Ramificado , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Progressão da Doença , Feminino , Infecções por HIV/sangue , Infecções por HIV/virologia , HIV-1/classificação , HIV-1/imunologia , Humanos , Masculino , RNA Viral/sangue , RNA Viral/imunologia , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Superinfecção/diagnóstico , Superinfecção/imunologia , Superinfecção/virologia , Carga ViralRESUMO
This longitudinal study aimed to determine the incidence and pathogenic implications of dual human immunodeficiency virus type 1 (HIV-1) infection in a cohort of female sex workers. Blood samples from 31 recently infected women were screened by use of a heteroduplex mobility assay and sequencing. The median viral load set point was 5404 copies/mL (n=22), which was measured by use of the bDNA assay. Within 3 months of infection, 19% (6/31) of the women were dually infected with 2 distinct HIV-1 subtype C viruses. No evidence of superinfection was detected over the course of 24 months of follow-up, indicating that the risk of dual infection is highest around the time of the initial infection. There was a significant association between dual infection and elevated viral load set point.