HIV-1 Superinfection in the Antiretroviral Therapy Era: Are Seroconcordant Sexual Partners at Risk?

• Published in: PloS one Vol. 4; no. 5; p. e5690
• Main Authors: Campbell, Mary S., Gottlieb, Geoffrey S., Hawes, Stephen E., Nickle, David C., Wong, Kim G., Deng, Wenjie, Lampinen, Thomas M., Kiviat, Nancy B., Mullins, James I.
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 28.05.2009; Public Library of Science (PLoS)
• Subjects: Algorithms; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Antiretroviral Therapy, Highly Active; Cladistic analysis; Cloning; Computer applications; Demography; Deoxyribonucleic acid; Disease prevention; Disease transmission; DNA; Drug resistance; Drug therapy; Epidemiology; Genomes; Genomics; Health aspects; Health risks; Highly active antiretroviral therapy; HIV; HIV Infections - blood; HIV Infections - drug therapy; HIV Infections - transmission; HIV-1 - physiology; Homosexuality, Male; Human immunodeficiency virus; Humans; Infection; Infections; Infectious diseases; Infectious Diseases/HIV Infection and AIDS; Leukocytes, Mononuclear - virology; Male; Medicine; Mens health; Mucous Membrane - virology; Phylogeny; Polymerase Chain Reaction; Public health; Public Health and Epidemiology/Infectious Diseases; Recombination; Recombination, Genetic - genetics; Risk Factors; Sequence Alignment; Sequence Analysis, DNA; Sexual Behavior; Sexual Partners; Sexually transmitted diseases; Species Specificity; STD; Strains (organisms); Superinfection; Superinfection - transmission; Superinfection - virology; Virology/Immunodeficiency Viruses; Viruses; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0005690

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. 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. Our 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. All 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.