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Abstract
No evidence of superinfection linked to a known source partner
L. Bragg1, J. McConnell1, T. Schmidt2, T. Liegler3, R. Grant1
Background: Case reports of superinfection have mostly involved recent seroconverters, in whom the incidence of apparent superinfection is comparable to the incidence of primary HIV infection. Most have been characterized by the emergence and persistence of genetically distinct variants at the population level. In contrast, apparent superinfection among chronically infected persons seems to be rare.
Methods: The Positive Partners study involves prospective follow-up of HIV-positive, seroconcordant couples in San Francisco. Eligibility was based on reported unprotected intercourse with HIV-positive partners in the past year. Pol, gag, and tat population sequences were analyzed phylogenetically.
Results: We followed a cohort of 99 HIV-positive, seroconcordant dyads with genetically distinguishable viruses at baseline and plasma RNA levels sufficient for viral sequence analysis. Eighty six percent of the cohort reported more than two years since HIV diagnosis (median =9.7 years). A total of 183.8 person-years of observation occurred. In the absence of mechanisms blocking HIV superinfection we would expect superinfection to occur as commonly as primary infection given the same exposure. Based on exposure we estimated expected superinfection incidence would be as high as 0.38 or, controlling for possible protective effects of suppressed viremia in a potential source partner and of ART in potential spread partners as low as 0.05. (9.3-69.4 superinfection cases expected). In one dyad baseline and exit viral linkages suggest a common co-infection or a superinfection prior to enrollment. Viral divergence during follow-up was detected in DNA in 1 individual and RNA in another, neither linked to a partner’s virus.
Conclusions: The incidence of systemic superinfection linked to known exposure to a source partner (0/183 person-years) is less than expected among these highly exposed couples. Evidence of divergent viral strains, especially in DNA during suppressive therapy may be evidence of frequent initial co-infection or limited superinfection that does not become systemic.
Additional documents
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Poster MOPE0404
Poster presented at IAC 2008 in .pdf format.
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AIDS 2008 - XVII International AIDS Conference
Abstract no.
MOPE0404
Suggested Citation
"L.Bragg, et al.
No evidence of superinfection linked to a known source partner.
:
AIDS 2008 - XVII International AIDS Conference:
Abstract no.
MOPE0404"
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