Abstract
Background: Recombination between strains of HIV-1 only occurs in individuals with multiple infections, and the incidence of recombinant forms implies that multiple infection is common. Most direct studies indicate that multiple infection is rare. We determined the rate of multiple infection in a longitudinal study of 58 HIV-1 positive participants from The Women's Interagency HIV Study with a richer sampling design than previous direct studies, and we investigated the role of recombination and sampling design on estimating the multiple infection rate. Results: 40% of our sample had multiple HIV-1 infections. This rate of multiple infection is statistically consistent with previous studies once differences in sampling design are taken into account. Injection drug use significantly increased the incidence of multiple infections. In general there was rapid elimination of secondary strains to undetectable levels, but in 3 cases a superinfecting strain displaced the initial infecting strain and in two cases the strains coexisted throughout the study. All but one secondary strain was detected as an inter- and/or intra-genic recombinant. Injection drug use significantly increased the rate of observed recombinants. Conclusion: Our multiple infection rate is consistent with rates estimated from the frequency of recombinant forms of HIV-1. The fact that our results are also consistent with previous direct studies that had reported a much lower rate illustrates the critical role of sampling design in estimating this rate. Multiple infection and recombination significantly add to the genetic diversity of HIV-1 and its evolutionary potential, and injection drug use significantly increases both.
| Original language | English |
|---|---|
| Article number | 54 |
| Journal | Retrovirology |
| Volume | 6 |
| DOIs | |
| State | Published - 3 Jun 2009 |
| Externally published | Yes |
Bibliographical note
Funding Information:This work was supported by NIH grants GM60730 and GM65509. Plasma specimens used as the source for data in this manuscript were collected by the Women's Interagency HIV Study (WIHS) Collaborative Study Group with centers (Principal Investigators) at New York City/Bronx Consortium (Kathryn Anastos); Brooklyn, NY (Howard Minkoff); Washington DC Metropolitan Consortium (Mary Young); The Connie Wofsy Study Consortium of Northern California (Ruth Greenblatt, Herminia Palacio); Los Angeles County/Southern California Consortium (Alexandra Levine); Chicago Consortium (Mardge Cohen); Data Coordinating Center (Stephen Gange). The WIHS is funded by the National Institute of Allergy and Infectious Diseases, with supplemental funding from the National Cancer Institute, the National Institute of Child Health & Human Development, and the National Institute on Drug Abuse (U01-AI-35004, U01-AI-31834, U01-AI-34994, AI-34989, U01-HD-32632, U01-AI-34993, U01-AI-42590). This research was also funded by grants from the National Institute on Drug Abuse, the National Institute of Allergy and Infectious Diseases R01-DA/ AI13347 and the National Institute of General Medical Sciences R01-GM60730. We thank two anonymous reviewers for their excellent suggestions on an earlier draft of this work.
ASJC Scopus subject areas
- Virology
- Infectious Diseases
