학술논문
Multiple infection and HIV superinfection among persons who inject drugs in Indonesia and Ukraine.
Document Type
Academic Journal
Author
Palumbo, Philip J; Grant-McAuley, Wendy; Grabowski, Mary Kate; Zhang, Yinfeng; Richardson, Paul; Piwowar-Manning, Estelle; Sharma, Deeksha; Clarke, William; Laeyendecker, Oliver; Rose, Scott; Ha, Tran V; Dumchev, Kostyantyn; Djoerban, Zubairi; Redd, Andrew; Hanscom, Brett; Hoffman, Irving; Miller, William C; Eshleman, Susan H
Source
Subject
Language
English
ISSN
0022-1899
Abstract
Background: HPTN 074 evaluated an integrated HIV treatment and prevention strategy among persons who inject drugs (PWID) in Indonesia, Ukraine and Vietnam. We previously detected multiple HIV infection in 3/7 (43%) of seroconverters with 3-8 HIV strains/person. In this report, we analyzed multiple HIV infection and HIV superinfection (SI) in the HPTN 074 cohort.Methods: We analyzed samples from 70 participants in Indonesia and Ukraine who had viral loads >400 copies/mL at enrollment and the final study visit (median follow-up 2.5 years). HIV was characterized with Sanger sequencing, next-generation sequencing, and phylogenetic analysis. Additional methods were used to characterize a rare case of triple-variant SI.Results: At enrollment, multiple infection was detected in only 3 (5.2%) of 58 participants with env sequence data. SI was detected in only one of 70 participants over 172.3 person-years of follow-up (SI incidence 0.58/100 person-years, 95% confidence intervals: 0.015, 3.2). The SI case involved acquisition of three HIV strains with rapid selection of a strain with a single pol region cluster.Conclusions: These data from a large cohort of PWID suggest that intra-host viral selection and other factors may lead to underestimation of the frequency of multiple HIV infection and SI events.