HIV-1 superinfection in the antiretroviral therapy era: are seroconcordant sexual partners at risk?
HIV-1 superinfection in the antiretroviral therapy era: are seroconcordant sexual partners at risk?
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DOI：
10.1371/journal.pone.0005690
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发表时间：
2009-05-28
期刊：
影响因子：
3.7
通讯作者：
Mullins JI
中科院分区：
文献类型：
--
作者：
Campbell MS;Gottlieb GS;Hawes SE;Nickle DC;Wong KG;Deng W;Lampinen TM;Kiviat NB;Mullins JI
据报道，在初次感染期间和之后都会感染一种以上的 1 型人类免疫缺陷病毒 (HIV-1)，但双重感染和重复感染的风险和影响尚不完全清楚。在这项研究中，我们评估了作为性伴侣的长期感染艾滋病毒的男性的纵向队列，以确定个人是否获得了其伴侣的病毒株。我们的艾滋病毒阳性男性队列由 8 对自认为是长期性伴侣的夫妇组成。从每个受试者中分离病毒序列并使用系统发育方法进行分析。此外，毒株特异性 PCR 使我们能够寻找低水平存在的伴侣病毒。最后，我们使用计算算法来评估合作伙伴病毒株之间的重组。在研究期间，所有夫妇都至少有一个与感染新艾滋病毒株风险增加相关的因素，包括可检测到的血浆病毒载量、性传播感染和无保护性行为。一名受试者患有双重 HIV-1 感染，但两种病毒株均与其伴侣的病毒株相符。三对夫妇的序列在入境访视时形成单系群，系统发育分析表明，这对夫妇中的一名成员从其确定的伴侣那里获得了艾滋病毒株，或者两人都是从伴侣之外的同一来源获得了该病毒株。使用系统发育分析和菌株特异性 PCR，剩下的 5 对夫妇最初没有显示出双重感染的证据。然而，在其中一对夫妇中，进一步分析显示，其中一名受试者体内存在带有病毒基因组片段的重组病毒株，该病毒株可能源自登记的伴侣。因此，长期感染 HIV-1 的个体可能会被来自其血清一致性伴侣的其他 HIV 毒株重复感染。在某些情况下，当检测到重组病毒株时，HIV-1 重复感染可能会变得明显。
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.
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