Chronic HIV-1 infection frequently fails to protect against superinfection.
Chronic HIV-1 infection frequently fails to protect against superinfection.
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DOI：
10.1371/journal.ppat.0030177
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发表时间：
2007-11
期刊：
影响因子：
6.7
通讯作者：
Overbaugh J
中科院分区：
文献类型：
--
作者：
Piantadosi A;Chohan B;Chohan V;McClelland RS;Overbaugh J
HIV-1重叠感染（再感染）的报告表明，针对一种HIV-1毒株产生的免疫应答并不总是针对其他毒株产生保护作用。然而，确定HIV-1重叠感染发生率的研究产生了相互矛盾的结果。此外，很少有研究试图确定初次感染后一年以上发生的重复感染病例，这是HIV-1特异性免疫反应最有可能发展的时期。我们筛选了一个队列的高风险肯尼亚妇女HIV-1重叠感染，通过比较部分gag和包膜序列超过5年的时间开始在原发感染。在36名个体中，我们检测到7例重叠感染，其中包括两种病毒属于同一HIV-1亚型A亚型的病例。在其中5例中，仅在两个基因组区域中的一个区域检测到重复感染菌株，这表明HIV-1重复感染后经常发生重组。此外，我们发现重复感染发生在首次感染的整个过程中：2例急性感染期间，3例感染后1-2年，2例感染后5年。我们的研究结果表明，重复感染通常发生在对初始感染的免疫反应有时间发展和成熟之后。HIV-1重叠感染病例的影响，其中自然再暴露导致再感染，将需要考虑在制定策略，引发对HIV-1的保护性免疫。当一个人感染了一种HIV-1病毒株，从另一个伴侣那里获得第二种病毒株时，就会发生HIV-1的双重感染。有20多个已发表的HIV-1重叠感染病例。这些病例引起了人们对HIV-1疫苗设计的关注，因为它们表明，针对自然感染产生的免疫反应并不总是足以防止以后接触该病毒。然而，目前尚不清楚HIV-1重叠感染发生的频率，特别是在预期免疫反应后感染的时间。我们调查了一组36名高危女性的HIV-1重叠感染发生率，这些女性在首次感染HIV-1后随访约5年。我们发现了7例HIV-1重叠感染。五例病例发生在初次感染后一年多，当时免疫反应有时间发展和扩大。在三个案例中，最初和重复感染的病毒被归类为相同的HIV-1基因亚型，表明缺乏对密切相关病毒的保护。我们的结果表明，自然的HIV-1感染并不总是会引起保护性免疫反应，这是制定HIV-1疫苗设计和测试策略的一个重要考虑因素。
Reports of HIV-1 superinfection (re-infection) have demonstrated that the immune response generated against one strain of HIV-1 does not always protect against other strains. However, studies to determine the incidence of HIV-1 superinfection have yielded conflicting results. Furthermore, few studies have attempted to identify superinfection cases occurring more than a year after initial infection, a time when HIV-1-specific immune responses would be most likely to have developed. We screened a cohort of high-risk Kenyan women for HIV-1 superinfection by comparing partial gag and envelope sequences over a 5-y period beginning at primary infection. Among 36 individuals, we detected seven cases of superinfection, including cases in which both viruses belonged to the same HIV-1 subtype, subtype A. In five of these cases, the superinfecting strain was detected in only one of the two genome regions examined, suggesting that recombination frequently occurs following HIV-1 superinfection. In addition, we found that superinfection occurred throughout the course of the first infection: during acute infection in two cases, between 1–2 y after infection in three cases, and as late as 5 y after infection in two cases. Our results indicate that superinfection commonly occurs after the immune response against the initial infection has had time to develop and mature. Implications from HIV-1 superinfection cases, in which natural re-exposure leads to re-infection, will need to be considered in developing strategies for eliciting protective immunity to HIV-1. Superinfection with HIV-1 occurs when an individual infected with one strain of HIV-1 acquires a second strain, from a different partner. There are more than 20 published cases of HIV-1 superinfection. These cases have raised concerns for HIV-1 vaccine design because they indicate that the immune response generated against natural infection is not always sufficient to protect against later exposures to the virus. However, it remains unclear how often HIV-1 superinfection occurs, especially at times in infection after an immune response would be expected. We investigated the incidence of HIV-1 superinfection in a cohort of 36 high-risk women followed for approximately five years after their first HIV-1 infections. We found seven cases of HIV-1 superinfection. Five cases occurred more than a year after the initial infection, a time when the immune response would have had time to develop and broaden. In three cases, the initial and superinfecting viruses were classified as the same HIV-1 genetic subtype, indicating a lack of protection against closely related viruses. Our results suggest that natural HIV-1 infection does not always elicit a protective immune response, an important consideration in developing strategies for HIV-1 vaccine design and testing.
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