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Abstract
During the past year, a number of reports have described HIV-1 superinfection in human subjects, defined as the reinfection of an individual with a second heterologous strain of HIV-1. These reports have challenged the assumption that HIV-1-specific immune responses generated during primary infection are protective against subsequent infection and have raised concern, not only with respect to HIV-1-positive individuals engaging in unsafe sex but also from the standpoint of developing effective vaccines. Herein we review the published reports of HIV-1 superinfection and highlight studies providing additional insight into the potential for HIV-1 superinfections to affect the global epidemic.
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Affiliation(s)
- Todd M Allen
- Partners AIDS Research Center, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA
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Pérez-Alvarez L, Carmona R, Muñoz M, Delgado E, Thomson MM, Contreras G, Pedreira JD, Real RR, de Parga EV, Medrano L, Taboada JA, Nájera R, Agulla A, Mariño A, López-Calvo S, Pedreira JD, Aguilera A, Losada E, Prieto A, Corredoira J, López- Alvarez MJ, Rodríguez A, Bustillo M, García-Costa J, Fernández-Rodríguez R, Rodríguez R, Miralles C, Ocampo A, Rodríguez-Real R, Díz-Aren J, de Castro RO, Morano LE, Pérez-Rodríguez R, Rodríguez A, Torres J. High Incidence of Non-B and Recombinant HIV-1 Strains in Newly Diagnosed Patients in Galicia, Spain: Study of Genotypic Resistance. Antivir Ther 2003. [DOI: 10.1177/135965350300800413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objectives of this study are to describe the incidence of non-B and recombinant HIV-1 strains in newly diagnosed HIV-1 infections in Galicia, northwest of Spain, during a 2-year period (May 2000 to June 2002), and the frequency of resistance-associated mutations in reverse transcriptase (RT) and protease (PR) genes, analysing the polymorphisms more frequently detected in non-B and recombinant viruses. All newly diagnosed HIV-1-infected patients attending the nine public hospitals of the seven main cities of Galicia were included in this study. RT, PR and V3 regions from HIV-1 RNA plasma were amplified and sequenced, being the corrected sequences sent to the Stanford HIV RT and Protease Sequence Database. Nineteen of 85 patients (22.3%) were infected by non-B or recombinant viruses: three subtype C, two G, one F1, one Dpol/A1V3, five CRF02_AG, one CRF14_BG, five BGpol/BV3 and one UKpol/UV3 (U, unknown fragment). Eleven of these 19 patients (57.9%) were foreign individuals living in Galicia infected through heterosexual contact, and the other eight (42.1%) were Spanish intravenous drug users who had shared injection equipment. Five of 85 patients (5.9%), all infected with B subtype viruses, showed resistance-associated mutations in RT (M184V, M41L, L210W, T215Y/D and K219Q). In one patient (1.2%) infected with a subtype G strain, resistance-associated mutations in PR (K20I+M36I+M46I+V82I) were detected. In subtype B viruses resistance mutations in PR were not detected. Several polymorphisms in RT: D123S, Q174K, D177E, T200A, V245Q, and PR: I13V, K20I, M36I, R41K, H69K, L89M were detected more frequently in non-B and recombinants than in B strains ( P<0.01 to P<0.001). This study reports a high incidence (22.3%) of newly diagnosed patients infected by different non-B and recombinant HIV-1 strains, in a geographical area of Spain, showing also a high frequency of polymorphisms in RT and PR genes.
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Affiliation(s)
- Lucía Pérez-Alvarez
- Area de Patogenia Viral, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Rocío Carmona
- Area de Patogenia Viral, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Mercedes Muñoz
- Area de Patogenia Viral, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Delgado
- Area de Patogenia Viral, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Michael M Thomson
- Area de Patogenia Viral, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Gerardo Contreras
- Area de Patogenia Viral, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - José D Pedreira
- Unidade de Seguimiento de VIH/SIDA, Hospital Juan Canalejo, La Coruña, Spain
| | | | - Elena Vázquez de Parga
- Area de Patogenia Viral, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Leandro Medrano
- Area de Patogenia Viral, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - José Antonio Taboada
- Consellería de Sanidade e Servicios Sociais, Dirección Xeral de Saúde Pública, Xunta de Galicia, Santiago de Compostela, Spain
| | - Rafael Nájera
- Area de Patogenia Viral, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - A Agulla
- Hospital Arquitecto Marcide, Ferrol (La Coruña)
| | - A Mariño
- Hospital Arquitecto Marcide, Ferrol (La Coruña)
| | | | | | - A Aguilera
- Complejo Hospitalario Universitario de Santiago (La Coruña)
| | - E Losada
- Complejo Hospitalario Universitario de Santiago (La Coruña)
| | - A Prieto
- Complejo Hospitalario Universitario de Santiago (La Coruña)
| | | | | | | | - M Bustillo
- Hospital Nuestra Señora del Cristal (Orense)
| | | | | | - R Rodríguez
- Hospital Provincial Santa María Madre (Orense)
| | | | - A Ocampo
- Hospital Xeral-Cíes, Vigo (Pontevedra)
| | | | | | | | - LE Morano
- Hospital Meixoeiro, Vigo (Pontevedra)
| | | | | | - J Torres
- Hospital Meixoeiro, Vigo (Pontevedra)
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