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Dual HIV Infection

| 3 Comments

We have known for quite a long time that it's possible to be infected with HIV more than once.  Dual HIV infections were first reported in 2002.

However recombinant HIVs were detected long before.

Recombinant HIVs are viruses that are derived from at least two different HIVs; parts of each join together to produce a new virus. Since this can only happen in a cell infected with both viruses, the existence of recombinant HIVs means that infection with more than one HIV must have occurred.

We don't know how frequently this occurs.  Some people will have been infected with more than one virus at the same time. But others already infected may be subsequently superinfected, that is infected with a different HIV.

 

The current issue of Clinical Infectious Diseases has an article on dual HIV infection.

It demonstrates that dual infection in one particular cohort   was associated with a more rapid decline in CD4 numbers.

In the authors' own words:

Conclusions. Dual HIV-1 infection is the main factor associated with CD4+ T-cell decline in men who have untreated primary infection with HIV-1 subtype B.

 

This conclusion is based on the study of only 10 men dually infected, drawn from an already selected group of 37 untreated men who were followed after a primary HIV infection.

 

Dual infection has also been reported among long term non-progressors, so  it's impossible at this time to generalize about its effects.  

The article demonstrates that dual infection may not be that uncommon.  It was detected in 10 of a group of 37, albeit selected, men.

Superinfection in treated individuals may result in a failure of particular drug regimen should the superinfecting virus be resistant to it.

Even if we still have much to learn about dual infections, the implications regarding continued condom use among seropositive individuals are clear enough, a point made by the authors.

 

 

 

 

 

3 Comments

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Comments on Joseph Sonnabend, MD's blog entry "Dual HIV Infection "

This is the same monster under the bed tactic that has gone no place. I do not mean to be disrespectful but for those of us that practice sero sorting and have dropped the use of rubbers in +/+, You should have far more empirical evidence. Other factor like drug use needle sharing etc need to be taken into account. Meth addicts often steel HIV meds and mish mash regimens thinking they can prevent HIV.
Also one of the early research into Vaccine was the understanding that the mature Virus set of proprietary house keeping, blocking multi strains, double infection can bee seen in new infection where the virus has not begun this function. to many times has medicine only focused on the result and not looked at the entire picture. Go back to the original circumcision and cervical cancer reasoning, it was not that religious group use of circumcision but the fact that for the most part they both had each other as there only sexual partner

And as usual, the possibility of reinfection is met with skepticism and all out disdain by people who want to continue practicing sex that is considered "unsafe". I have argued about this with many poz people and the general consensus is that we no longer have to practice safe sex and can have orgasms in each other with reckless abandon. I have seen low CD4 counts in men who have only been infected in a relatively short time period. These are people who are on the medications. These are people who are on the receiving end of a "poz load". Of course we hope that 2 people, both on meds are able to have bareback sex with climax and not have to worry about progression because of multiple infections.
After 20 years, my CD4 is 1900. (I would attribute this to the fact that I made sure I never got re-infected. but that isn't to suggest that it was always that high. Its been down to 600 before. The meds have always made my CD4 skyrocket in a short period of time, after going off of them for extended periods of time over these years. This is certainly a case for starting meds at a relatively high count instead of waiting until the CD4 has fallen well below 500.
I for one, am not ready to practice totally unsafe sex even with the meds. The proof is in the pudding....

It would be much more effective and give credence to studies if the amount of suppressed information was available even when it dose not fit classic preventative goals it does no service to anyone when they are closed away in a vault. After 25 years Poz ED has made condoms as useful as tits on a boar. To many apples and oranges studies get released you can prove what ever point you want to come to if you look hard enough and have complete tunnel vision. Life is not lived in a lab or in test tube or even spot analyses of raw data. This is raw data with no follow up The DR admits this in the article, there is no break down of drug use/abuse. The biggest Issue in regards to HIV is not rubbers it is Drug abuse/addiction. Survive ability is genetic 1 receptor site on the CD T4 cell instead of 2. Medication resistance is do to poor adherence to medication regime, or being on the same meds 10 years. 2 HIV viruses do not meet up in the blood "Starbucks" and sit down over coffee to exchange recipes. We would have no functional anti virus meds at all by this point in time if cross resistance was as simple as is made out.

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This page contains a single entry by Joseph Sonnabend published on December 10, 2011 11:40 AM.

HIV and Herpes Viruses was the previous entry in this blog.

The 2012 revised DHHS HIV treatment guidelines and what's wrong with expert opinion. is the next entry in this blog.

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