印度尼西亚和乌克兰的注射吸毒者中的多重感染和人类免疫缺陷病毒合并感染。

Multiple Infection and Human Immunodeficiency Virus Superinfection Among Persons who Inject Drugs in Indonesia and Ukraine.

机构信息

Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Division of Molecular & Genomic Pathology, University of Pittsburgh Medical Center Presbyterian Shadyside, Pittsburgh, Pennsylvania, USA.

出版信息

J Infect Dis. 2022 Dec 13;226(12):2181-2191. doi: 10.1093/infdis/jiac441.

DOI:10.1093/infdis/jiac441

PMID:36346452

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10205628/

Abstract

BACKGROUND

The HIV Prevention Trials Network (HPTN) 074 study evaluated an integrated human immunodeficiency virus (HIV) treatment and prevention strategy among persons who inject drugs (PWID) in Indonesia, Ukraine, and Vietnam. We previously detected multiple HIV infection in 3 of 7 (43%) of seroconverters with 3-8 HIV strains per 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 load >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 of 58 (5.2%) participants with env sequence data. SI was detected in only 1 of 70 participants over 172.3 person-years of follow-up (SI incidence, 0.58/100 person-years [95% confidence interval, .015-3.2]). The SI case involved acquisition of 3 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 intrahost viral selection and other factors may lead to underestimation of the frequency of multiple HIV infection and SI events.

摘要

背景

HIV 预防试验网络（HPTN）074 研究评估了在印度尼西亚、乌克兰和越南的注射吸毒者（PWID）中实施的一种综合人类免疫缺陷病毒（HIV）治疗和预防策略。我们之前在 7 名血清转换者中有 3 名（43%）检测到了多重 HIV 感染，每个人有 3-8 株 HIV 毒株。在本报告中，我们分析了 HPTN 074 队列中的多重 HIV 感染和 HIV 超感染（SI）。

方法

我们分析了来自印度尼西亚和乌克兰的 70 名参与者的样本，这些参与者在入组时和最后一次研究访视时的病毒载量>400 拷贝/ml（中位随访时间为 2.5 年）。通过 Sanger 测序、下一代测序和系统发育分析对 HIV 进行了特征分析。还使用了其他方法来对一个罕见的三重变体 SI 进行了特征分析。

结果

在入组时，仅有 58 名参与者中的 3 名（5.2%）具有 env 序列数据，检测到了多重感染。在 172.3 个人年的随访中，仅在 70 名参与者中的 1 名（SI 发生率为 0.58/100 人年[95%置信区间，0.015-3.2]）中检测到了 SI。该 SI 病例涉及 3 株 HIV 株的获得，且快速选择了一株具有单一 pol 区簇的株。