The rates of HIV superinfection and primary HIV incidence in a general population in Rakai, Uganda.

Abstract

BACKGROUND:

Human immunodeficiency virus (HIV) superinfection has been documented in high-risk individuals; however, the rate of superinfection among HIV-infected individuals within a general population remains unknown.

METHODS:

A novel next-generation ultra-deep sequencing technique was utilized to determine the rate of HIV superinfection in a heterosexual population by examining two regions of the viral genome in longitudinal samples from recent HIV seroconverters (n=149) in Rakai District, Uganda.

RESULTS:

The rate of superinfection was 1.44 per 100 person years (PYs) (95% confidence interval [CI], .4-2.5) and consisted of both inter- and intrasubtype superinfections. This was compared to primary HIV incidence in 20 220 initially HIV-negative individuals in the general population in Rakai (1.15 per 100 PYs; 95% CI, 1.1-1.2; P= .26). Propensity score matching (PS) was used to control for differences in sociodemographic and behavioral characteristics between the HIV-positive individuals at risk for superinfection and the HIV-negative population at baseline and follow-up. After PS matching, the estimated rate of primary incidence was 3.28 per 100 PYs (95% CI, 2.0-5.3; P = .07) controlling for baseline differences and 2.51 per 100 PYs (95% CI, 1.5-4.3; P = .24) controlling for follow-up differences.

CONCLUSIONS:

This suggests that the rate of HIV superinfection in a general population is substantial, which could have a significant impact on future public health and HIV vaccine strategies.

• Authors: Andrew D Redd, Caroline E Mullis, David Serwadda, Xiangrong Kong, Craig Martens, Stacy M Ricklefs, Aaron A R Tobian, Changchang Xiao, Mary K Grabowski, Fred Nalugoda, Godfrey Kigozi, Oliver Laeyendecker, Joseph Kagaayi, Nelson Sewankambo, Ronald H Gray, Stephen F Porcella, Maria J Wawer, Thomas C Quinn
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 206 Issue 2 Pg. 267-74 (Jul 15 2012) ISSN: 1537-6613 [Electronic] United States
• PMID: 22675216 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, N.I.H., Intramural, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Cohort Studies
• Female
• HIV Infections (epidemiology, pathology, virology)
• Humans
• Incidence
• Male
• Middle Aged
• Risk Factors
• Superinfection (epidemiology, virology)
• Uganda (epidemiology)
• Young Adult