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HIV superinfection. More common than thought?

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http://www.nih.gov/news/health/jun2012/niaid-07.htm"Of the samples tested from 149 HIV-infected people, the scientists found seven cases of HIV superinfection, all detected in the gp41 region of the virus. Of these cases, four individuals were initially infected and then later superinfected with different strains of HIV subtype D, the most common viral subtype found in Rakai. The other three were initially infected with subtype D and superinfected with a different HIV subtype, subtype A. These findings suggest a rate of superinfection of 1.44 per 100 people annually. The investigators were surprised to find that the rate of superinfection was comparable to the current estimated annual rate of new, initial HIV infections in the Rakai cohort, or 1.15 infections per 100 people per year. HIV superinfection had been thought to be less common than initial infection. "The list has been quiet lately, time to chuck a grenade.JB
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These data is from treatment naive patients. Very little data are available about those on treatment and with controlled viral load. Do they also get superinfection? If that was the case, we would be seeing a lot of barebackers progressing to illness and immune decline.  I am not seeing that among people I know bareback.  Does it make sense to always a condom even between two poz people? Of course it does, not only because of potential superinfection (which we have hardly any data) and STD's that activate the immune system. But are barebackers who are having lots of sex experiencing viral breakthroughs due to superinfections? I am waiting for data on this.

On Thu, Jun 7, 2012 at 2:48 PM, J Barrowster <barrowster@...> wrote:

http://www.nih.gov/news/health/jun2012/niaid-07.htm " Of the samples tested from 149 HIV-infected people, the scientists found seven cases of HIV superinfection, all detected in the gp41 region of the virus. Of these cases, four individuals were initially infected and then later superinfected with different strains of HIV subtype D, the most common viral subtype found in Rakai. The other three were initially infected with subtype D and superinfected with a different HIV subtype, subtype A. These findings suggest a rate of superinfection of 1.44 per 100 people annually. The investigators were surprised to find that the rate of superinfection was comparable to the current estimated annual rate of new, initial HIV infections in the Rakai cohort, or 1.15 infections per 100 people per year.  HIV superinfection had been thought to be less common than initial infection.  "

The list has been quiet lately, time to chuck a grenade.JB

-- Regards, VergelBooks

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These data is from treatment naive patients. Very little data are available about those on treatment and with controlled viral load. Do they also get superinfection? If that was the case, we would be seeing a lot of barebackers progressing to illness and immune decline.  I am not seeing that among people I know bareback.  Does it make sense to always a condom even between two poz people? Of course it does, not only because of potential superinfection (which we have hardly any data) and STD's that activate the immune system. But are barebackers who are having lots of sex experiencing viral breakthroughs due to superinfections? I am waiting for data on this.

On Thu, Jun 7, 2012 at 2:48 PM, J Barrowster <barrowster@...> wrote:

http://www.nih.gov/news/health/jun2012/niaid-07.htm " Of the samples tested from 149 HIV-infected people, the scientists found seven cases of HIV superinfection, all detected in the gp41 region of the virus. Of these cases, four individuals were initially infected and then later superinfected with different strains of HIV subtype D, the most common viral subtype found in Rakai. The other three were initially infected with subtype D and superinfected with a different HIV subtype, subtype A. These findings suggest a rate of superinfection of 1.44 per 100 people annually. The investigators were surprised to find that the rate of superinfection was comparable to the current estimated annual rate of new, initial HIV infections in the Rakai cohort, or 1.15 infections per 100 people per year.  HIV superinfection had been thought to be less common than initial infection.  "

The list has been quiet lately, time to chuck a grenade.JB

-- Regards, VergelBooks

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As always, it's an interesting question. The problem is that the tests to detect superinfection are rarely done, and even if it's a clinical problem, it's apparently infrequent enough that it's isn't a huge problem….That said, I am aware of one case where superinfection did correlate with clinical deterioration, and anecdotally, have heard of others.If it were a huge issue, we'd probably all be dead.JBOn Jun 7, 2012, at 6:24 PM, Vergel wrote:These data is from treatment naive patients. Very little data are available about those on treatment and with controlled viral load. Do they also get superinfection? If that was the case, we would be seeing a lot of barebackers progressing to illness and immune decline. I am not seeing that among people I know bareback. Does it make sense to always a condom even between two poz people? Of course it does, not only because of potential superinfection (which we have hardly any data) and STD's that activate the immune system. But are barebackers who are having lots of sex experiencing viral breakthroughs due to superinfections? I am waiting for data on this.

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As always, it's an interesting question. The problem is that the tests to detect superinfection are rarely done, and even if it's a clinical problem, it's apparently infrequent enough that it's isn't a huge problem….That said, I am aware of one case where superinfection did correlate with clinical deterioration, and anecdotally, have heard of others.If it were a huge issue, we'd probably all be dead.JBOn Jun 7, 2012, at 6:24 PM, Vergel wrote:These data is from treatment naive patients. Very little data are available about those on treatment and with controlled viral load. Do they also get superinfection? If that was the case, we would be seeing a lot of barebackers progressing to illness and immune decline. I am not seeing that among people I know bareback. Does it make sense to always a condom even between two poz people? Of course it does, not only because of potential superinfection (which we have hardly any data) and STD's that activate the immune system. But are barebackers who are having lots of sex experiencing viral breakthroughs due to superinfections? I am waiting for data on this.

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