Multiple Infection and Human Immunodeficiency Virus Superinfection Among Persons who Inject Drugs in Indonesia and Ukraine. (8th November 2022)

• Record Type: Journal Article
• Authors: Palumbo, Philip J; Grant-McAuley, Wendy; Grabowski, Mary Kate; Zhang, Yinfeng; Richardson, Paul; Piwowar-Manning, Estelle; Sharma, Deeksha; Clarke, William; Laeyendecker, Oliver; Rose, Scott; Ha, Tran V; Dumchev, Kostyantyn; Djoerban, Zubairi; Redd, Andrew; Hanscom, Brett; Hoffman, Irving; Miller, William C; Eshleman, Susan H
• Is Part Of: Journal of infectious diseases. Volume 226:Number 12(2022)
• Page Start: 2181
• Page End: 2191
• Publication Date: 2022-11-08
• Subjects: HIV -- HPTN 074 -- Indonesia -- Ukraine -- multiple infection -- persons who inject drugs -- phylogenetic analysis -- superinfection; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiac441
• Languages: English
• ISSNs: 0022-1899

Abstract

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. Abstract : Low rates of multiple HIV infection were detected among a nonseroconverter cohort of people who inject drugs in Indonesia and Ukraine.