HIV type 1 superinfection with a dual-tropic virus and rapid progression to AIDS: A case report

被引:29
作者
Gottlieb, Geoffrey S. [1 ]
Nickle, David C.
Jensen, Mark A.
Wong, Kim G.
Kaslow, Richard A.
Shepherd, James C.
Margolick, Joseph B.
Mullins, James I.
机构
[1] Univ Washington, Dept Med, Div Allergy & Infect Dis, Seattle, WA 98195 USA
[2] Univ Georgia, Dept Hlth Adm Biostat & Epidemiol, Athens, GA USA
[3] Univ Georgia, Dept Genet, Athens, GA 30602 USA
[4] Univ Maryland, Dept Med, Div Geograph Med, Baltimore, MD 21201 USA
[5] Univ Washington, Sch Med, Dept Med, Div Allergy & Infect Dis, Seattle, WA 98195 USA
[6] Univ Washington, Sch Med, Dept Microbiol, Div Allergy & Infect Dis, Seattle, WA 98195 USA
[7] Univ Alabama, Dept Epidemiol, Birmingham, AL USA
[8] Univ Alabama, Dept Med, Birmingham, AL 35294 USA
[9] Univ Alabama, Dept Microbiol, Birmingham, AL 35294 USA
[10] Johns Hopkins Univ, Dept Med, Div Infect Dis, Baltimore, MD USA
[11] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mol Microbiol & Immunol, Baltimore, MD USA
关键词
D O I
10.1086/520024
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. The occurrence of human immunodeficiency virus type 1 (HIV-1) superinfection has implications for vaccine development and our understanding of HIV pathogenesis and transmission. Methods and Results. We describe a subject from the Multicenter AIDS Cohort Study who was superinfected with a dual-tropic (CXCR4/CCR5-utilizing) HIV-1 subtype B strain between 0.8 and 1.3 years after seroconversion who had rapid progression to AIDS; the subject developed Pneumocystis pneumonia 3.4 years after seroconversion, as well as multiple other opportunistic infections. The superinfecting strain rapidly became the predominant population virus, suggesting that the initial and superinfecting viruses in this individual differed in virulence. However, we found no molecular epidemiological evidence in the HIV database to suggest that this strain had been found in other individuals. In addition, this subject's HIV-1 viral load and pattern of human leukocyte antigen and coreceptor polymorphisms only partially explained his rapid disease progression. Conclusions. Additional studies are needed to determine whether superinfection itself and/or infection with a dual-tropic virus causes rapid disease progression, or whether certain individuals who are innately more susceptible to rapid disease progression also lack the ability to resist the challenge of a second infection. This case appears to support the latter hypothesis.
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收藏
页码:501 / 509
页数:9
相关论文
共 77 条
[1]   HIV-1 superinfection despite broad CD8+ T-cell responses containing replication of the primary virus [J].
Altfeld, M ;
Allen, TM ;
Yu, XG ;
Johnston, MN ;
Agrawal, D ;
Korber, BT ;
Montefiori, DC ;
O'Connor, DH ;
Davis, BT ;
Lee, PK ;
Maier, EL ;
Harlow, J ;
Goulder, PJR ;
Brander, C ;
Rosenberg, ES ;
Walker, BD .
NATURE, 2002, 420 (6914) :434-439
[2]   Virological evaluation of the 'Ottawa case' indicates no evidence for HIV-1 superinfection [J].
Angel, JB ;
Hu, YW ;
Kravcik, S ;
Tsui, R ;
Lee, KH ;
Barbour, J ;
Balaskas, E ;
Branson, BM ;
Delwart, EL ;
Grant, RM .
AIDS, 2004, 18 (02) :331-334
[3]  
ANGEL JB, 2000, PROGR ABSTR 7 C RETR
[4]   Persistence of primary drug resistance among recently HIV-1 infected adults [J].
Barbour, JD ;
Hecht, FA ;
Wrin, T ;
Liegler, TJ ;
Ramstead, CA ;
Busch, MP ;
Segal, MR ;
Petropoulos, CJ ;
Grant, RM .
AIDS, 2004, 18 (12) :1683-1689
[5]   New York's AIDS 'superstrain' could be two mediocre strains [J].
Basu, P .
NATURE MEDICINE, 2005, 11 (08) :810-810
[6]   Broad spectrum of coreceptor usage and rapid disease progression in HIV-1-infected individuals from Central African Republic [J].
Bégaud, E ;
Feindirongai, G ;
Versmisse, P ;
Ipero, J ;
Léal, J ;
Germani, Y ;
Morvan, J ;
Fleury, H ;
Müller-Trutwin, M ;
Barré-Sinousi, F ;
Pancino, G .
AIDS RESEARCH AND HUMAN RETROVIRUSES, 2003, 19 (07) :551-560
[7]   Human immunodeficiency virus superinfection and recombination: Current state of knowledge and potential clinical consequences [J].
Blackard, JT ;
Cohen, DE ;
Mayer, KH .
CLINICAL INFECTIOUS DISEASES, 2002, 34 (08) :1108-1114
[8]   Persistence of mutidrug-resistant HIV-1 in primary infection leading to superinfection [J].
Brenner, B ;
Routy, J ;
Quan, YD ;
Moisi, D ;
Oliveira, M ;
Turner, D ;
Wainberg, MA ;
Baril, JG ;
Bélanger, M ;
Côté, P ;
Dufresne, S ;
Leplante, F ;
Lebel, J ;
Boissonnault, M ;
Lavoie, H ;
Lessard, B ;
Olivier, C ;
Trottier, RB ;
Vézina, S ;
Gilmore, N ;
Klein, M ;
Lalonde, P ;
MacLeod, J ;
Smith, G ;
Cholette, P ;
Laponte, N ;
Samson, J ;
Frenette, C ;
Valois, C ;
Bélanger, M .
AIDS, 2004, 18 (12) :1653-1660
[9]   HLA and HIV-1:: Heterozygote advantage and B*35-Cw*04 disadvantage [J].
Carrington, M ;
Nelson, GW ;
Martin, MP ;
Kissner, T ;
Vlahov, D ;
Goedert, JJ ;
Kaslow, R ;
Buchbinder, S ;
Hoots, K ;
O'Brien, SJ .
SCIENCE, 1999, 283 (5408) :1748-1752
[10]   Can HIV-1 superinfection compromise antiretroviral therapy? [J].
Chakraborty, B ;
Kiser, P ;
Rangel, HR ;
Weber, A ;
Mirza, M ;
Marotta, ML ;
Asaad, R ;
Rodriguez, B ;
Valdez, H ;
Lederman, MM ;
Quiñones-Mateu, ME .
AIDS, 2004, 18 (01) :132-134