近日，来自约翰霍普金斯大学的研究者和国家过敏传染病研究所（NIAID）的研究人员在国际著名杂志Journal of Infectious Diseases上刊登其关于HIV的最新研究结果，研究者发现HIV重复感染和潜在感染的比例是等同的。这就激发了研究者关于天然免疫反应和为什么机体无法产生对HIV再次感染的抵抗力相关研究的兴趣。
一直以来，科学家们关于在人群中HIV重复感染的比率存在分歧，以前有研究表明，个体可以通过高频率的性活动和药物注射增加感染HIV的风险，这项研究中，研究者使用了一项足够灵敏的技术来检测人群中的HIV重复感染的比例以及检测HIV病毒循环感染的最低水平。
样品开始进行HIV检测之后，进行抗病毒疗法治疗以前，同一时段中，HIV重复感染的比例和HIV阴性个体所估计的总体艾滋病发病率进行比较。研究者Quinn对149个个体进行检测，随后他们发现了7例重复感染的个体，这些个体提前注射了HIV的突变株。另外，相比起初HIV隐形个体的HIV发病率来说，个体重复感染的比例为1.44%，而且包括了种内和种外的双重重复感染。
研究结果对于估计HIV流行的年龄段以及构建病毒系统进化模型都具有重要的指示作用。另外研究者指出在HIV亚类之间或者内部发生重复感染很常见，而且起初感染产生的免疫效应保护能力是有限的。
这项研究揭示了设计HIV疫苗或许对于真正保护个体免于感染尚不充足，然而，实验数据显示我们或许会提供一些新的探索，因为有些人是免于重复感染的，这或许为我们开辟新的疫苗研究可以提供一些建议。（生物谷Bioon.com）
编译自：HIV Superinfection Rate Comparable to Initial HIV Infection
编译者：天使托
doi:10.1093/infdis/jis325
PMC:
PMID:
The Rates of HIV Superinfection and Primary HIV Incidence in a General Population in Rakai, Uganda
Andrew D. Redd1, Caroline E. Mullis2, David Serwadda4,5, Xiangrong Kong3, Craig Martens7, Stacy M. Ricklefs7, Aaron A. R. Tobian2, Changchang Xiao3, Mary K. Grabowski3, Fred Nalugoda4, Godfrey Kigozi4, Oliver Laeyendecker1,2, Joseph Kagaayi4, Nelson Sewankambo4,6, Ronald H. Gray3, Stephen F. Porcella7, Maria J. Wawer3,a and Thomas C. Quinn1,2,a
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.
