HIV-1 superinfection occurs less frequently than initial infection in a cohort of high-risk Kenyan women.

HIV superinfection (reinfection) has been reported in several settings, but no study has been designed and powered to rigorously compare its incidence to that of initial infection. Determining whether HIV infection reduces the risk of superinfection is critical to understanding whether an immune res...

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Autores principales:	Keshet Ronen, Connor O McCoy, Frederick A Matsen, David F Boyd, Sandra Emery, Katherine Odem-Davis, Walter Jaoko, Kishor Mandaliya, R Scott McClelland, Barbra A Richardson, Julie Overbaugh
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Immunologic diseases. Allergy RC581-607 Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/f48682b443f04e6b86c8c288aee20b86
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spelling	oai:doaj.org-article:f48682b443f04e6b86c8c288aee20b862021-11-18T06:07:42ZHIV-1 superinfection occurs less frequently than initial infection in a cohort of high-risk Kenyan women.1553-73661553-737410.1371/journal.ppat.1003593https://doaj.org/article/f48682b443f04e6b86c8c288aee20b862013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24009513/?tool=EBIhttps://doaj.org/toc/1553-7366https://doaj.org/toc/1553-7374HIV superinfection (reinfection) has been reported in several settings, but no study has been designed and powered to rigorously compare its incidence to that of initial infection. Determining whether HIV infection reduces the risk of superinfection is critical to understanding whether an immune response to natural HIV infection is protective. This study compares the incidence of initial infection and superinfection in a prospective seroincident cohort of high-risk women in Mombasa, Kenya. A next-generation sequencing-based pipeline was developed to screen 129 women for superinfection. Longitudinal plasma samples at <6 months, >2 years and one intervening time after initial HIV infection were analyzed. Amplicons in three genome regions were sequenced and a median of 901 sequences obtained per gene per timepoint. Phylogenetic evidence of polyphyly, confirmed by pairwise distance analysis, defined superinfection. Superinfection timing was determined by sequencing virus from intervening timepoints. These data were combined with published data from 17 additional women in the same cohort, totaling 146 women screened. Twenty-one cases of superinfection were identified for an estimated incidence rate of 2.61 per 100 person-years (pys). The incidence rate of initial infection among 1910 women in the same cohort was 5.75 per 100 pys. Andersen-Gill proportional hazards models were used to compare incidences, adjusting for covariates known to influence HIV susceptibility in this cohort. Superinfection incidence was significantly lower than initial infection incidence, with a hazard ratio of 0.47 (CI 0.29-0.75, p = 0.0019). This lower incidence of superinfection was only observed >6 months after initial infection. This is the first adequately powered study to report that HIV infection reduces the risk of reinfection, raising the possibility that immune responses to natural infection are partially protective. The observation that superinfection risk changes with time implies a window of protection that coincides with the maturation of HIV-specific immunity.Keshet RonenConnor O McCoyFrederick A MatsenDavid F BoydSandra EmeryKatherine Odem-DavisWalter JaokoKishor MandaliyaR Scott McClellandBarbra A RichardsonJulie OverbaughPublic Library of Science (PLoS)articleImmunologic diseases. AllergyRC581-607Biology (General)QH301-705.5ENPLoS Pathogens, Vol 9, Iss 8, p e1003593 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Immunologic diseases. Allergy RC581-607 Biology (General) QH301-705.5
spellingShingle	Immunologic diseases. Allergy RC581-607 Biology (General) QH301-705.5 Keshet Ronen Connor O McCoy Frederick A Matsen David F Boyd Sandra Emery Katherine Odem-Davis Walter Jaoko Kishor Mandaliya R Scott McClelland Barbra A Richardson Julie Overbaugh HIV-1 superinfection occurs less frequently than initial infection in a cohort of high-risk Kenyan women.
description	HIV superinfection (reinfection) has been reported in several settings, but no study has been designed and powered to rigorously compare its incidence to that of initial infection. Determining whether HIV infection reduces the risk of superinfection is critical to understanding whether an immune response to natural HIV infection is protective. This study compares the incidence of initial infection and superinfection in a prospective seroincident cohort of high-risk women in Mombasa, Kenya. A next-generation sequencing-based pipeline was developed to screen 129 women for superinfection. Longitudinal plasma samples at <6 months, >2 years and one intervening time after initial HIV infection were analyzed. Amplicons in three genome regions were sequenced and a median of 901 sequences obtained per gene per timepoint. Phylogenetic evidence of polyphyly, confirmed by pairwise distance analysis, defined superinfection. Superinfection timing was determined by sequencing virus from intervening timepoints. These data were combined with published data from 17 additional women in the same cohort, totaling 146 women screened. Twenty-one cases of superinfection were identified for an estimated incidence rate of 2.61 per 100 person-years (pys). The incidence rate of initial infection among 1910 women in the same cohort was 5.75 per 100 pys. Andersen-Gill proportional hazards models were used to compare incidences, adjusting for covariates known to influence HIV susceptibility in this cohort. Superinfection incidence was significantly lower than initial infection incidence, with a hazard ratio of 0.47 (CI 0.29-0.75, p = 0.0019). This lower incidence of superinfection was only observed >6 months after initial infection. This is the first adequately powered study to report that HIV infection reduces the risk of reinfection, raising the possibility that immune responses to natural infection are partially protective. The observation that superinfection risk changes with time implies a window of protection that coincides with the maturation of HIV-specific immunity.
format	article
author	Keshet Ronen Connor O McCoy Frederick A Matsen David F Boyd Sandra Emery Katherine Odem-Davis Walter Jaoko Kishor Mandaliya R Scott McClelland Barbra A Richardson Julie Overbaugh
author_facet	Keshet Ronen Connor O McCoy Frederick A Matsen David F Boyd Sandra Emery Katherine Odem-Davis Walter Jaoko Kishor Mandaliya R Scott McClelland Barbra A Richardson Julie Overbaugh
author_sort	Keshet Ronen
title	HIV-1 superinfection occurs less frequently than initial infection in a cohort of high-risk Kenyan women.
title_short	HIV-1 superinfection occurs less frequently than initial infection in a cohort of high-risk Kenyan women.
title_full	HIV-1 superinfection occurs less frequently than initial infection in a cohort of high-risk Kenyan women.
title_fullStr	HIV-1 superinfection occurs less frequently than initial infection in a cohort of high-risk Kenyan women.
title_full_unstemmed	HIV-1 superinfection occurs less frequently than initial infection in a cohort of high-risk Kenyan women.
title_sort	hiv-1 superinfection occurs less frequently than initial infection in a cohort of high-risk kenyan women.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/f48682b443f04e6b86c8c288aee20b86
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HIV-1 superinfection occurs less frequently than initial infection in a cohort of high-risk Kenyan women.

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