TY - JOUR
T1 - The rates of HIV superinfection and primary HIV incidence in a general population in Rakai, Uganda
AU - Redd, Andrew
AU - Mullis, Caroline E.
AU - Serwadda, David
AU - Kong, Xiangrong
AU - Martens, Craig
AU - Ricklefs, Stacy M.
AU - Tobian, Aaron A.R.
AU - Xiao, Changchang
AU - Grabowski, Mary K.
AU - Nalugoda, Fred
AU - Kigozi, Godfrey
AU - Laeyendecker, Oliver B.
AU - Kagaayi, Joseph
AU - Sewankambo, Nelson
AU - Gray, Ronald H
AU - Porcella, Stephen F.
AU - Wawer, Maria
AU - Quinn, Thomas C
N1 - Funding Information:
Financial support. This study was supported in part by funding from the Division of Intramural Research, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH); Office of AIDS Research, NIH; Division of AIDS, NIAID (R01 A134826 and R01 A134265); National Institute of Child Health & Human Development (R01 HD 050180 and 5P30HD06826); HPTN Network Lab grant (U01-AI-068613); the Gates Foundation (22006.03), Henry M. Jackson Foundation; and the Fogarty Foundation (grant 5D43TW00010). A. A. R. T. was supported by the NIH (1K23AI093152-01A1) and Doris Duke Charitable Foundation Clinician Scientist Development Award (2011036). Potential conflicts of interest. All authors: No reported conflicts.
PY - 2012/7/15
Y1 - 2012/7/15
N2 - 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.
AB - 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.
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U2 - 10.1093/infdis/jis325
DO - 10.1093/infdis/jis325
M3 - Article
C2 - 22675216
AN - SCOPUS:84862857091
SN - 0022-1899
VL - 206
SP - 267
EP - 274
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 2
ER -