近日,，來(lái)自約翰霍普金斯大學(xué)的研究者和國(guó)家過(guò)敏傳染病研究所（NIAID）的研究人員在國(guó)際著名雜志Journal of Infectious Diseases上刊登其關(guān)于HIV的最新研究結(jié)果,，研究者發(fā)現(xiàn)HIV重復(fù)感染和潛在感染的比例是等同的,。這就激發(fā)了研究者關(guān)于天然免疫反應(yīng)和為什么機(jī)體無(wú)法產(chǎn)生對(duì)HIV再次感染的抵抗力相關(guān)研究的興趣,。
一直以來(lái),，科學(xué)家們關(guān)于在人群中HIV重復(fù)感染的比率存在分歧,，以前有研究表明,，個(gè)體可以通過(guò)高頻率的性活動(dòng)和藥物注射增加感染HIV的風(fēng)險(xiǎn),，這項(xiàng)研究中,，研究者使用了一項(xiàng)足夠靈敏的技術(shù)來(lái)檢測(cè)人群中的HIV重復(fù)感染的比例以及檢測(cè)HIV病毒循環(huán)感染的最低水平,。
樣品開(kāi)始進(jìn)行HIV檢測(cè)之后，進(jìn)行抗病毒療法治療以前,，同一時(shí)段中,，HIV重復(fù)感染的比例和HIV陰性個(gè)體所估計(jì)的總體艾滋病發(fā)病率進(jìn)行比較。研究者Quinn對(duì)149個(gè)個(gè)體進(jìn)行檢測(cè),，隨后他們發(fā)現(xiàn)了7例重復(fù)感染的個(gè)體,，這些個(gè)體提前注射了HIV的突變株。另外,，相比起初HIV隱形個(gè)體的HIV發(fā)病率來(lái)說(shuō),，個(gè)體重復(fù)感染的比例為1.44%，而且包括了種內(nèi)和種外的雙重重復(fù)感染,。
研究結(jié)果對(duì)于估計(jì)HIV流行的年齡段以及構(gòu)建病毒系統(tǒng)進(jìn)化模型都具有重要的指示作用,。另外研究者指出在HIV亞類(lèi)之間或者內(nèi)部發(fā)生重復(fù)感染很常見(jiàn)，而且起初感染產(chǎn)生的免疫效應(yīng)保護(hù)能力是有限的,。
這項(xiàng)研究揭示了設(shè)計(jì)HIV疫苗或許對(duì)于真正保護(hù)個(gè)體免于感染尚不充足,，然而，實(shí)驗(yàn)數(shù)據(jù)顯示我們或許會(huì)提供一些新的探索,，因?yàn)橛行┤耸敲庥谥貜?fù)感染的,，這或許為我們開(kāi)辟新的疫苗研究可以提供一些建議。（生物谷Bioon.com）
編譯自：HIV Superinfection Rate Comparable to Initial HIV Infection
編譯者：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.
