14th International AIDS Conference Barcelona, Spain — July 7-12, 2002

Int Conf AIDS. 2002 Jul 7-12;14:Abstract No. ThOrA1381

BACKGROUND: New HIV-1 circulating recombinant forms are increasingly reported. This suggest that co-infection occurs in vivo. Case history A 38 year-old male with an acute retroviral syndrome (ARS) following previous multiple unprotected sexual contacts with male partners was enrolled in the Quest trial (AZT, 3TC, Abacavir, Amprenavir for 25 months, with from 19 to 25 months, vaccination by Alvac vCP 1452 and stop of all treatment at month 25). Viremia declined from >106 HIV-1 RNA copies/ml (c/mL) and remained <200 c/mL while on HAART. One months after treatment interruption, viremia rebounded to 80'000 c/mL then declined to 20'000 c/ml and raised again, two weeks later, at 200'000c/ml (second rebound), to finally fluctuate between 200'000-400'000 c/mL for 5 months before HAART re-initiation.

Methods and

RESULTS: Protease (Pr), reverse transcriptase (RT) gag and C2V3 gene sequencing documented an initial infection by subtype AE during the ARS whereas subtype B rapidly replaced AE at the time of the second rebound. To discriminate between co-infection and super-infection we set up a subtype specific PCR (end Pr-proximal third of RT) using subtype specific primers for AE and B designed according to patient's sequences. The subtype specific PCR confirmed 1/ the absence of B subtype in both plasma and proviral DNA before the second viremia rebound 2/ the emergence, during the second rebound and later on of B subtype as the majority subtype in both DNA and plasma. The C2V3 sequences of the B subtype was related to B Brazilian strains. This correlates with a Brazilian trip of the patient with several unprotected sexual contacts 3 weeks before B emergence. In in vitro cultures B subtype primary isolate had a much higher replicative capacity than AE subtype.

CONCLUSIONS: This is the first documented case of HIV-1 superinfection. Super-infection has implications for the ever increasing HIV-1 genetic diversity, public health and vaccines development.

Presenting author: S Jost

1Division of Infectious diseases, University of Geneva, Laboratoire Central de Virologie, Hôpital Cantonal universitaire de Genève, Genève 4, Switzerland

2GlaxoSmithKline, London, United Kingdom

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ThOrA1381

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.