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Journal of Virology, August 2002, p. 7444-7452, Vol. 76, No. 15
0022-538X/02/$04.00+0     DOI: 10.1128/JVI.76.15.7444-7452.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Intersubtype Human Immunodeficiency Virus Type 1 Superinfection following Seroconversion to Primary Infection in Two Injection Drug Users

Artur Ramos,1 Dale J. Hu,1 Lily Nguyen,1 Kim-Oanh Phan,1,{dagger} Suphak Vanichseni,2 Nattawan Promadej,1 Kachit Choopanya,2 Margaret Callahan,1 Nancy L. Young,1,3 Janet McNicholl,1 Timothy D. Mastro,1,3 Thomas M. Folks,1 and Shambavi Subbarao1*

Centers for Disease Control and Prevention, Atlanta, Georgia,1 Bangkok Metropolitan Administration, Bangkok,2 Thai MOPH-US CDC Collaboration, Nonthaburi, Thailand3

Received 26 February 2002/ Accepted 6 May 2002

In this study, we describe two cases of human immunodeficiency virus type 1 (HIV-1) intersubtype superinfection with CRF01_AE and subtype B strains, which occurred in two injection drug users participating in a prospective cohort study in Bangkok, Thailand. In both cases, the superinfecting strain was detected by molecular and serologic analyses several weeks after complete seroconversion to the primary infection with a strain belonging to a different subtype. Superinfection occurred despite specific T-cell and humoral antibody responses to the primary virus. In both cases, cross-subtype immune responses were limited or absent prior to the second infection. These data show that, in some individuals, the quality and quantity of the immune response elicited by primary HIV-1 infection may not protect against superinfection. This finding has important implications for vaccine design. HIV-1 vaccines, at a minimum, will need to include potent, broadly protective, conserved immunogens derived from several group M subtypes.

* Corresponding author. Mailing address: Division of AIDS, STD, TB Laboratory Research (MS G-19), National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA 30333. Phone: (404) 639-1397. Fax: (404) 639-1174. E-mail: Ssubbarao{at}cdc.gov.

{dagger} Present address: Accenture, Phoenix, AZ 85016.

Journal of Virology, August 2002, p. 7444-7452, Vol. 76, No. 15
0022-538X/02/$04.00+0     DOI: 10.1128/JVI.76.15.7444-7452.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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