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Frequency of occurrence of HIV-1 dual infection in a Belgian MSM population.

Frequency of occurrence of HIV-1 dual infection in a Belgian MSM population.
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Hebberecht L, Vancoillie L, Schauvliege M, Staelens D, Dauwe K, Mortier V, Verhofstede C,


Hebberecht L, Vancoillie L, Schauvliege M, Staelens D, Dauwe K, Mortier V, Verhofstede C, (click to view)

Hebberecht L, Vancoillie L, Schauvliege M, Staelens D, Dauwe K, Mortier V, Verhofstede C,

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PloS one 2018 04 0613(4) e0195679 doi 10.1371/journal.pone.0195679

Abstract
INTRODUCTION
HIV-1 dual infection is a condition that results from infection with at least two HIV-1 variants from different sources. The scarceness of information on this condition is partly due to the fact that its detection is technically challenging. Using next-generation sequencing we defined the extent of HIV-1 dual infection in a cohort of men who have sex with men (MSM).

MATERIAL & METHODS
Eighty-six MSM, diagnosed with HIV-1 subtype B infection between 2008 and 2013 were selected for next-generation sequencing of the HIV-1 envelope V3. Sequencing was performed on 2 plasma samples collected with an interval of > 6 months before the initiation of antiretroviral therapy. Maximum likelihood phylogenetic trees were inspected for dual infection, defined as the presence of two or more monophyletic clusters with ≥ 90% bootstrap support and a mean between-cluster genetic distance of ≥ 10%. To confirm dual infection, deep V3 sequencing of intermediate samples was performed as well as clonal sequencing of the HIV-1 protease-reverse transcriptase gene.

RESULTS
Five of the 74 patients (6.8%) for whom deep sequencing was successful, showed clear evidence of dual infection. In 4 of them, the second strain was absent in the first sample but occurred in subsequent samples. This was highly suggestive for superinfection. In 3 patients both virus variants were of subtype B, in 2 patients at least one of the variants was a subtype B/non-B recombinant virus.

CONCLUSIONS
Dual infection was confirmed in 6.8% of MSM diagnosed with HIV-1 in Belgium. This prevalence is probably an underestimation, because stringent criteria were used to classify viral variants as originating from a new infection event.

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