title: Wide variation in the multiplicity of HIV-1 infection among injection drug users.
abstract: Recent studies indicate that sexual transmission of human immunodeficiency virus type 1 (HIV-1) generally results from productive infection by only one virus, a finding attributable to the mucosal barrier. Surprisingly, a recent study of injection drug users (IDUs) from St. Petersburg, Russia, also found most subjects to be acutely infected by a single virus. Here, we show by single-genome amplification and sequencing in a different IDU cohort that 60% of IDU subjects were infected by more than one virus, including one subject who was acutely infected by at least 16 viruses. Multivariant transmission was more common in IDUs than in heterosexuals (60% versus 19%; odds ratio, 6.14; 95% confidence interval [CI], 1.37 to 31.27; P = 0.008). These findings highlight the diversity in HIV-1 infection risks among different IDU cohorts and the challenges faced by vaccines in protecting against this mode of infection.
authors.affiliation: University of Alabama at Birmingham, 720 South 20th Street, 816 KAUL Building, Birmingham, AL 35294-0024, USA.
authors.forename: Katharine J
authors.initials: KJ
authors.lastname: Bar
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.forename: Annie
authors.initials: A
authors.lastname: Chamberland
authors.forename: Cecile
authors.initials: C
authors.lastname: Tremblay
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Routy
authors.forename: Truman
authors.initials: T
authors.lastname: Grayson
authors.forename: Chuanxi
authors.initials: C
authors.lastname: Sun
authors.forename: Shuyi
authors.initials: S
authors.lastname: Wang
authors.forename: Gerald H
authors.initials: GH
authors.lastname: Learn
authors.forename: Charity J
authors.initials: CJ
authors.lastname: Morgan
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Schumacher
authors.forename: Barton F
authors.initials: BF
authors.lastname: Haynes
authors.forename: Brandon F
authors.initials: BF
authors.lastname: Keele
authors.forename: Beatrice H
authors.initials: BH
authors.lastname: Hahn
authors.forename: George M
authors.initials: GM
authors.lastname: Shaw
mesh_terms: D000293:Adolescent; D000328:Adult; D001483:Base Sequence; D015331:Cohort Studies; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D014644:Genetic Variation; D016679:Genome, Viral; D019302:HIV Envelope Protein gp160 / Q000235:genetics; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012426:Russia / Q000453:epidemiology; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D019302:HIV Envelope Protein gp160