The rates of HIV superinfection and primary HIV incidence in a general population in Rakai, Uganda

Andrew D. Redd, Caroline E. Mullis, David Serwadda, Xiangrong Kong, Craig Martens, Stacy M. Ricklefs, Aaron A R Tobian, Changchang Xiao, Mary K. Grabowski, Fred Nalugoda, Godfrey Kigozi, Oliver Laeyendecker, Joseph Kagaayi, Nelson Sewankambo, Ronald H. Gray, Stephen F. Porcella, Maria J. Wawer, Thomas C. Quinn

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)267-274
Number of pages8
JournalJournal of Infectious Diseases
Volume206
Issue number2
DOIs
StatePublished - Jul 15 2012

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Superinfection
Uganda
HIV
Incidence
Population
Confidence Intervals
Propensity Score
High-Throughput Nucleotide Sequencing
Viral Genome
Heterosexuality
Vaccines
Public Health

ASJC Scopus subject areas

  • Infectious Diseases
  • Immunology and Allergy

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The rates of HIV superinfection and primary HIV incidence in a general population in Rakai, Uganda. / Redd, Andrew D.; Mullis, Caroline E.; Serwadda, David; Kong, Xiangrong; Martens, Craig; Ricklefs, Stacy M.; Tobian, Aaron A R; Xiao, Changchang; Grabowski, Mary K.; Nalugoda, Fred; Kigozi, Godfrey; Laeyendecker, Oliver; Kagaayi, Joseph; Sewankambo, Nelson; Gray, Ronald H.; Porcella, Stephen F.; Wawer, Maria J.; Quinn, Thomas C.

In: Journal of Infectious Diseases, Vol. 206, No. 2, 15.07.2012, p. 267-274.

Research output: Contribution to journalArticle

Redd, Andrew D. ; Mullis, Caroline E. ; Serwadda, David ; Kong, Xiangrong ; Martens, Craig ; Ricklefs, Stacy M. ; Tobian, Aaron A R ; Xiao, Changchang ; Grabowski, Mary K. ; Nalugoda, Fred ; Kigozi, Godfrey ; Laeyendecker, Oliver ; Kagaayi, Joseph ; Sewankambo, Nelson ; Gray, Ronald H. ; Porcella, Stephen F. ; Wawer, Maria J. ; Quinn, Thomas C. / The rates of HIV superinfection and primary HIV incidence in a general population in Rakai, Uganda. In: Journal of Infectious Diseases. 2012 ; Vol. 206, No. 2. pp. 267-274.
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abstract = "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.",
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AU - Mullis, Caroline E.

AU - Serwadda, David

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AU - Martens, Craig

AU - Ricklefs, Stacy M.

AU - Tobian, Aaron A R

AU - Xiao, Changchang

AU - Grabowski, Mary K.

AU - Nalugoda, Fred

AU - Kigozi, Godfrey

AU - Laeyendecker, Oliver

AU - Kagaayi, Joseph

AU - Sewankambo, Nelson

AU - Gray, Ronald H.

AU - Porcella, Stephen F.

AU - Wawer, Maria J.

AU - Quinn, Thomas C.

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N2 - 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.

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