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Re-Infection, urban myth or medical scare tatic!
Oct 4, 2011

Where's the proof of re-infection? With over 33 million HIV positive people worldwide where is the evidence of re-infection? Please site the peer-reviewed published study or studies discussing how re-infection is real! I keep hearing about it over and over and over again, but no one has ever been able to show me a scientific study where this has been shown. HIV positive patients volunteer for studies all the time so please tell me where I can read this material!

Response from Dr. Young

Hello and thanks for posting your provocative question.

I'm not sure who you've been asking your questions to. A quick search about super infection finds those elusive peer-reviewed publications.

HIV superinfection definitely occurs, minimally, this can be demonstrated by the observation of the various circulating recombinant forms (CRFs) that exist in many parts of the world. For example the CRF A/E represents a combination of genetic sequences from both HIV subtype A and subtype E. This could only have occurred in an individual that was coinfected with both subtypes. CRF A/E is common in south and east Asia; CRF A/G is common in Central Africa.

There are also various well-detailed molecular analyses that have been published in peer-reviewed journals, such as this one from authors at Johns Hopkins University that describe two cases of HIV subtype coinfection from Uganda, or this recent report from London.

What perhaps is more interesting is the question about how frequently superinfection occurs. A interesting peer-reviewed analysis from Amsterdam found no cases when molecular analyses were performed 15 gay men followed for 6 years. So, yes, your notion is somewhat correct. Superinfection is not common indeed.

I believe that there can be a boogie-man discussion about superinfection- that it's inevitable and the overarching reason why some talk about safe sex. A more scientifically-accurate (and pragmatic) way of looking at this says that condom use is imperfect; that superinfection is a rare, but possible outcome of positives having unprotected sex with positives.

[FYI, if you're interested in that peer-reviewed journal literature search, go to the PubMed (National Library of Medicine) search tool. You might find answers to your questions there.]

Be well, BY



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