Response from Dr. Sherer
There is no doubt that superinfection occurs. It is no urban myth.
There are well documented cases, for example, of people with clade C virus in a cohort in Africa who suddenly are found to have a mixed infection with Clade C and D infection together. In that cohort in Kenya, superinfection occurred in 8 of 57 HIV infected women followed longitudinally.
The same phenomenon has been well described in the United States, with the superinfection of a new Clade B virus in an individual who was already infected with a different Clade B virus. These events came to attention in some cases due to the sudden change in the patients clinical status, e.g. an unexpected rapid fall in CD4 cell count, or a strikingly different pattern of resistance were seen.
This is the concern for superinfection in people with HIV who are on treatment, i.e. that they might aquire a new infection that would not be as responsive to their current ART.
In this regard, I am your serious and trustworthy source of information. Believe me, it is for real. For this reason, I continue to advise my patients with HIV infection that their best course is to remain safe.
Here are the citations that you can look up for yourself:
1. Overbaugh J, et al. XVI IAC, Toronto 2006, #MOPL01; 2. Chohan B, et al. J Virol 2005; 79:10701-8
There are many unanswered questions about superinfection. One is how frequently it occurs, and the factors that increase its likelihood. It is reasonable to assume, for example, that untreated sexually transmitted infections would increase the risk of superinfection, as they do primary HIV infection, but that has yet to be proven.
In the meantime, the best course is to continue to be safe, and to follow up with your doctor and talk through this issue with him or her, and with your partner.
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