Socio-demographic and drug use factors associated with HIV-1 recombinants and dual infections in Northern Thai drug users: Associations of risk with genetic complexity

Authors

G. H. Kijak, US Military HIV Research ProgramFollow
C. Beyrer, Johns Hopkins Bloomberg School of Public Health
S. Tovanabutra, US Military HIV Research Program
T. Sripaipan, Johns Hopkins Bloomberg School of Public Health
V. Suriyanon, Research Institute for Health Sciences
N. Moqueet, US Military HIV Research Program
E. Sanders-Buell, US Military HIV Research Program
P. Saokhieo, Research Institute for Health Sciences
U. Timpan, Research Institute for Health Sciences
J. Jittiwutikarn, Northern Drug Treatment Center
M. L. Robb, US Military HIV Research Program
D. L. Birx, Centers for Disease Control and Prevention
D. D. Celentano, Johns Hopkins Bloomberg School of Public Health
F. E. McCutchan, Bill and Melinda Gates Foundation

Date of this Version

2010

Comments

Published in Drug and Alcohol Dependence (2010) doi:10.1016/j.drugalcdep.2010.11.013

Abstract

Background:

Dual infection with diverse HIV strains can foster the emergence of recombinants. The resulting increase in viral genetic diversity is a major challenge for vaccine development HIV treatment. In this study we aim to investigate the socio demographic factors associated with an increasing level of genetic diversity among HIV strains in a population of drug-users in Northern Thailand.

Methods:

From 1999 through 2000, 2231 volunteers were enrolled in the Opiate- Users Research in Chiang Mai, Thailand. HIV subtype analysis was conducted among those HIV-1 seropositive (n = 347) using a multi-region hybridization assay. Social and demographic variables were assessed using a structured questionnaire.

Results:

Overall, 336/347 (96.8%) of the samples could be typed. 81.8% were CRF01_AE, 3.9% were sub-type B, 9.2% were recombinants (mostly between CRF01_AE and B) and 5.1% were dual infections. Dual infections were more frequent among those with a lower education level (AOR:5.2; 95% Cl 1.4–20.3), those who have initiated injecting in the last 3 years (AOR:3.9; 95% Cl 1.1–14.6), and those reporting frequent needle sharing in the last 3 months (AOR:7.0; 95% Cl 1.5–34.1). Both recombinant strains and dual infection were more frequent among those reporting frequent needle sharing in the last 3months (AOR: 5.3; 95% Cl 1.6–17.1).

Conclusion:

To limit the expanding complexity of HIV-1 strains, early intervention should be aimed at reduction in needle sharing, especially among new intravenous drug users.