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

Document Type

Article

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.