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93 Evidence of Dual Infection with Two Distinct Subtype C Viral Populations in a Female Sex Worker from KwaZulu-Natal, South Africa
J. Grobler*1, C. Rademeyer1, L. Morris2, C. M. Gray2, G. Ramjee3, S. S. Abdool-Karim3, and C. Williamson1
1Univ. of Cape Town, South Africa; 2Natl. Inst. for Virology, Johannesburg, South Africa; and 3Med. Res. Council, Durban, South Africa
Background: Dual infection and timing thereof may provide information on correlates of protection. The aim of this study was to determine if dual infection occurs in a cohort of sex workers from Kwazulu-Natal, and if so, the frequency of dual infection.
Methods: Twenty-three sex workers have been monitored for dual infection from seroconversion over a 24-month period. A 504-bp region spanning the V3 region was amplified and diversity was assessed by HMA. Where high diversity was observed, PCR fragments were cloned, and diversity was determined by the number of HMA banding patterns for 20 clones. At least 1 representative from each pattern was sequenced.
Results: High diversity was detected in 4/23 women, demonstrated by HMA. Dual infection was detected in 1 woman (Du151) where 2 independent subtype C phylogenetic clusters were observed. Viral diversity increased over time with at least 4 different HMA banding patterns detected at 8 months post infection compared with 8 HMA banding patterns at 19 months. The predicted phenotype of the infecting virus was NSI, with the SI viruses forming a minor group at 8 months and becoming dominant by 19 months. Analysis of viral loads in this individual showed that at no stage did she control viral replication, and she died within 2 years of infection.
Conclusions: Sex workers are at risk of multiple exposures and dual infection has been detected in 1 women. Further studies need to be done to determine the extent and implications of dual infection.
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