This study reports a case series of HIV-1-infected patients that had dengue infection during the outbreak in 2009 in Colima, Mexico and it analyzes the effect of the interaction in relation to the progression of HIV disease.
Methods:
Whole blood samples from 22 HIV-1-infected patients who were suspected to have dengue infection were analyzed. The diagnosis of dengue infection was confirmed through the detection of NS1 antigen using SD Bioline Dengue Duo Rapid Test. Dengue virus serotype was determined by RT-PCR technique. Amplicons were cloned and submitted for automated sequencing for both strands. Comparison of the sequences with all of those published in GenBank (NCBI) were done using Blast Software. Written informed consent was obtained under the protocol approved by the Ethical Review Committee of the Center for Biomedical Research, University of Colima.
Results:
We tested 22 whole blood samples from HIV-1-infected patients in our laboratory, and 7 were positive for Dengue virus type 1. Two strains of DEN1 were identified in these infections. The strains were DENV-1/MX/BID-V3664/2006 (GenBank: GQ868499) and DENV-1/MX/BID-V3744/2008 (GenBank: GQ868529) with a similarity of 99% each. CD4+ cells remained at normal levels and it was not observed an accelerated progression of HIV disease.
Conclusions:
This is the fifth and largest report dealing with a coinfection among HIV and Dengue virus in the world, and the first report documented in Mexico. The lack of complications associated with this interaction suggests that this combination is relatively benign. Little has been documented about the interaction among these pathogens and further research is needed to understand the biology of HIV reproduction in the context of coinfection with Dengue virus. Furthermore, this report supports the circulation of multiple genetic variations of DEN1 in hyperendemic areas which may complicate the epidemiological panorama of the disease in those areas.