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Author Topic: Confused about super-infection.  (Read 5102 times)

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Offline mecch

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Confused about super-infection.
« on: December 29, 2009, 01:41:40 PM »
A lot of the hiv+ gay guys around me seem to screw without condoms. 
I just got a lecture from one who does not, warning me and the community at length about super-infection.
I will see my specialist in two weeks - I think from a doctor we only get the legal and medical opinion - all the diseases you could still catch - the few cases of super-infection, etc.
Has anyone in this forum ever got the nod from an HIV specialist that super-infection is not a risk (but other things certainly are, of course).  Just interested in the message on HIV super-infection - I know all about other STDs.
thanks.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline pozniceguy

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Re: Confused about super-infection.
« Reply #1 on: December 29, 2009, 07:48:42 PM »
I discussed this with my ID Dr,  he specializes in HIV and other chronic diseases, most of his patients are HIV+   He  has been my Dr since initial diagnosis.  ( jan 1994)  according to his records he has only seen 2 cases of what might be called "super-infection"  in all those years....hundreds of patients, years of records and he also runs a "studies clinic"     so I guess it is possible but very unlikely...


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Offline newt

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Re: Confused about super-infection.
« Reply #2 on: December 29, 2009, 08:26:26 PM »
I think possible but unlikely is the correct conclusion, especially if you are on treatment. I am sure it happens, and happens more often than is recorded, but whether it is clinically siginifcant - which is the main point - seems to be only true in very, very few cases. I can give you a list of other things, transmissable and not, I am more worried about, eg syphilis and bone density reduction, hepatitis C and heart disease etc etc. - matt
"The object is to be a well patient, not a good patient"

Offline minismom

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Re: Confused about super-infection.
« Reply #3 on: December 29, 2009, 08:49:46 PM »
Mim was diagnosed with a "mega virus" (same as super-infection?) because of the number of med changes she had over a short amount of time and how long it took to get her u/d (22mths).  Her virus also is resistence to a lot of meds.



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Offline RapidRod

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Offline Theyer

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Re: Confused about super-infection.
« Reply #5 on: December 30, 2009, 06:22:29 AM »
Thanks RapidRod, very useful
"If we can find the money to kill people, we can find the money to help people ."  Tony Benn

Offline jclarke

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Re: Confused about super-infection.
« Reply #6 on: December 30, 2009, 11:17:17 AM »
Well, not sure about this "super-infection" issue.  I was extremely promiscuis with both genders for many years.  With men, I was bottom, I very much enjoyed giving oral and having my ass "used".  With girls, I enjoyed "using" them.

Then, I got married 19 years ago (I'm 56 now), and 3 1/2 years into being married, and our son 7 months old, I was diagnosed as having AIDS (CD4 < 50), and Jane was HIV+.  Our son "escaped" being infected.

Jane has had to change meds several times, whereas I have only changed twice.  Her CD4 count is over 700, VL undetectable, as is mine.

So, not sure if things have changed as far as the potency of the virus is concerned, I do know it acts differently between men and women, and it changes from person to person.

Offline Ann

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Re: Confused about super-infection.
« Reply #7 on: December 30, 2009, 11:51:02 AM »
The "super" in the term superinfection does not mean super as in super-duper, it means super as in superimposed. One on top of the other. Hiv superinfection refers to being infected with more than one type of hiv. For example, a person could have been infected with clade B hiv and then get infected with clade C hiv.  Or they could be infected with a "wild type" virus and then subsequently become infected with a drug-resistant virus. I've got a wild clade C. ;D

Everything I've read on the subject seems to point to the idea that superinfection is only a danger when one is newly infected in the first place - in other words, before the body has come to grips with the original infection.

My doctor told me that I shouldn't worry about superinfection. I have unprotected sex with my hiv postiive partner and I don't worry about it.

Ann
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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

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Offline mecch

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Re: Confused about super-infection.
« Reply #8 on: December 30, 2009, 11:54:10 AM »
Thanks for your thoughts, and for that link, rapid.

I don't know what to decide.  My inner pig says whoop it up, while my inner angel says be wise.  
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline GSOgymrat

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Re: Confused about super-infection.
« Reply #9 on: December 30, 2009, 11:55:58 AM »
http://www.caps.ucsf.edu/pubs/FS/revsuperinfection.php

Very good link.

The "super" in the term superinfection does not mean super as in super-duper, it means super as in superimposed. One on top of the other. Hiv superinfection refers to being infected with more than one type of hiv. For example, a person could have been infected with clade B hiv and then get infected with clade C hiv.  Or they could be infected with a "wild type" virus and then subsequently become infected with a drug-resistant virus. I've got a wild clade C. ;D
Ann

I'm glad you clarified this.

Offline lilguru

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Re: Confused about super-infection.
« Reply #10 on: December 30, 2009, 12:44:59 PM »
As a long-term survivor (22 years), I have been told by several doctors that my virus is a very weak strain.  I have always been very careful not to get exposed to another strain of virus.  I was without meds for 14 years and started them (combivir and viramune) in 2001.  My numbers are 700/u/d.  I have always felt "lucky" that my virus is weak and that I never progressed to the point of no return.  I think we should all keep in mind that there are many more viruses out there that we can be exposed to and we have to take precautions.
September 1987 - HIV+

Offline Los Angeles Native

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Re: Confused about super-infection.
« Reply #11 on: December 30, 2009, 01:28:45 PM »
When I discussed superinfection with my infectious disease doctor, he more or less just acknowledged it's existence but didn't seem concerned with it's occurence.   

Offline Forevergreen

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Re: Confused about super-infection.
« Reply #12 on: December 30, 2009, 03:47:31 PM »
i discussed superinfection with my doc a couple of months ago. he's a hiv specialist and participates in a very well respected hiv clinic in my city, so he's seen a lot of cases and informed about the latest studies and new info. he told me that most doctors won't advocate unprotected sex between poz partners because there's a theoretical risk of contracting another strain. he told me that it isn't likely especially for someone who has been infected for awhile. he didn't say how long, but i've been poz for 3 years and he said that it was very unlikely for me and didn't seem worried about my exposure to other poz partners. i never use condoms anymore.

Offline mecch

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Re: Confused about super-infection.
« Reply #13 on: December 30, 2009, 08:33:03 PM »
HIV 1.5 years and on HAART already as well.
Does being on HAART protect from a new HIV infection? I suppose in theory I could get a virus that is resistant to my HAART.  That would ... ugh.. suck. But is it only theoretical?

I could go deeper into the whys of all this. Have you all done so?

For instance I thought about it again recently because some guys invited me to a raw sex party and they are all HIV+.  And I didn't accept.  But then, I never liked chem sex (besides booze and poppers) and never liked orgies so I think I didn't accept because of that, more than the raw part.

I guess I should just stick to my 25+ years of safe sex habits with casual sex, even though it seems like I could enjoy condomless sex now.  But the guys are not exactly knocking at my door for casual safe sex.  Most of my former f*buddies dropped me like Typhoid Mary.  I gave up contacted any of them, eventually.

It seems Im more or less still desireable on the HIV+ market but not very much so on the HIV- market, (or those in denial, or those who don't want to disclose) so I guess I should bide my time and find a new boyfriend and avoid all the marketing alltogether. Hehehe.  

Have to admit I'm a bit curious for wanton raw sex but at what price?  

Looking back on all my relationships, I don't think it made any difference in the long run whether I was doing it with or without condoms with my boyfriends (some were exclusively safe sex, the last really long term one was unsafe in the couple, safe outside - you know the pattern...)  

I feel pretty horny again and more in my shoes as HIV+ and suddenly I want to try a bunch of stuff i never tried before with strangers....  
WHY????????
« Last Edit: December 30, 2009, 08:35:34 PM by mecch »
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Assurbanipal

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Re: Confused about super-infection.
« Reply #14 on: December 31, 2009, 04:40:01 PM »
Risk is about the combination of likelihood and the severity of the consequences.


So far you've gotten a lot of discussion about the likelihood.  But what about the severity of the consequences?

I think many of us assume that should the unlikely superinfection occur, we would have plenty of time to catch developing drug resistance and switch to another regimen, given that we get lab work every 3 months or so.  But with your own fairly unique history as a very rapid progressor, would you have the same amount of time to catch a problem?  That might mean that the consequences would be relatively more severe?  Has your doc taken your specific situation into account in taking this line with you (I think you said he is a leading Swixx HIV specialist in other posts). 

Might be worth exploring how your doc views your risk (likelihood and consequence) vs. that of other of his patients who bareback.






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Offline mecch

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Re: Confused about super-infection.
« Reply #15 on: December 31, 2009, 08:52:03 PM »
Thats a good question to ask, Assurb, next friday i see the ID.  He pretty much sticks to doctor appropriate response (err on side of caution, very conservative with treatment, no discussing anything which is not medical and scientific - he always says "the medical opinion on that is xzy...... and I have no other comment...").  I guess that has its good points and bad points. The good point is that when he said HAART would work, even for me, I believed him even if the shock of those first months made me not trust my own belief. 

I'm getting over a rotten post xmas flu - barely got down a flute of champagne tonight! Happy New Year.  It was horrible just to have the flu.  I guess I should always remember that my health is a priority. 
Maybe I shojuld take the New Year New Decade spirit and do something radical but healthy for my body and spirit, like a huge hike or bike ride this summer, and start training for it now, and keep sex on the back burner.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline newt

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Re: Confused about super-infection.
« Reply #16 on: December 31, 2009, 09:07:24 PM »
It is important to get the sex you want at minimal risk to yourself and others. - matt
"The object is to be a well patient, not a good patient"

Offline Cliff

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Re: Confused about super-infection.
« Reply #17 on: January 01, 2010, 06:08:49 AM »
Maybe I shojuld take the New Year New Decade spirit and do something radical but healthy for my body and spirit, like a huge hike or bike ride this summer, and start training for it now, and keep sex on the back burner.
I think you should keep sex at the forefront AND do the hiking, biking thing.

I'm not convinced superinfection/reinfection is a significant issue.  I think likelihood and consequence is a good point.  I just don't know if you're going to gain much clarity from a discussion with your doctor.  It happens.  It likely happens more than people think and is just missed.  But it probably has minimal impact on all but a very few.  About two years ago, maybe longer, my tcell count dropped significantly (from say 600-800 range to 100-200) and viral load shot up.  Doc at the time said it's time to take meds and referred me to another doc to start that process.  That doc said this is odd, it normally doesn't happen like this.  They ran a few more tests and believed it was a reinfection (superinfection, but I kinda don't like that word).  By the time the tests were done and dusted, my viral load went back to normal as did the tcell count.  This would have been an unknown event had I taken my labs a few weeks earlier/later.

Anyways, there are more important things to worry about (other STIs, emotional baggage that can come with sleeping around, etc..).  I used to have lots of walls/rules that kept me safe but not really just mostly prevented me from having the life I wanted.  I now keep only the bare minimum of walls to keep me (and others) safe, but can still get out there and do what I want.  This is all quite personal.  For me, I don't wanna contemplate woulda, coulda, shoulda somewhere down the line.  I make the best decision I can and accept there may be consequences.  I trust my own judgement and simply move forward.  Having a fun life is just as important as having a safe one; to me!
« Last Edit: January 01, 2010, 07:30:23 AM by Cliff »

Offline tednlou2

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Re: Confused about super-infection.
« Reply #18 on: January 04, 2010, 12:36:02 AM »
I get different answers on this issue as well.  I know docs on thebody say it is unlikely and rare.  My HIV pharmacist insists it is very real and she claims she sees several people who are super infected.  She says she can tell when their vl goes up after years of being undetectable.  She also says she sees it in couples who are both poz.  Who knows.  As I've said on here before, I've been skeptical of both my HIV doc and pharmacist.  But maybe they are right.  You would think that if you could get infected with HIV once, then you could get infected several times.

I know it is frustrating when a couple are both poz and are told, "Oh, you still have to use condoms." 

Offline jclarke

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Re: Confused about super-infection.
« Reply #19 on: January 04, 2010, 04:19:49 PM »
Well, Jane (female, my wife,  ;D ) she was + while we found my CD4's were below 50 (Valentine's Day, 1993).  And, as time went on, I went from 25 pills daily (5 years of the Crix!  That took some f'ing doing), down to simply Viramune and Combivir.  Jane is on a more complex set, altho' her VL is undetectable (as is mine) and has been since before 1998), and her CD4's have climbed from 200 to over 700 (as is mine).  

We both detest the condom  :o and have heard, or not heard to use it (we don't).  We enjoy the fluids too much  :D .  We almost kind of look at it like we do our cholestorol.  Also, our "intamicies" are infrequent with usually a couple of weeks inbetween.  We're not in the best shape in the world, but we keep busy.  She works part-time at a place she enjoys, and I'm chief cook and bottle washer (we also have 16 yr. son).  I can make a dam good cheesecake  ;D , and clean house and do the laundry.

My biggest complaint about my appearence is I look like almost ready to drop a baby (6'5", 208), and it looks emabarrassing.  An MD I'm seeing thinks I have bad bacteria in my gut, so had me take some high level antibiotics, and now has me on Align.  Things kind of move when they want to, and when they want to, it's f'ing right now.  Have had accidents in more places than I want to think of.
« Last Edit: January 04, 2010, 04:21:39 PM by jclarke »

Offline bismarck06

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Re: Confused about super-infection.
« Reply #20 on: January 07, 2010, 05:07:03 PM »
This article I was reading on this topic is very interesting:

Title: Unprotected sex between long-term partners with HIV: no evidence for superinfection

Link: http://www.aidsmap.com/en/news/29AD410B-DD10-43B7-A8AE-D86B1EE79E63.asp

I believe the greater risk between two HIV+ people not wearing condoms is exposure to STI's and not exposure to another strain/version of HIV.

Interesting topic.


Offline OddlyEven

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Re: Confused about super-infection.
« Reply #21 on: January 12, 2010, 11:59:30 AM »
Interesting topic. This is what worried me about my latest test results because days before I had my test results, I had unprotected sex with another HIV + individual. I know I shouldn't do that...but I did. It seems there isn't a clear answer on this one.

Offline newt

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Re: Confused about super-infection.
« Reply #22 on: January 12, 2010, 04:32:57 PM »
Quote
I know I shouldn't do that...

I am interested to know why. In the case of unprotected (anal or vaginal) sex with an HIV-negative individual I know why, but with HIV-positive people I don't particularly. Clearly, risk of other "standard" infections, hepatitis n all that, but otherwise, why (or indeed why not)?

- matt
"The object is to be a well patient, not a good patient"

Offline OddlyEven

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Re: Confused about super-infection.
« Reply #23 on: January 12, 2010, 05:01:11 PM »
I've always been advised to not even do it with another HIV + person because of risk of super-infection and drug resistant viruses. I honestly don't know what to believe regarding this issue. I'm hearing and reading two different stories here.

Offline mecch

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Re: Confused about super-infection.
« Reply #24 on: January 12, 2010, 08:30:38 PM »
In a related matter - on the gay chat and cruise site - how many HIV- guys use these two questions
Tu es OK?  (Are you OK)
and
T clean? (Are you clean - yeah the English word and it means HIV-).

Voila. I'm not OK (what's the opposite of not ok) and I'm dirty...  Does this stigma make me fear bareback sex with other "not ok dirty" guys? 

Just semantics, but....
“From each, according to his ability; to each, according to his need” 1875 K Marx

 


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