Question
Could I have picked up a different strain of HIV?
2 April 2009. Related: All topics, HIV reinfection (superinfection), HIV transmission, Resistance.
I was infected aproximately in year 2000. I was diagnosed in 2008. Between these years, could I have picked up different strains of HIV from different partners? Or, perhaps, created my own strain of HIV? Is this the way it operates? My medicines are Truvada and efavirenz. Thank you.
Answer
If you had unprotected sex with HIV positive partners during those years, then there is a chance that you have been reinfected with a different strain of HIV.
That is why, nowadays, it is almost imperative to have a genotype resistance test before you start treatment. Most probably, your clinic has done that for you to avoid putting you on medicines that may not work for you, but it always worth asking.
As for a ‘personalised’ strain of the virus, this happens to everyone. After infection, HIV makes small mistakes when it reproduces. This means not only that everyone develops their own individual variations, but that everyone develops a wide range of similar but slightly different versions of their own strain.
This only becomes clinically important if resistance develops to one or more ARVs. HIV with no drug resistance is called wild-type. The majority of the people have the wild strain, but unfortunately, sometimes they may be infected or reinfected with a resistant strain. Resistance appears when people are not adherent to the medicines. There is more information about drug resistance here.