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The first cases of dual HIV infection (i.e., infection with 2 or more distinct viral strains, presumably from different source patients) were described in 2002. To date, most cases of dual infection have been notable for rapid progression of clinical disease. Now, researchers in Spain describe two cases of dual infection among patients with long-term, nonprogressive HIV disease (>15 years of infection, no symptoms, low viral loads, and preserved CD4-cell counts in the absence of antiretroviral therapy).
Phylogenetic analysis demonstrated that each patient was infected with two distinct viral populations. Multiple samples obtained during chronic infection showed persistent dual infection; samples from early after HIV seroconversion, when dual…