Data on the prevalence of double infection (DI) in HIV individuals are lacking in Spain. To fill this gap, we analyzed the prevalence of DI in a cohort of men who have sex with men (MSM) and examined factors contributing to DI. We selected 81 MSM attending Centro Sanitario Sandoval, a sexually transmitted diseases clinic in Madrid. We obtained by ultra-deep sequencing the proviral sequences in gag and env genes and performed a phylogenetic analysis for the identification of DI. Clinical, behavioral, host, and viral factors were studied for its association with DI. We detected six individuals with DI and one case of superinfection with a global prevalence of 8.6%. The genetic distance among the subtype B viruses in monoinfected individuals (24.4%) was lower than the distance between the two viruses in subtype B DI individuals (29.5%). Individuals with a high number of sexual contacts (>25 partners/year) had an 8.66 times higher risk of DI (p = .017). In this MSM cohort the prevalence of HIV DI was estimated at 8.6%. DI was strongly associated with the number of sexual partners. Because of the pathogenic consequences of HIV DI, this high prevalence should promote public health programs targeted at high-risk population such as MSM for the control of HIV infection and DI. HIV DI should be considered for a better clinical management of these individuals.

中文翻译：

---

马德里的男男性行为者中，高危性行为导致 HIV-1 双重感染。

西班牙缺乏关于 HIV 个体双重感染 (DI) 流行率的数据。为了填补这一空白，我们分析了男男性行为者 (MSM) 队列中 DI 的患病率，并检查了导致 DI 的因素。我们选择了 81 名 MSM 就诊于马德里的性传播疾病诊所 Centro Sanitario Sandoval。我们通过超深度测序获得了gag和env中的原病毒序列基因并进行系统发育分析以鉴定 DI。研究了临床、行为、宿主和病毒因素与 DI 的关联。我们检测到 6 名 DI 患者和 1 例重复感染病例，全球患病率为 8.6%。单一感染个体中 B 亚型病毒之间的遗传距离（24.4%）低于 B 亚型 DI 个体中两种病毒之间的遗传距离（29.5%）。有大量性接触（> 25 个伴侣/年）的个体患 DI 的风险高 8.66 倍（p = .017）。在这个 MSM 队列中，HIV DI 的流行率估计为 8.6%。DI 与性伴侣的数量密切相关。由于 HIV DI 的致病后果，这种高流行率应促进针对高危人群（如 MSM）的公共卫生计划，以控制 HIV 感染和 DI。为了更好地临床管理这些个体，应考虑 HIV DI。