We encountered a case of serial HIV-1 superinfection resulting in a triple infection in a Dutch patient who was originally infected with a subtype B virus
. A 35-year-old homosexual man was found to be HIV-1–seropositive in March 2001 and was referred for follow-up. Early in July 2003, the patient presented with acute onset of fever, rhinorrhea, cough, and arthralgia; the symptoms lasted for approximately one week. A plasma sample drawn during the episode of illness on July 24, 2003, showed an extremely high HIV-1 load with a markedly reduced CD4+ cell count (Figure 1FIGURE 1
Changes in Plasma HIV-1 RNA Levels, CD4+ Cell Counts, and Viral Sequences in Samples Obtained from a Dutch Patient Serially Infected with Three Strains of HIV-1.
). Analysis of serial samples for viral genotype provided evidence of a novel HIV-1