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Coinfection
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Coinfection is the simultaneous of a host by multiple . In , coinfection includes simultaneous infection of a single cell by two or more particles. An example is the coinfection of cells with hepatitis B virus and hepatitis D virus, which can arise incrementally by initial infection followed by .

Global or incidence of coinfection among humans is unknown, but it is thought to be commonplace, sometimes more common than single infection. Coinfection with affects around 800 million people worldwide.

Coinfection is of particular human health importance because pathogen species can interact within the host. The net effect of coinfection on human health is thought to be negative. Interactions can have either positive or negative effects on other parasites. Under positive parasite interactions, disease transmission and progression are enhanced and this is also known as . Negative parasite interactions include microbial interference when one bacterial species suppresses the or colonisation of other bacteria, such as Pseudomonas aeruginosa suppressing pathogenic Staphylococcus aureus colony formation. The general patterns of ecological interactions between parasite species are unknown, even among common coinfections such as those between sexually transmitted infections. However, of a of coinfection in humans suggests that there is greater potential for interactions via shared food sources than via the .

A globally common coinfection involves and . In some countries, up to 80% of tuberculosis patients are also HIV-positive. The potential for dynamics of these two infectious diseases to be linked has been known for decades. Other common examples of coinfections are , which involves coinfection of end-stage with opportunistic parasites and polymicrobial infections like with other diseases. Coinfections sometimes can epitomize a zero sum game of bodily resources, and precise viral quantitation demonstrates children co-infected with and respiratory syncytial virus, or parainfluenza virus have lower nasal viral loads than those with rhinovirus alone.


Poliovirus
Poliovirus is a positive single-stranded RNA virus in the family . Coinfections appear to be common and several pathways have been identified for transmitting multiple virions to a single host cell.Aguilera ER, Pfeiffer JK. Strength in numbers: Mechanisms of viral co-infection. Virus Res. 2019;265:43-46. doi:10.1016/j.virusres.2019.03.003 These include transmission by virion aggregates, transmission of viral within membrane vesicles, and transmission by bound by several viral particles.

Drake demonstrated that poliovirus is able to undergo multiplicity reactivation. That is, when polioviruses were irradiated with UV light and allowed to undergo multiple infections of host cells, viable progeny could be formed even at UV doses that inactivated the virus in single infections. Poliovirus can undergo genetic recombination when at least two viral are present in the same host cell. Kirkegaard and Baltimore presented evidence that RNA-dependent RNA polymerase (RdRP) catalyzes recombination by a copy choice mechanism in which the RdRP switches between (+)ssRNA templates during negative strand synthesis. Recombination in RNA viruses appears to be an adaptive mechanism for transmitting an undamaged genome to virus progeny.


Examples
  • Anaplasmosis
  • Bacteriophage coinfection
  • GB virus C
  • HIV-HCV coinfection
  • HIV-TB coinfection (enhances TB transmission and lethality)
  • Hookworm-malaria coinfection
  • Mansonella perstans
  • Trichuriasis
  • and coinfection
  • and HIV coinfection (suppresses HIV)
  • and HIV coinfection
  • Most sexually transmitted diseases and HIV (enhance HIV transmission)
  • Some COVID-19 patients, or those who were ill with other , can be co-infected with seasonal (flu) viral strains, certain viral strains that cause the , or can be co-infected with or from another bacterial or viral micro-organism. Even more dangerous, some of them could already have conditions like or active that make patients very vulnerable.


See also
  • Infectious disease
  • List of human diseases associated with infectious pathogens
  • Opportunistic infection


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