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

SpecialtyInfectious disease

Global prevalence or incidence of coinfection among humans is unknown, but it is thought to be commonplace,[1] sometimes more common than single infection.[2] Coinfection with helminths affects around 800 million people worldwide.[3]

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.[4] 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 syndemism. Negative parasite interactions include microbial interference when one bacterial species suppresses the virulence or colonisation of other bacteria, such as Pseudomonas aeruginosa suppressing pathogenic Staphylococcus aureus colony formation.[5] The general patterns of ecological interactions between parasite species are unknown, even among common coinfections such as those between sexually transmitted infections.[6] However, network analysis of a food web of coinfection in humans suggests that there is greater potential for interactions via shared food sources than via the immune system.[7]

A globally common coinfection involves tuberculosis and HIV. In some countries, up to 80% of tuberculosis patients are also HIV-positive.[8] The potential for dynamics of these two infectious diseases to be linked has been known for decades.[9] Other common examples of coinfections are AIDS, which involves coinfection of end-stage HIV with opportunistic parasites[10] and polymicrobial infections like Lyme disease with other diseases.[11]



See alsoEdit


  1. ^ Cox, FE (2001). "Concomitant infections, parasites and immune responses". Parasitology. 122. Suppl: S23–38. doi:10.1017/s003118200001698x. PMID 11442193.
  2. ^ Petney, TN; Andrews, RH (1998). "Multiparasite communities in animals and humans: frequency, structure and pathogenic significance". International Journal for Parasitology. 28 (3): 377–93. doi:10.1016/S0020-7519(97)00189-6. PMID 9559357.
  3. ^ Crompton, DW (1999). "How much human helminthiasis is there in the world?". The Journal of Parasitology. 85 (3): 397–403. doi:10.2307/3285768. JSTOR 3285768. PMID 10386428.
  4. ^ Griffiths, EC; Pedersen, ABP; Fenton, A; Petchey, OP (2011). "The nature and consequences of coinfection in humans". Journal of Infection. 63 (3): 200–206. doi:10.1016/j.jinf.2011.06.005. PMC 3430964. PMID 21704071.
  5. ^ Hoffman, L. R.; Deziel, E.; D'argenio, D. A.; Lepine, F.; Emerson, J.; McNamara, S.; Gibson, R. L.; Ramsey, B. W.; Miller, S. I. (2006). "Selection for Staphylococcus aureus small-colony variants due to growth in the presence of Pseudomonas aeruginosa". Proceedings of the National Academy of Sciences. 103 (52): 19890–5. doi:10.1073/pnas.0606756104. PMC 1750898. PMID 17172450.
  6. ^ Shrestha, S. (2011). "Influence of host genetic and ecological factors in complex concomitant infections – relevance to sexually transmitted infections". Journal of Reproductive Immunology. 92 (1–2): 27–32. doi:10.1016/j.jri.2011.09.001. PMID 22019002.
  7. ^ Griffiths, E.; Pedersen, A.; Fenton, A.; Petchey, O. (2014). "Analysis of a summary network of co-infection in humans reveals that parasites interact most via shared resources". Proceedings of the Royal Society B. 281 (1782): 20132286. doi:10.1098/rspb.2013.2286. PMC 3973251. PMID 24619434.
  8. ^ "Tuberculosis and HIV". World Health Organization.
  9. ^ Di Perri, G; Cruciani, M; Danzi, MC; Luzzati, R; De Checchi, G; Malena, M; Pizzighella, S; Mazzi, R; et al. (1989). "Nosocomial epidemic of active tuberculosis among HIV-infected patients". Lancet. 2 (8678–8679): 1502–4. doi:10.1016/s0140-6736(89)92942-5. PMID 2574778.
  10. ^ Lawn, SD (2004). "AIDS in Africa: the impact of coinfections on the pathogenesis of HIV-1 infection". Journal of Infection. 48 (1): 1–12. doi:10.1016/j.jinf.2003.09.001. PMID 14667787.
  11. ^ Mitchell, PD; Reed, KD; Hofkes, JM (1996). "Immunoserologic evidence of coinfection with Borrelia burgdorferi, Babesia microti, and human granulocytic Ehrlichia species in residents of Wisconsin and Minnesota". Journal of Clinical Microbiology. 34 (3): 724–7. PMC 228878. PMID 8904446.

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