1
|
|
2
|
Balestre E, Ekouevi DK, Tchounga B, Eholie SP, Messou E, Sawadogo A, Thiébaut R, May MT, Sterne JA, Dabis F. Immunologic response in treatment-naïve HIV-2-infected patients: the IeDEA West Africa cohort. J Int AIDS Soc 2016; 19:20044. [PMID: 26861115 PMCID: PMC4748109 DOI: 10.7448/ias.19.1.20044] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 12/09/2015] [Accepted: 12/21/2015] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Response to antiretroviral therapy (ART) among individuals infected with HIV-2 is poorly described. We compared the immunological response among patients treated with three nucleoside reverse-transcriptase inhibitors (NRTIs) to boosted protease inhibitor (PI) and unboosted PI-based regimens in West Africa. METHODS This prospective cohort study enrolled treatment-naïve HIV-2-infected patients within the International Epidemiological Databases to Evaluate AIDS collaboration in West Africa. We used mixed models to compare the CD4 count response to treatment over 12 months between regimens. RESULTS Of 422 HIV-2-infected patients, 285 (67.5%) were treated with a boosted PI-based regimen, 104 (24.6%) with an unboosted PI-based regimen and 33 (7.8%) with three NRTIs. Treatment groups were comparable with regard to gender (54.5% female) and median age at ART initiation (45.3 years; interquartile range 38.3 to 51.8). Treatment groups differed by clinical stage (21.2%, 16.8% and 17.3% at CDC Stage C or World Health Organization Stage IV for the triple NRTI, boosted PI and unboosted PI groups, respectively, p=0.02), median length of follow-up (12.9, 17.7 and 44.0 months for the triple NRTI, the boosted PI and the unboosted PI groups, respectively, p<0.001) and baseline median CD4 count (192, 173 and 129 cells/µl in the triple NRTI, the boosted PI and the unboosted PI-based regimen groups, respectively, p=0.003). CD4 count recovery at 12 months was higher for patients treated with boosted PI-based regimens than those treated with three NRTIs or with unboosted PI-based regimens (191 cells/µl, 95% CI 142 to 241; 110 cells/µl, 95% CI 29 to 192; 133 cells/µl, 95% CI 80 to 186, respectively, p=0.004). CONCLUSIONS In this observational study using African data, boosted PI-containing regimens had better immunological response compared to triple NRTI combinations and unboosted PI-based regimens at 12 months. A randomized clinical trial is still required to determine the best initial regimen for treating HIV-2 infected patients.
Collapse
Affiliation(s)
- Eric Balestre
- University Bordeaux, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000 Bordeaux, France;
| | - Didier Koumavi Ekouevi
- University Bordeaux, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- Programme PAC-CI, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire;
| | - Boris Tchounga
- University Bordeaux, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- Programme PAC-CI, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | - Serge Paul Eholie
- Programme PAC-CI, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
- Service de Maladies Infectieuses et Tropicales, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
- Département de Dermatologie-Infectiologie de l'Unité de Formation et de Recherche des Sciences médicales, Université Félix Houphouet Boigny, Abidjan, Côte d'Ivoire
| | - Eugène Messou
- Programme PAC-CI, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
- Centre de Prise en charge de Recherche et de Formation, Hôpital Yopougon Attié, Abidjan, Côte d'Ivoire
| | - Adrien Sawadogo
- Institut Supérieur des Sciences de la santé, Université Polytechnique de Bobo-Dioulasso, Nasso, Burkina Faso
| | - Rodolphe Thiébaut
- University Bordeaux, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| | - Margaret T May
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, United Kingdom
| | - Jonathan Ac Sterne
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, United Kingdom
| | - François Dabis
- University Bordeaux, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
- INSERM, ISPED, Centre INSERM U1219-Epidemiologie-Biostatistique, F-33000 Bordeaux, France
| |
Collapse
|
3
|
Jespersen S, Hønge BL, Oliveira I, Medina C, da Silva Té D, Correira FG, Erikstrup C, Laursen AL, Østergaard L, Wejse C. Cohort Profile: The Bissau HIV Cohort-a cohort of HIV-1, HIV-2 and co-infected patients. Int J Epidemiol 2014; 44:756-63. [PMID: 25342251 DOI: 10.1093/ije/dyu201] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2014] [Indexed: 12/27/2022] Open
Abstract
The West African country Guinea-Bissau is home to the world's highest prevalence of HIV-2, and its HIV-1 prevalence is rising. Other chronic viral infections like human T-lymphotropic virus type 1 (HTLV-1) and hepatitis B virus are common as well. The Bissau HIV Cohort was started in 2007 to gain new insights into the overall effect of introducing antiretroviral treatment in a treatment-naïve population with concomitant infection with three retroviruses (HIV-1, HIV-2 and HTLV-1) and tuberculosis. The cohort includes patients from the HIV clinic at Hospital Nacional Simão Mendes, the main hospital in Bissau, the capital of the country. From July 2007 to June 2013, 3762 HIV-infected patients (69% HIV-1, 18% HIV-2, 11% HIV-1/2 and 2% HIV type unknown) were included in the world's largest single-centre HIV-2 cohort. Demographic and clinical data are collected at baseline and every 6 months, together with CD4 cell count and routine biochemistry analyses. Plasma and cells are stored in a biobank in Denmark. The Bissau HIV Cohort is administered by the Bissau HIV Cohort study group. Potential collaborators are invited to contact the chair of the cohort study group, Christian Wejse, e-mail: [wejse@dadlnet.dk].
Collapse
Affiliation(s)
- Sanne Jespersen
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau, Department of Infectious Diseases, Aarhus University Hospital, Copenhagen, Denmark,
| | - Bo Langhoff Hønge
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau, Department of Infectious Diseases, Aarhus University Hospital, Copenhagen, Denmark
| | - Inés Oliveira
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau
| | - Candida Medina
- National HIV Programme, Ministry of Health, Bissau, Guinea-Bissau
| | | | | | | | - Alex Lund Laursen
- Department of Infectious Diseases, Aarhus University Hospital, Copenhagen, Denmark
| | - Lars Østergaard
- Department of Infectious Diseases, Aarhus University Hospital, Copenhagen, Denmark
| | - Christian Wejse
- Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau, Department of Infectious Diseases, Aarhus University Hospital, Copenhagen, Denmark, Center for Global Health, Aarhus University, Copenhagen, Denmark
| | | |
Collapse
|
4
|
Antiretroviral therapy response among HIV-2 infected patients: a systematic review. BMC Infect Dis 2014; 14:461. [PMID: 25154616 PMCID: PMC4156654 DOI: 10.1186/1471-2334-14-461] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 08/15/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Few data are available on antiretroviral therapy (ART) response among HIV-2 infected patients. We conducted a systematic review on treatment outcomes among HIV-2 infected patients on ART, focusing on the immunological and virological responses in adults. METHODS Data were extracted from articles that were selected after screening of PubMed/MEDLINE up to November 2012 and abstracts of the 1996-2012 international conferences. Observational cohorts, clinical trials and program reports were eligible as long as they reported data on ART response (clinical, immunological or virological) among HIV-2 infected patients. The determinants investigated included patients' demographic characteristics, CD4 cell count at baseline and ART received. RESULTS Seventeen reports (involving 976 HIV-2 only and 454 HIV1&2 dually reactive patients) were included in the final review, and the analysis presented in this report are related to HIV-2 infected patients only. There was no randomized controlled trial and only two cohorts had enrolled more than 100 HIV-2 only infected patients. The median CD4 count at ART initiation was 165 cells/mm3, [IQR; 137-201] and the median age at ART initiation was 44 years (IQR: 42-48 years). Ten studies included 103 patients treated with three nucleoside reverse transcriptase inhibitors (NRTI). Protease inhibitor (PI) based regimens were reported by 16 studies. Before 2009, the most frequent PIs used were Nelfinavir and Indinavir, whereas it was Lopinavir/ritonavir thereafter. The immunological response at month-12 was reported in six studies and the mean CD4 cell count increase was +118 cells/μL (min-max: 45-200 cells/μL). CONCLUSION Overall, clinical and immuno-virologic outcomes in HIV-2 infected individuals treated with ART are suboptimal. There is a need of randomized controlled trials to improve the management and outcomes of people living with HIV-2 infection.
Collapse
|
5
|
Sustained virological response to a raltegravir-containing salvage therapy in an HIV-2-infected patient. AIDS 2011; 25:2306-8. [PMID: 22067200 DOI: 10.1097/qad.0b013e32834cdb89] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
6
|
Mortality and immunovirological outcomes on antiretroviral therapy in HIV-1 and HIV-2-infected individuals in the Gambia. AIDS 2011; 25:2167-75. [PMID: 21881480 DOI: 10.1097/qad.0b013e32834c4adb] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study's objective was to assess outcomes in HIV-1 and HIV-2 infected antiretroviral therapy (ART)-naïve patients starting ART in the Gambia, West Africa. DESIGN A cohort design was used to estimate survival in ART patients and determine whether survival and time to virologic failure varied across patient subgroups. METHODS Mortality, virologic failures and CD4(+) cell recovery were assessed in a clinical cohort of patients from the Genito-Urinary Medicine (GUM) clinic of the MRC Laboratories in the Gambia. Kaplan-Meier estimates of survival were determined for mortality and virologic failure. A Cox proportional hazards model was used to identify baseline demographic, clinical, immunologic and virologic factors associated with increased risk of death. RESULTS The overall Kaplan-Meier estimate of survival to 36 months was 73.4% (66.5, 80.3). Survival was marginally higher in HIV-2-infected patients compared to HIV-1-infected patients; it was significantly higher in patients with a baseline CD4(+) lymphocyte cell count of greater than 50 cells/μl compared to those with a baseline CD4(+) count of less than 50 cells/μl. CD4(+) cell recovery was faster in HIV-1-infected individuals compared to HIV-2-infected patients up to 24 months, although this did not result higher mortality in the latter group. No differences in virologic failure were observed by HIV type. CONCLUSION HIV-1 and HIV-2-infected patients receiving ART in a clinical setting in the Gambia had good survival to 36 months. HIV-2-infected patients did as well as HIV-1-infected patients in terms of long-term immunological and virological responses and overall survival.
Collapse
|
7
|
Benard A, van Sighem A, Taieb A, Valadas E, Ruelle J, Soriano V, Calmy A, Balotta C, Damond F, Brun-Vezinet F, Chene G, Matheron S. Immunovirological response to triple nucleotide reverse-transcriptase inhibitors and ritonavir-boosted protease inhibitors in treatment-naive HIV-2-infected patients: The ACHIEV2E Collaboration Study Group. Clin Infect Dis 2011; 52:1257-66. [PMID: 21507923 DOI: 10.1093/cid/cir123] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Triple nucleoside reverse-transcriptase inhibitors (NRTIs) are recommended by the World Health Organization as first-line regimen in treatment-naïve HIV-2-infected patients. However, ritonavir-boosted protease inhibitor (PI/r)-containing regimens are frequently prescribed. In the absence of previous randomized trials, we retrospectively compared these regimens in observational cohorts. METHODS HIV-2-infected patients from 7 European cohorts who started triple NRTI or PI/r since January 1998 were included. Piecewise linear models were used to estimate CD4 cell count and plasma HIV-2 RNA level slopes, differentiating an early phase (until end of month 3) and a second phase (months 4-12). On-treatment analyses censored data at major treatment modification and systematically at month 12. RESULTS Forty-four patients started triple NRTI therapy and 126 started PI/r therapy. Overall, the median CD4 cell count was 191 cells/mm(3) and the median plasma HIV-2 RNA level was ≥2.7 log(10) copies/ml in 61% of the patients at combination antiretroviral therapy (cART) initiation; the median duration of the first cART was 20 months, not differing between groups. PI/r regimens were associated with better CD4 cell count and HIV-2 RNA level outcomes, compared with NRTI regimens. Estimated CD4 cell count slopes were +6 and +12 cells/mm(3)/month during the early phase (P = .22), and -60 cells/mm(3)/year versus +76 cells/mm(3)/year during the second phase (P = .002), for triple NRTI and PI/r, respectively. Estimated mean HIV-2 RNA levels at month 12 in patients with detectable viremia at cART initiation were 4.0 and 2.2 log(10) copies/ml, respectively (P = .005). CONCLUSIONS In this observational study, PI/r-containing regimens showed superior efficacy over triple NRTI regimens as first-line therapy in HIV-2-infected patients.
Collapse
|
8
|
Almaghrabi RS, Ali B, Al-Thawadi S, Halim MA, Alrajhi AA. Human immunodeficiency virus type 2 in two Saudi families. Ann Saudi Med 2011; 31:417-20. [PMID: 21293067 PMCID: PMC3156521 DOI: 10.4103/0256-4947.76408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Human immunodeficiency virus type 2 (HIV-2), the second retrovirus that causes the acquired immune deficiency syndrome (AIDS) in humans, is limited in its distribution to West Africa. We report cases in two Saudi families with HIV-2 infection and AIDS, resulting in death of the index cases-the husbands, while the wives and a daughter were maintained on antiretroviral therapy. When HIV viral loads were undetectable in initial assays, further testing confirmed the presence of HIV-2. In the first family, the 30-year-old wife was found to be HIV-positive after the diagnosis in her 30-year-old husband, who later died with AIDS. In the second family, HIV-2 infection was diagnosed in the 50-year-old wife and 18-year-old daughter of a man who had died of AIDS at the age of 48 years. Recognizing HIV-2 infection is essential for appropriate workup, assessment, therapy and care of the pregnant woman.
Collapse
Affiliation(s)
- Reem S Almaghrabi
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | | | | | | |
Collapse
|
9
|
Gilleece Y, Chadwick DR, Breuer J, Hawkins D, Smit E, McCrae LX, Pillay D, Smith N, Anderson J. British HIV Association guidelines for antiretroviral treatment of HIV-2-positive individuals 2010. HIV Med 2011; 11:611-9. [PMID: 20961377 DOI: 10.1111/j.1468-1293.2010.00889.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Y Gilleece
- British HIV Association (BHIVA), BHIVA Secretariat, Mediscript Ltd, London, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Cell-associated viral burden provides evidence of ongoing viral replication in aviremic HIV-2-infected patients. J Virol 2010; 85:2429-38. [PMID: 21159859 DOI: 10.1128/jvi.01921-10] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Viremia is significantly lower in HIV-2 than in HIV-1 infection, irrespective of disease stage. Nevertheless, the comparable proviral DNA burdens observed for these two infections indicate similar numbers of infected cells. Here we investigated this apparent paradox by assessing cell-associated viral replication. We found that untreated HIV-1-positive (HIV-1(+)) and HIV-2(+) individuals, matched for CD4 T cell depletion, exhibited similar gag mRNA levels, indicating that significant viral transcription is occurring in untreated HIV-2(+) patients, despite the reduced viremia (undetectable to 2.6 × 10(4) RNA copies/ml). However, tat mRNA transcripts were observed at significantly lower levels in HIV-2(+) patients, suggesting that the rate of de novo infection is decreased in these patients. Our data also reveal a direct relationship of gag and tat transcripts with CD4 and CD8 T cell activation, respectively. Antiretroviral therapy (ART)-treated HIV-2(+) patients showed persistent viral replication, irrespective of plasma viremia, possibly contributing to the emergence of drug resistance mutations, persistent hyperimmune activation, and poor CD4 T cell recovery that we observed with these individuals. In conclusion, we provide here evidence of significant ongoing viral replication in HIV-2(+) patients, further emphasizing the dichotomy between amount of plasma virus and cell-associated viral burden and stressing the need for antiretroviral trials and the definition of therapeutic guidelines for HIV-2 infection.
Collapse
|
11
|
Gottlieb GS, Badiane NMD, Hawes SE, Fortes L, Toure M, Ndour CT, Starling AK, Traore F, Sall F, Wong KG, Cherne SL, Anderson DJ, Dye SA, Smith RA, Mullins JI, Kiviat NB, Sow PS. Emergence of multiclass drug-resistance in HIV-2 in antiretroviral-treated individuals in Senegal: implications for HIV-2 treatment in resouce-limited West Africa. Clin Infect Dis 2009; 48:476-83. [PMID: 19143530 DOI: 10.1086/596504] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The efficacy of various antiretroviral (ARV) therapy regimens for human immunodeficiency virus type 2 (HIV-2) infection remains unclear. HIV-2 is intrinsically resistant to the nonnucleoside reverse-transcriptase inhibitors and to enfuvirtide and may also be less susceptible than HIV-1 to some protease inhibitors (PIs). However, the mutations in HIV-2 that confer ARV resistance are not well characterized. METHODS Twenty-three patients were studied as part of an ongoing prospective longitudinal cohort study of ARV therapy for HIV-2 infection in Senegal. Patients were treated with nucleoside reverse-transcriptase inhibitor (NRTI)- and PI (indinavir)-based regimens. HIV-2 pol genes from these patients were genotyped, and the mutations predictive of resistance in HIV-2 were assessed. Correlates of ARV resistance were analyzed. RESULTS Multiclass drug-resistance mutations (NRTI and PI) were detected in strains in 30% of patients; 52% had evidence of resistance to at least 1 ARV class. The reverse-transcriptase mutations M184V and K65R, which confer high-level resistance to lamivudine and emtricitabine in HIV-2, were found in strains from 43% and 9% of patients, respectively. The Q151M mutation, which confers multinucleoside resistance in HIV-2, emerged in strains from 9% of patients. HIV-1-associated thymidine analogue mutations (M41L, D67N, K70R, L210W, and T215Y/F) were not observed, with the exception of K70R, which was present together with K65R and Q151M in a strain from 1 patient. Eight patients had HIV-2 with PI mutations associated with indinavir resistance, including K7R, I54M, V62A, I82F, L90M, L99F; 4 patients had strains with multiple PI resistance-associated mutations. The duration of ARV therapy was positively associated with the development of drug resistance (P = .02). Nine (82%) of 11 patients with HIV-2 with no [corrected] detectable ARV resistance had undetectable plasma HIV-2 RNA loads (<1.4 log(10) copies/mL), compared with 3 (25%) of 12 patients with HIV-2 with detectable ARV resistance (P = .009). Patients with ARV-resistant virus had higher plasma HIV-2 RNA loads, compared with those with non-ARV-resistant virus (median, 1.7 log(10) copies/mL [range, <1.4 to 2.6 log(10) copies/mL] vs. <1.4 log(10) copies/mL [range, <1.4 to 1.6 log(10) copies/mL]; P = .003). CONCLUSIONS HIV-2-infected individuals treated with ARV therapy in Senegal commonly have HIV-2 mutations consistent with multiclass drug resistance. Additional clinical studies are required to improve the efficacy of primary and salvage treatment regimens for treating HIV-2 infection.
Collapse
Affiliation(s)
- Geoffrey S Gottlieb
- Department of Medicine, School of Medicine, University of Washington, Seattle, WA 98195, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Virological response to highly active antiretroviral therapy in patients infected with human immunodeficiency virus type 2 (HIV-2) and in patients dually infected with HIV-1 and HIV-2 in the Gambia and emergence of drug-resistant variants. J Clin Microbiol 2009; 47:2200-8. [PMID: 19420165 DOI: 10.1128/jcm.01654-08] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Drug design, antiretroviral therapy (ART), and drug resistance studies have focused almost exclusively on human immunodeficiency virus type 1 (HIV-1), resulting in limited information for patients infected with HIV-2 and for those dually infected with HIV-1 and HIV-2. In this study, 20 patients, 12 infected with HIV-2 and 8 dually infected with HIV-1 and HIV-2, all treated with zidovudine (ZDV), lamivudine (3TC), and lopinavir-ritonavir (LPV/r), were followed up longitudinally for about 3 years. For 19/20 patients, viral loads were reduced to undetectable levels; the patient whose viral load remained detectable reported adverse effects associated with LPV/r that had caused him to stop taking all the drugs. HIV-2 strains containing mutations in both the protease and the reverse transcriptase gene that may confer drug resistance were observed in two patients with viral rebound, as early as 130 days (4.3 months) after the initiation of therapy. We conclude that the combination of ZDV, 3TC, and LPV/r is able to provide efficient and durable suppression of HIV-1 and HIV-2 for as long as 3 years in HIV-2-infected and dually infected patients. However, the emergence of HIV-1 and HIV-2 strains containing drug-resistant mutations can compromise the efficacy of this highly active ART.
Collapse
|
13
|
A call for randomized controlled trials of antiretroviral therapy for HIV-2 infection in West Africa. AIDS 2008; 22:2069-72; discussion 2073-4. [PMID: 18832869 DOI: 10.1097/qad.0b013e32830edd44] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
14
|
Leligdowicz A, Rowland-Jones S. Tenets of protection from progression to AIDS: lessons from the immune responses to HIV-2 infection. Expert Rev Vaccines 2008; 7:319-31. [PMID: 18393602 DOI: 10.1586/14760584.7.3.319] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the past 25 years, life survival curves of many countries have been remodeled owing to HIV infection. Both HIV-1 and HIV-2 can cause AIDS, yet patients infected with HIV-2 fare much better clinically and most will never experience detrimental effects of the infection. Despite over two decades of comprehensive research into vaccine development, a prophylactic vaccine is not yet realized. An essential missing link in the innovation of a successful vaccine strategy is the description of a favorable immune response that abolishes virus replication. Lessons learned from studying the role of the immune system in the long-term nonprogression characteristic of HIV-2 infection will offer insight into how a balanced immune response can protect from the destruction of the immune system associated with chronic HIV-1 infection.
Collapse
Affiliation(s)
- Aleksandra Leligdowicz
- Medical Research Council Laboratories, Fajara, Atlantic Road, PO Box 273, The Gambia, West Africa.
| | | |
Collapse
|
15
|
Virological and immunological response to HAART regimen containing integrase inhibitors in HIV-2-infected patients. AIDS 2008; 22:665-6. [PMID: 18317013 DOI: 10.1097/qad.0b013e3282f51203] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
16
|
Ruelle J, Roman F, Vandenbroucke AT, Lambert C, Fransen K, Echahidi F, Piérard D, Verhofstede C, Van Laethem K, Delforge ML, Vaira D, Schmit JC, Goubau P. Transmitted drug resistance, selection of resistance mutations and moderate antiretroviral efficacy in HIV-2: analysis of the HIV-2 Belgium and Luxembourg database. BMC Infect Dis 2008; 8:21. [PMID: 18304321 PMCID: PMC2292191 DOI: 10.1186/1471-2334-8-21] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2007] [Accepted: 02/27/2008] [Indexed: 11/24/2022] Open
Abstract
Background Guidelines established for the treatment of HIV-1 infection and genotype interpretation do not apply for HIV-2. Data about antiretroviral (ARV) drug efficacy and resistance mutations is scarce. Methods Clinical data about HIV-2 infected patients in Belgium and Luxembourg were collected and the effect of ARV therapy on plasma viral load and CD4 counts were analysed. Viral RNA encoding for protease (PR) and reverse transcriptase (RT) from ARV-naïve and treated patients were sequenced. Results Sixty-five HIV-2 infected patients were included in this cohort. Twenty patients were treated with 25 different ARV combinations in a total of 34 regimens and six months after the start of ARV therapy, only one third achieved viral load suppression. All of these successful regimens bar one contained protease inhibitors (PIs). Mean CD4 gains in the group of viral load suppressors and the group of patients treated with PI-containing regimens were respectively significantly higher than in the group of non-suppressors and the group of PI-sparing regimens. The most frequent mutations selected under therapy (compared to HIV-2 ROD) were V71I, L90M and I89V within PR. Within RT, they were M184V, Q151M, V111I and K65R. All of these mutations, except K65R and M184V, were also found in variable proportions in ARV-naïve patients. Conclusion Despite a high rate of ARV treatment failure, better virological and immunological results were achieved with PI-containing regimens. The analysis of polymorphic positions and HIV-2 specific mutations selected during therapy showed for the first time that transmission of drug resistant viruses has occurred in Belgium and Luxembourg. The high heterogeneity in ARV combinations reflects a lack of guidelines for the treatment of HIV-2 infection.
Collapse
Affiliation(s)
- Jean Ruelle
- Université Catholique de Louvain, AIDS Reference Laboratory, Avenue Hippocrate 54 -5492, 1200 Bruxelles, Belgium.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Comparison of viro-immunological marker changes between HIV-1 and HIV-2-infected patients in France. AIDS 2008; 22:457-68. [PMID: 18301058 DOI: 10.1097/qad.0b013e3282f4ddfc] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND HIV-2 is known to be less pathogenic than HIV-1, although the underlying mechanisms are still debated. We compared the changes over time in viro-immunological markers in HIV-1 and HIV-2-infected patients living in France during natural history and after initiation of the first combination antiretroviral therapy (CART). METHOD Patients were included in the ANRS CO3 HIV-1 cohort (N = 6707) or the ANRS CO5 HIV-2 cohort (N = 572). HIV-1-infected patients were matched to HIV-2 patients according to sex, age, HIV transmission group and period of treatment initiation. Changes in markers were estimated using linear mixed models. RESULTS Analyses were performed for three groups of patients: those with estimated date of contamination (98 HIV-1 and 49 HIV-2-seroincident patients); untreated seroprevalent patients (320 HIV-1 and 160 HIV-2); and those initiating a first CART (59 HIV-1 and 63 HIV-2). In group 1, CD4 T-cell counts decreased less rapidly in HIV-2 than HIV-1 patients (-9 versus -49 cells/microl per year, P < 10(-4)). Results were similar in group 2. Baseline CD4 cell count at CART initiation was not different according to the type of infection. During the first 2 months of treatment, the CD4 cell count increased by +59 cells/microl per month (CI 34; 84) for HIV-1 and +24 (CI 6; 42) for HIV-2. The plasma viral load drop was threefold more important in HIV-1 patients: -1.56 log10/ml per month versus -0.62 among HIV-2 patients (P < 10(-4)). CONCLUSION Differences between the two infections during natural history are similar to those previously described in Africa. Once treatment is started, response is poorer in HIV-2 than in HIV-1 patients.
Collapse
|
18
|
Syed Iqbal H, Balakrishnan P, Murugavel K, Suniti S. Performance characteristics of a new rapid immunochromatographic test for the detection of antibodies to human immunodeficiency virus (HIV) types 1 and 2. J Clin Lab Anal 2008; 22:178-85. [PMID: 18484656 PMCID: PMC6649098 DOI: 10.1002/jcla.20238] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 02/07/2008] [Indexed: 11/07/2022] Open
Abstract
Diagnostic kits for the detection of human immunodeficiency virus (HIV) antibodies have reached an unprecedented number. But choice of an ideal, cost-effective, and rapid test for HIV infection is of immense value for use in developing countries like India, where resources are limited. In this study we have evaluated the performance characteristics of the rapid immunochromatographic HIV test kit First Response HIV 1-2.O. First, the laboratory archived 450 characterized plasma/serum specimens, which were tested on First Response HIV 1-2.O. Second, a total of 134 consecutive voluntary counseling and testing (VCT) specimens were also tested and positive specimens were further confirmed with HIV TRI-DOT. All these VCT specimens were cross-checked with HIV double-enzyme-linked immunosorbent assay (ELISA) (Murex and Vironostika), and the results were matched. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and efficiency of First Response HIV 1-2.O with the 450 characterized specimens was 100% for HIV-1 with reference assay. The results in the VCT algorithm were correlating with double-ELISA. In the HIV-2 analysis, five HIV-2-positive specimens in First Response HIV 1-2.O were found to be HIV-2-indeterminate on Western blot. HIV TRI-DOT was unable to pick up two HIV-2 Western blot-positive specimens. First Response HIV 1-2.O has several advantages: low-cost (U.S. $0.70); only 10 microL of specimen; involves only two steps; room temperature storage; ability to differentiate HIV-1 and 2; and use of whole blood specimen. Hence this test kit could be suitable for initial screening in the HIV testing algorithm in resource-limited settings. J. Clin. Lab. Anal. 22:178-185, 2008. (c) 2008 Wiley-Liss, Inc.
Collapse
Affiliation(s)
- H. Syed Iqbal
- YRG Centre for AIDS Research and Education (YRG CARE), Voluntary Health Services Hospital Campus, Chennai, India
| | - P. Balakrishnan
- YRG Centre for AIDS Research and Education (YRG CARE), Voluntary Health Services Hospital Campus, Chennai, India
| | - K.G. Murugavel
- YRG Centre for AIDS Research and Education (YRG CARE), Voluntary Health Services Hospital Campus, Chennai, India
| | - Solomon Suniti
- YRG Centre for AIDS Research and Education (YRG CARE), Voluntary Health Services Hospital Campus, Chennai, India
| |
Collapse
|
19
|
Epidemiology, Natural History and Treatment of HIV-2 Infections. GLOBAL HIV/AIDS MEDICINE 2008. [PMCID: PMC7151785 DOI: 10.1016/b978-1-4160-2882-6.50060-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
20
|
Ruelle J, Sanou M, Liu HF, Vandenbroucke AT, Duquenne A, Goubau P. Genetic polymorphisms and resistance mutations of HIV type 2 in antiretroviral-naive patients in Burkina Faso. AIDS Res Hum Retroviruses 2007; 23:955-64. [PMID: 17725411 DOI: 10.1089/aid.2007.0034] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Natural polymorphisms in the pol gene of HIV-2 may influence the susceptibility to antiretroviral drugs and the choice of treatment. We collected samples in centers for anonymous HIV testing in Ouagadougou, Burkina Faso, in patients supposedly naive for any antiretroviral treatment. Eighty-four samples were first tested as HIV-2 positive in Burkina Faso and then shipped to Brussels, Belgium, for confirmation of the serological status and plasma viral load. Fifty-two samples were confirmed as HIV-2 positive in Belgium. Twelve others were HIV-1 positive and 20 were dually reactive. Twenty-one of HIV-2 confirmed samples had an HIV-2 plasma viral load higher than 1000 copies/ml. These viruses were sequenced in the protease and reverse trancriptase genes and 17 sequences of the pol gene were obtained. Highly polymorphic positions were identified in protease and RT genes. Two samples harbored known resistance mutations: M184V RT mutation in one and Q151M with M184V in the other. Phylogenetic analysis showed that viruses in Burkina Faso did not cluster separately from published sequences from neighboring countries. The two resistant strains were unrelated. Our findings imply either that resistant viruses are circulating in Burkina Faso or that some individuals take unsupervised treatment. Both hypotheses present problems.
Collapse
Affiliation(s)
- Jean Ruelle
- AIDS Reference Laboratory-Microbiology Unit, Université Catholique de Louvain, 1200 Brussels, Belgium
| | | | | | | | | | | |
Collapse
|
21
|
Masse S, Lu X, Dekhtyar T, Lu L, Koev G, Gao F, Mo H, Kempf D, Bernstein B, Hanna GJ, Molla A. In vitro selection and characterization of human immunodeficiency virus type 2 with decreased susceptibility to lopinavir. Antimicrob Agents Chemother 2007; 51:3075-80. [PMID: 17576848 PMCID: PMC2043247 DOI: 10.1128/aac.00146-07] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Lopinavir (LPV)-ritonavir has demonstrated durable antiviral activity in human immunodeficiency virus type 1 (HIV-1)-infected antiretroviral-naïve and protease inhibitor (PI)-experienced patients. However, information on LPV activity against HIV-2 and the patterns of mutations in HIV-2 in response to selection by LPV is limited. The activity of LPV against three strains of HIV-2 was assessed and compared to activity against a reference HIV-1 strain. LPV demonstrated activity similar to that observed against HIV-1 in two HIV-2 strains (HIV-2(MS) and HIV-2(CBL-23)) tested. On the other hand, approximately 10-fold-reduced susceptibility was observed with the third HIV-2 strain, HIV-2(CDC310319). Passage of HIV-2(MS) with increasing concentrations of LPV selected mutations V47A and D17N in the HIV-2 protease gene. The introduction of both 17N and 47A either individually or together into HIV-2(ROD) molecular infectious clones showed that the single V47A substitution in HIV-2 resulted in a substantial reduction in susceptibility to LPV. In contrast, this mutant retained wild-type susceptibility to other PIs and appeared to be hypersusceptible to atazanavir and saquinavir.
Collapse
Affiliation(s)
- Sherie Masse
- Antiviral Research, Global Pharmaceutical Research and Development, AP52N-1 Rm. 1133, 200 Abbott Park Road, Abbott Park, IL 60064, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Toro C, Soriano V. Infección por el virus de la inmunodeficiencia humana tipo 2 y virus linfotrópicos humanos tipos 1 y 2 en España. Med Clin (Barc) 2007; 129:14-6. [PMID: 17570181 DOI: 10.1157/13106692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
23
|
Rodés B, Sheldon J, Toro C, Cuevas L, Pérez-Pastrana E, Herrera I, Soriano V. Quantitative detection of plasma human immunodeficiency virus type 2 subtype A RNA by the Nuclisens EasyQ Assay (version 1.1). J Clin Microbiol 2006; 45:88-92. [PMID: 17093034 PMCID: PMC1828987 DOI: 10.1128/jcm.01613-06] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
No commercial viral load assay has yet been approved for use for measurement of human immunodeficiency virus type 2 (HIV-2) RNA levels in plasma. We assessed the performance of the NucliSens EasyQ (version 1.1) assay (EasyQ; bioMérieux, Boxtel, The Netherlands) to quantify HIV-2 viremia. A viral stock was prepared from an HIV-2 (subtype A)-infected patient. Culture supernatant was subjected to viral particle counting by electron microscopy. Serial dilutions of the viral stock were made in HIV-negative plasma and were used to test EasyQ for its sensitivity, linearity, and reproducibility. RNA was quantified by the NucliSens EasyQ (version 1.1) assay. Plasma samples from 75 HIV-2-infected patients were further tested. EasyQ was able to quantify HIV-2 RNA in a reproducible manner. Overall, estimates of the number of HIV-2 RNA copies/ml obtained with EasyQ were lower than those obtained by electron microscopy; however, the differences were always less than 0.7 log (mean, 0.55 +/- 0.19 log(10)). The assay showed good linearity (r(2) = 0.964; P < 0.0001). The agreement between both measures was assessed by use of a Bland-Altman plot; the narrow limits (0.158 to 0.952), defined as the mean difference +/- 2 standard deviations, indicated good agreement. The reproducibility was also good, since the between-run coefficients of variation were 1.49, 3.60, and 12.25% for samples containing 6.30, 4.30, and 2.30 log(10) HIV-2 RNA copies/ml, respectively. HIV-2 RNA was detected in 34 of 75 (45%) plasma specimens (mean, 2.72 log RNA copies/ml; range, 1.74 to 4.11 log RNA copies/ml); the rest of the specimens were considered to have undetectable viremia. A negative correlation was found between the number of HIV-2 RNA copies/ml and CD4 counts. In summary, EasyQ was shown to be reliable for the measurement of plasma HIV-2 subtype A RNA levels and may be a feasible tool for routine clinical monitoring of HIV-2 subtype A-infected patients.
Collapse
Affiliation(s)
- Berta Rodés
- Department of Infectious Diseases, Hospital Carlos III, Sinesio Delgado, 10, Madrid 28029, Spain.
| | | | | | | | | | | | | |
Collapse
|
24
|
Jallow S, Kaye S, Alabi A, Aveika A, Sarge-Njie R, Sabally S, Corrah T, Whittle H, Vanham G, Rowland-Jones S, Janssens W, McConkey SJ. Virological and immunological response to Combivir and emergence of drug resistance mutations in a cohort of HIV-2 patients in The Gambia. AIDS 2006; 20:1455-8. [PMID: 16791023 DOI: 10.1097/01.aids.0000233582.64467.8e] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Sabelle Jallow
- Medical Research Council Laboratories, Banjul, The Gambia
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Matheron S, Damond F, Benard A, Taieb A, Campa P, Peytavin G, Pueyo S, Brun-Vezinet F, Chene G. CD4 cell recovery in treated HIV-2-infected adults is lower than expected: results from the French ANRS CO5 HIV-2 cohort. AIDS 2006; 20:459-62. [PMID: 16439883 DOI: 10.1097/01.aids.0000199829.57112.2f] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In 61 antiretroviral-naive HIV-2-infected patients starting triple therapy at a median CD4 cell count of 136 cells/microl, the median increase was 41 cells/microl at month 12, which was no different among those on protease inhibitors or triple nucleoside analogues. Despite virological response, as the median plasma load was under the detectable threshold from month 3, CD4 cell recovery remained poor in treated HIV-2 infection. Our results raise the question of the optimal regimen to recommend in HIV-2-infected patients.
Collapse
Affiliation(s)
- Sophie Matheron
- Bichat Claude Bernard Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Rodés B, Sheldon J, Toro C, Jiménez V, Alvarez MA, Soriano V. Susceptibility to protease inhibitors in HIV-2 primary isolates from patients failing antiretroviral therapy. J Antimicrob Chemother 2006; 57:709-13. [PMID: 16464891 DOI: 10.1093/jac/dkl034] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Current protease inhibitors (PIs) are designed against HIV-1, and information on their performance against HIV-2 clinical isolates is scarce. METHODS Genetic and phenotypic analyses using all available PIs were performed in five HIV-2 primary isolates from two patients on regular follow-up who failed PI-HAART. RESULTS HIV-2 proteases before therapy showed amino acids associated with resistance in HIV-1 (pro10V, pro32I, pro36I, pro46I, pro47V, pro71V and pro73A). Phenotypic results showed that indinavir, saquinavir, lopinavir and tipranavir had full activity against wild-type HIV-2. However, a susceptibility reduction was noticed for nelfinavir (6.6-fold) and amprenavir (31-fold). During therapy with lopinavir, one patient developed proV47A, which translated into high-level resistance (13.4- to 41-fold) to indinavir, lopinavir and amprenavir, and hypersusceptibility to saquinavir. All isolates from the other patient had multiple mutations after several PIs failed (proV10I, proV33L, proI54M, proV71I and proI82F). The acquisition of mutations 54M and 82F along with naturally occurring changes resulted in multi-PI-resistant viruses (33- to >1000-fold), and only saquinavir retained full activity. CONCLUSIONS Naturally occurring secondary mutations or polymorphisms in the HIV-2 protease may decrease the activity of nelfinavir and amprenavir. Moreover, upon selection of primary resistance mutations, pre-existing secondary changes might play an important role in the acquisition of a multi-PI resistance phenotype in HIV-2.
Collapse
Affiliation(s)
- Berta Rodés
- Molecular Biology Laboratory, Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain.
| | | | | | | | | | | |
Collapse
|
27
|
Dougan S, Patel B, Tosswill JH, Sinka K. Diagnoses of HIV-1 and HIV-2 in England, Wales, and Northern Ireland associated with west Africa. Sex Transm Infect 2005; 81:338-41. [PMID: 16061543 PMCID: PMC1745000 DOI: 10.1136/sti.2004.013011] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To describe HIV diagnoses, including those of HIV-2 infection, made in England, Wales, and Northern Ireland (E,W&NI) among those probably infected in west Africa, and to consider whether there is evidence for ongoing heterosexual transmission within the United Kingdom. METHODS Reports of new HIV diagnoses received at the Communicable Disease Surveillance Centre were analysed. Individuals probably infected in west Africa and those infected through heterosexual intercourse within the United Kingdom by a heterosexual partner infected in west Africa were included. RESULTS Between 1985 and 2003 inclusive, 1324 individuals diagnosed and reported with HIV had probably been infected in west Africa, with 222 diagnoses made in 2003. 917 (69%) were HIV-1 infected and 52 (6%) HIV-2 or HIV-1/HIV-2 co-infected. For 355 (27%) the HIV type was not reported. The proportion of HIV-2 and HIV-1/HIV-2 infections varied by country of infection (p<0.001): ranging from the Gambia (11.7%-15.2%) to Nigeria (0.7%-1.0%). A further 130 individuals were probably infected through heterosexual intercourse within the United Kingdom by a heterosexual partner infected in west Africa. 89 (68%) were HIV-1 infected and three (2%) HIV-2 infected or HIV-1/HIV-2 co-infected. For 38 (29%) HIV type was not reported. CONCLUSION The number of people infected with HIV in west Africa and diagnosed in E,W&NI has increased in recent years, and there is evidence of heterosexual transmission within the United Kingdom from people infected in west Africa. While numbers of HIV-2 diagnoses remain relatively low, an appreciable proportion of people infected in some west African countries and diagnosed in the United Kingdom may be HIV-2 positive, with implications for prognosis and treatment.
Collapse
Affiliation(s)
- S Dougan
- Department of HIV and Sexually Transmitted Infections, Communicable Disease Surveillance Centre, Health Protection Agency Centre for Infections, 61 Colindale Avenue, London NW9 5EQ, UK.
| | | | | | | |
Collapse
|
28
|
Rodés B, Toro C, Jiménez V, Soriano V. Viral response to antiretroviral therapy in a patient coinfected with HIV type 1 and type 2. Clin Infect Dis 2005; 41:e19-21. [PMID: 15983906 DOI: 10.1086/431204] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2005] [Accepted: 02/23/2005] [Indexed: 11/03/2022] Open
Abstract
Clinical experience with the treatment of human immunodeficiency virus (HIV) type 2 (HIV-2) infection is limited, and even more scarce is information on therapy for patients coinfected with HIV type 1 (HIV-1) and HIV-2. Here, we describe the outcome for a coinfected patient in whom infection with both viruses was successfully controlled at the start of antiretroviral therapy, but for whom HIV-2 infection escaped control after a treatment simplification change while HIV-1 remained undetectable.
Collapse
Affiliation(s)
- Berta Rodés
- Molecular Biology Laboratory, Department of Infectious Diseases, Hospital Carlos III, Madrid, Spain.
| | | | | | | |
Collapse
|
29
|
Toro C, Soriano V. Situación actual de la infección por el VIH-2 y el HTLV-1/2 en España: luces y sombras. Med Clin (Barc) 2005; 124:616-7. [PMID: 15871778 DOI: 10.1157/13074391] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
30
|
Valadas E, Antunes F. HIV-2: the Portuguese Connection. Clin Infect Dis 2004; 39:1553-4; author reply 1554. [PMID: 15546104 DOI: 10.1086/425506] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
31
|
Kanki P, Mullins C. Reply to Valadas and Antunes. Clin Infect Dis 2004. [DOI: 10.1086/425511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|