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Eholie SP, Ekouevi DK, Chazallon C, Charpentier C, Messou E, Diallo Z, Zoungrana J, Minga A, Ngom Gueye NF, Hawerlander D, Dembele F, Colin G, Tchounga B, Karcher S, Le Carrou J, Tchabert-Guié A, Toni TD, Ouédraogo AS, Bado G, Toure Kane C, Seydi M, Poda A, Mensah E, Diallo I, Drabo YJ, Anglaret X, Brun-Vezinet F. Efficacy and safety of three antiretroviral therapy regimens for treatment-naive African adults living with HIV-2 (FIT-2): a pilot, phase 2, non-comparative, open-label, randomised controlled trial. Lancet HIV 2024; 11:e380-e388. [PMID: 38740027 DOI: 10.1016/s2352-3018(24)00085-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Due to the low number of individuals with HIV-2, no randomised trials of HIV-2 treatment have ever been done. We hypothesised that a non-comparative study describing the outcomes of several antiretroviral therapy (ART) regimens in parallel groups would improve understanding of how differences between HIV-1 and HIV-2 might lead to different therapeutic approaches. METHODS This pilot, phase 2, non-comparative, open-label, randomised controlled trial was done in Burkina Faso, Côte d'Ivoire, Senegal, and Togo. Adults with HIV-2 who were ART naive with CD4 counts of 200 cells per μL or greater were randomly assigned 1:1:1 to one of three treatment groups. A computer-generated sequentially numbered block randomisation list stratified by country was used for online allocation to the next available treatment group. In all groups, tenofovir disoproxil fumarate (henceforth tenofovir) was dosed at 245 mg once daily with either emtricitabine at 200 mg once daily or lamivudine at 300 mg once daily. The triple nucleoside reverse transcriptase inhibitor (NRTI) group received zidovudine at 250 mg twice daily. The ritonavir-boosted lopinavir group received lopinavir at 400 mg twice daily boosted with ritonavir at 100 mg twice daily. The raltegravir group received raltegravir at 400 mg twice daily. The primary outcome was the rate of treatment success at week 96, defined as an absence of serious morbidity event during follow-up, plasma HIV-2 RNA less than 50 copies per mL at week 96, and a substantial increase in CD4 cells between baseline and week 96. This trial is registered at ClinicalTrials.gov, NCT02150993, and is closed to new participants. FINDINGS Between Jan 26, 2016, and June 29, 2017, 210 participants were randomly assigned to treatment groups. Five participants died during the 96 weeks of follow-up (triple NRTI group, n=2; ritonavir-boosted lopinavir group, n=2; and raltegravir group, n=1), eight had a serious morbidity event (triple NRTI group, n=4; ritonavir-boosted lopinavir group, n=3; and raltegravir group, n=1), 17 had plasma HIV-2 RNA of 50 copies per mL or greater at least once (triple NRTI group, n=11; ritonavir-boosted lopinavir group, n=4; and raltegravir group, n=2), 32 (all in the triple NRTI group) switched to another ART regimen, and 18 permanently discontinued ART (triple NRTI group, n=5; ritonavir-boosted lopinavir group, n=7; and raltegravir group, n=6). The Data Safety Monitoring Board recommended premature termination of the triple NRTI regimen for safety reasons. The overall treatment success rate was 57% (95% CI 47-66) in the ritonavir-boosted lopinavir group and 59% (49-68) in the raltegravir group. INTERPRETATION The raltegravir and ritonavir-boosted lopinavir regimens were efficient and safe in adults with HIV-2. Both regimens could be compared in future phase 3 trials. The results of this pilot study suggest a trend towards better virological and immunological efficacy in the raltegravir-based regimen. FUNDING ANRS MIE.
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Affiliation(s)
- Serge P Eholie
- Université Félix Houphouët-Boigny, Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Abidjan, Côte d'Ivoire; Centre Hospitalier Universitaire de Treichville Service des Maladies Infectieuses et Tropicales, Abidjan, Côte d'Ivoire; Programme PACCI, Abidjan, Côte d'Ivoire
| | - Didier K Ekouevi
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France; Centre Africain de Recherche en Epidémiologie et en Santé Publique, Lomé, Togo; Université de Lomé, Département Santé Publique, Lomé, Togo
| | - Corine Chazallon
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Charlotte Charpentier
- Service de virologie, Université Paris Cité, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
| | - Eugène Messou
- Centre de Prise en Charge et de Formation (CePReF), Abidjan, Côte d'Ivoire
| | - Zelica Diallo
- Université Félix Houphouët-Boigny, Département de Dermatologie et d'Infectiologie, UFR des Sciences Médicales, Abidjan, Côte d'Ivoire; Centre Hospitalier Universitaire de Treichville Service des Maladies Infectieuses et Tropicales, Abidjan, Côte d'Ivoire; Programme PACCI, Abidjan, Côte d'Ivoire
| | - Jacques Zoungrana
- Service des Maladies Infectieuses et Tropicales, CHU Sourô Sanou, Bobo-Dioulasso, Burkina-Faso
| | - Albert Minga
- Centre Médical de Suivi des Donneurs de Sang (CMSDS-CNTSCI), Abidjan, Côte d'Ivoire
| | | | - Denise Hawerlander
- Centre Intégré de Recherches Biocliniques d'Abidjan (CIRBA) Abidjan, Côte d'Ivoire
| | - Fassery Dembele
- Unité de soins ambulatoires et de conseil (USAC), CHU de Treichville, Abidjan, Côte d'Ivoire
| | - Géraldine Colin
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Boris Tchounga
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Sophie Karcher
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Jérome Le Carrou
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France
| | | | - Thomas-d'Aquin Toni
- Programme PACCI, Abidjan, Côte d'Ivoire; CeDReS, Centre Hospitalier Universitaire de Treichville, Abidjan, Côte d'Ivoire
| | | | - Guillaume Bado
- Unité de Virologie, CHU Sourô Sanou, Bobo-Dioulasso, Burkina-Faso
| | - Coumba Toure Kane
- Laboratoire de Bacteriologie, Virologie, CHU Le Dantec, Dakar, Sénégal
| | - Moussa Seydi
- Service des Maladies Infectieuses et Tropicales, CHNU Fann, Dakar, Sénégal
| | - Armel Poda
- Service des Maladies Infectieuses et Tropicales, CHU Sourô Sanou, Bobo-Dioulasso, Burkina-Faso
| | - Ephrem Mensah
- ONG espoir Vie Togo, Cente Medico-social, Licia Lomé, Togo
| | - Illah Diallo
- Service de Médecine Interne, CHU Yalgado OUEDRAOGO, Ouagadougou, Burkina Faso
| | | | - Xavier Anglaret
- Programme PACCI, Abidjan, Côte d'Ivoire; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France.
| | - Françoise Brun-Vezinet
- Service de virologie, Université Paris Cité, INSERM, IAME, UMR 1137, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France
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Boschloo WJ, van Welzen BJ. Clinical Outcomes of Integrase Strand Transfer Inhibitors Containing Antiretroviral Therapy in HIV-2: A Narrative Review. Infect Dis Ther 2024; 13:1161-1175. [PMID: 38722462 PMCID: PMC11128418 DOI: 10.1007/s40121-024-00982-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/19/2024] [Indexed: 05/28/2024] Open
Abstract
The human immunodeficiency virus type 2 (HIV-2) is a particular subtype of HIV, which is endemic in West Africa and is characterized by a more indolent course than HIV-1. As people living with HIV-2 (PWH-2) are at risk for the development of acquired immunodeficiency syndrome and can transmit the virus, antiretroviral therapy is usually indicated. However, the optimal treatment of HIV-2 is unknown and historically the protease inhibitors (PIs) were a regular part of therapy. Nowadays, the use of integrase strand transfer inhibitors (INSTIs) in HIV-2 is increasing but the evidence supporting this approach is limited. In this narrative review, we outline the clinical data on the use of INSTI-containing antiretroviral therapy in HIV-2. We found that in the setting of treatment-naïve PWH-2, the use of INSTIs is successful, but also noted large heterogeneity in reported outcomes and that most cohorts are small with limited follow-up time. There is a lack of studies comparing the efficacy of INSTIs to other first-line options. For treatment-experienced PWH-2, the efficacy of INSTI is highly variable.
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Affiliation(s)
- Wendy J Boschloo
- Department of Infectious Diseases, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Berend J van Welzen
- Department of Infectious Diseases, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
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3
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Pacheco P, Marques N, Rodrigues P, Mansinho K, Maltez F, Janeiro N, Franco C, Trigo D, Batista J, Duque L, Lopes MJ, Aleixo MJ, Silva AR, Tavares R, Alves J, Peres S, Póvoas D, Lino S, Gomes P, Araújo V, Lopes C. Safety and Efficacy of Triple Therapy With Dolutegravir Plus 2 Nucleoside Reverse Transcriptase Inhibitors in Treatment-Naive Human Immunodeficiency Virus Type 2 Patients: Results From a 48-Week Phase 2 Study. Clin Infect Dis 2023; 77:740-748. [PMID: 37288954 DOI: 10.1093/cid/ciad339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/30/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Integrase strand transfer inhibitor-based regimens are recommended for first-line therapy in human immunodeficiency virus type 2 (HIV-2). Nonetheless, dolutegravir (DTG) clinical trial data are lacking. METHODS We conducted a phase 2, single-arm, open-label trial to evaluate the safety and efficacy of a triple therapy regimen that included DTG in persons with HIV-2 (PWHIV-2) in Portugal. Treatment-naive adults receive DTG in combination with 2 nucleoside reverse transcriptase inhibitors (NRTIs). Treatment efficacy was evaluated by the proportion of patients who achieved a plasma viral load (pVL) <40 copies/mL and/or by the change from baseline in CD4+ T-cell count and in CD4/CD8 ratio at week 48. RESULTS A total of 30 patients were enrolled (22 women; median age, 55 years). At baseline, 17 (56.7%) individuals were viremic (median, pVL 190 copies/mL; interquartile range [IQR], 99-445). The median CD4 count was 438 cells/μL (IQR, 335-605), and the CD4/CD8 ratio was 0.8. Three patients discontinued the study. At week 48, all participants (27) had pVL <40 copies/mL. No virological failures were observed. Mean changes in CD4 count and CD4/CD8 ratio at week 48 were 95.59 cells/µL (95% confidence interval [CI], 28-163) and 0.32 (95% CI, .19 to .46). The most common drug-related adverse events were headache and nausea. One participant discontinued due to central nervous system symptoms. No serious adverse events were reported. CONCLUSIONS DTG plus 2 NRTIs is safe and effective as first-line treatment for PWHIV-2 with a tolerability profile previously known. No virological failures were observed that suggest a high potency of DTG in HIV-2 as occurs in HIV-1. CLINICAL TRIALS REGISTRATION M NCT03224338.
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Affiliation(s)
- Patrícia Pacheco
- Infectious Diseases Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Nuno Marques
- Infectious Diseases Department, Hospital Garcia de Orta, Almada, Portugal
| | - Paulo Rodrigues
- Infectious Diseases Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Kamal Mansinho
- Infectious Diseases Department, Hospital Egas Moniz, Lisboa, Portugal
| | - Fernando Maltez
- Infectious Diseases Department, Hospital Curry Cabral, Lisboa, Portugal
| | - Nuno Janeiro
- Infectious Diseases Department, Hospital Santa Maria, Lisboa, Portugal
| | - Cláudia Franco
- Infectious Diseases Department, Hospital Santa Maria, Lisboa, Portugal
| | - Diva Trigo
- Infectious Diseases Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Joana Batista
- Infectious Diseases Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Luís Duque
- Infectious Diseases Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Maria João Lopes
- Infectious Diseases Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Maria João Aleixo
- Infectious Diseases Department, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Rita Silva
- Infectious Diseases Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Raquel Tavares
- Infectious Diseases Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - João Alves
- Infectious Diseases Department, Hospital Egas Moniz, Lisboa, Portugal
| | - Susana Peres
- Infectious Diseases Department, Hospital Egas Moniz, Lisboa, Portugal
| | - Diana Póvoas
- Infectious Diseases Department, Hospital Curry Cabral, Lisboa, Portugal
| | - Sara Lino
- Infectious Diseases Department, Hospital Curry Cabral, Lisboa, Portugal
| | - Perpétua Gomes
- Molecular Biology Laboratory, Hospital Egas Moniz, Lisboa, Portugal
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4
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Gottlieb GS. Dolutegravir-based Antiretroviral Therapy for Human Immunodeficiency Virus Type 2 (HIV-2) Infection: Progress for People With HIV-2. Clin Infect Dis 2023; 77:749-751. [PMID: 37288974 DOI: 10.1093/cid/ciad340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023] Open
Affiliation(s)
- Geoffrey S Gottlieb
- Center for Emerging and Re-Emerging Infectious Diseases, University of Washington, Seattle, Washington, USA
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Department of Enivormental Health & Safety, University of Washington, Seattle, Washington, USA
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5
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Moranguinho I, Taveira N, Bártolo I. Antiretroviral Treatment of HIV-2 Infection: Available Drugs, Resistance Pathways, and Promising New Compounds. Int J Mol Sci 2023; 24:ijms24065905. [PMID: 36982978 PMCID: PMC10053740 DOI: 10.3390/ijms24065905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Currently, it is estimated that 1-2 million people worldwide are infected with HIV-2, accounting for 3-5% of the global burden of HIV. The course of HIV-2 infection is longer compared to HIV-1 infection, but without effective antiretroviral therapy (ART), a substantial proportion of infected patients will progress to AIDS and die. Antiretroviral drugs in clinical use were designed for HIV-1 and, unfortunately, some do not work as well, or do not work at all, for HIV-2. This is the case for non-nucleoside reverse transcriptase inhibitors (NNRTIs), the fusion inhibitor enfuvirtide (T-20), most protease inhibitors (PIs), the attachment inhibitor fostemsavir and most broadly neutralizing antibodies. Integrase inhibitors work well against HIV-2 and are included in first-line therapeutic regimens for HIV-2-infected patients. However, rapid emergence of drug resistance and cross-resistance within each drug class dramatically reduces second-line treatment options. New drugs are needed to treat infection with drug-resistant isolates. Here, we review the therapeutic armamentarium available to treat HIV-2-infected patients, as well as promising drugs in development. We also review HIV-2 drug resistance mutations and resistance pathways that develop in HIV-2-infected patients under treatment.
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Affiliation(s)
- Inês Moranguinho
- Instituto de Investigação do Medicamento (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-019 Lisboa, Portugal
| | - Nuno Taveira
- Instituto de Investigação do Medicamento (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-019 Lisboa, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, 2829-511 Caparica, Portugal
| | - Inês Bártolo
- Instituto de Investigação do Medicamento (iMed.ULisboa), Faculdade de Farmácia, Universidade de Lisboa, 1649-019 Lisboa, Portugal
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Smith RA, Wu VH, Song J, Raugi DN, Diallo Mbaye K, Seydi M, Gottlieb GS. Spectrum of Activity of Raltegravir and Dolutegravir Against Novel Treatment-Associated Mutations in HIV-2 Integrase: A Phenotypic Analysis Using an Expanded Panel of Site-Directed Mutants. J Infect Dis 2022; 226:497-509. [PMID: 35134180 PMCID: PMC9417127 DOI: 10.1093/infdis/jiac037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/28/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Integrase inhibitors (INIs) are a key component of antiretroviral therapy for human immunodeficiency virus-1 (HIV-1) and HIV-2 infection. Although INI resistance pathways are well-defined for HIV-1, mutations that emerge in HIV-2 in response to INIs are incompletely characterized. METHODS We performed systematic searches of GenBank and HIV-2 drug resistance literature to identify treatment-associated mutations for phenotypic evaluation. We then constructed a library of 95 mutants of HIV-2ROD9 that contained single or multiple amino acid changes in the integrase protein. Each variant was tested for susceptibility to raltegravir and dolutegravir using a single-cycle indicator cell assay. RESULTS We observed extensive cross-resistance between raltegravir and dolutegravir in HIV-2ROD9. HIV-2-specific integrase mutations Q91R, E92A, A153G, and H157Q/S, which have not been previously characterized, significantly increased the half maximum effective concentration (EC50) for raltegravir when introduced into 1 or more mutational backgrounds; mutations E92A/Q, T97A, and G140A/S conferred similar enhancements of dolutegravir resistance. HIV-2ROD9 variants encoding G118R alone, or insertions of residues SREGK or SREGR at position 231, were resistant to both INIs. CONCLUSIONS Our analysis demonstrates the contributions of novel INI-associated mutations to raltegravir and dolutegravir resistance in HIV-2. These findings should help to improve algorithms for genotypic drug resistance testing in HIV-2-infected individuals.
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Affiliation(s)
- Robert A Smith
- Correspondence: Robert A. Smith, PhD, Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, 750 Republican Street, Building E, Box 358061, Seattle, WA 98109 ()
| | - Vincent H Wu
- Center for Emerging and Reemerging Infectious Diseases, University of Washington, Seattle, Washington, USA,Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Jennifer Song
- Center for Emerging and Reemerging Infectious Diseases, University of Washington, Seattle, Washington, USA,Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Dana N Raugi
- Center for Emerging and Reemerging Infectious Diseases, University of Washington, Seattle, Washington, USA,Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Khardiata Diallo Mbaye
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - Moussa Seydi
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire de Fann, Dakar, Senegal
| | - Geoffrey S Gottlieb
- Center for Emerging and Reemerging Infectious Diseases, University of Washington, Seattle, Washington, USA,Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA,Department of Global Health, University of Washington, Seattle, Washington, USA
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7
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Reeves I, Cromarty B, Deayton J, Dhairyawan R, Kidd M, Taylor C, Thornhill J, Tickell-Painter M, van Halsema C. British HIV Association guidelines for the management of HIV-2 2021. HIV Med 2021; 22 Suppl 4:1-29. [PMID: 34927347 DOI: 10.1111/hiv.13204] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Iain Reeves
- Consultant in HIV Medicine, Homerton University Hospital NHS Trust, London, UK
| | | | - Jane Deayton
- Clinical Senior Lecturer in HIV, Barts and the London, Queen Mary University of London, London, UK
| | - Rageshri Dhairyawan
- Consultant in Sexual Health and HIV Medicine, Barts Health NHS Trust, London, UK
| | - Mike Kidd
- Consultant Virologist, National Infection Service, Public Health England, UK
| | - Chris Taylor
- Consultant Physician Sexual Health and HIV, Kings College Hospital, London, UK
| | - John Thornhill
- Consultant in Sexual Health and HIV Medicine, Barts Health NHS Trust, London, UK
| | - Maya Tickell-Painter
- Specialist Registrar in Infectious Diseases and Microbiology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Clare van Halsema
- Consultant in Infectious Diseases, North Manchester General Hospital, Manchester, UK
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Khopkar-Kale P, Kulkarni S. HIV-2: still off the radar for India's 90-90-90 targets. Indian J Med Res 2021; 154:24-26. [PMID: 34782527 PMCID: PMC8715681 DOI: 10.4103/ijmr.ijmr_828_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Priyanka Khopkar-Kale
- Department of Virology, Indian Council of Medical Research-National AIDS Research Institute, Bhosari, Pune 411 026; Symbiosis School of Biological Sciences, Faculty of Health Sciences, Symbiosis International (Deemed University), Lavale, Pune 412 115, Maharashtra, India
| | - Smita Kulkarni
- Department of Virology, Indian Council of Medical Research-National AIDS Research Institute, Bhosari, Pune 411 026; Symbiosis School of Biological Sciences, Faculty of Health Sciences, Symbiosis International (Deemed University), Lavale, Pune 412 115, Maharashtra, India
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9
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Pujari S, Patel A, Gaikwad S, Patel K, Dabhade D, Chitalikar A, Joshi K, Bele V. Effectiveness of dolutegravir-based antiretroviral treatment for HIV-2 infection: retrospective observational study from Western India. J Antimicrob Chemother 2021; 75:1950-1954. [PMID: 32277827 DOI: 10.1093/jac/dkaa112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/23/2020] [Accepted: 03/03/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Data on the use of dolutegravir for treatment of HIV-2 infection are limited. OBJECTIVES To assess the effectiveness of dolutegravir in people living with HIV-2 (PLHIV-2). METHODS A retrospective chart review was performed in two clinics in Western India. PLHIV-2 initiated on dolutegravir-based regimens were included. Response to treatment in both treatment-naive (TN) and treatment-experienced (TE; substitution and not in the context of failure) was assessed by CD4 counts and HIV-2 viral load (VL) in a proportion of individuals. The primary objective was to assess immunological effectiveness (absence of a drop in absolute CD4 counts by more than 30% of baseline). Change in absolute CD4 counts was assessed by fitting a mixed-effects model. RESULTS Sixty-two PLHIV-2 treated with dolutegravir were included. The immunological effectiveness rates (95% CI) were 91.9% (82.4%-96.5%), 92% (81.1%-96.8%) and 91.6% (64.6%-98.5%) amongst all, TE and TN individuals, respectively. Median change in absolute CD4 counts at 6, 12 and 18 months were +29 cells/mm3, +101 cells/mm3 and +72 cells/mm3, respectively. The virological effectiveness rates (HIV-2 VL <100 copies/mL) (95% CI) for all, TE and TN individuals were 88.8% (74.6%-95%), 89.6% (73.6%-96.4%) and 85.7% (48.6%-97.4%), respectively. Three clinical events were documented: spinal tuberculosis, relapsed non-Hodgkin's lymphoma and herpes simplex virus retinitis. One individual reported self-limiting somnolence. CONCLUSIONS Dolutegravir was well tolerated and associated with immunological, virological and clinical effectiveness in both TN and TE PLHIV-2 in a large cohort from Western India. Dolutegravir-based ART is an excellent option for treatment of individuals with HIV-2 infection.
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Affiliation(s)
| | - Atul Patel
- Infectious Diseases Clinic, Ahmedabad, India
| | | | - Ketan Patel
- Infectious Diseases Clinic, Ahmedabad, India
| | | | | | - Kedar Joshi
- Institute of Infectious Diseases, Pune, India
| | - Vivek Bele
- Institute of Infectious Diseases, Pune, India
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10
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Berzow D, Descamps D, Obermeier M, Charpentier C, Kaiser R, Guertler L, Eberle J, Wensing A, Sierra S, Ruelle J, Gomes P, Mansinho K, Taylor N, Jensen B, Döring M, Stürmer M, Rockstroh J, Camacho R. Human Immunodeficiency Virus-2 (HIV-2): A Summary of the Present Standard of Care and Treatment Options for Individuals Living with HIV-2 in Western Europe. Clin Infect Dis 2021; 72:503-509. [PMID: 32227124 DOI: 10.1093/cid/ciaa275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/12/2020] [Indexed: 11/13/2022] Open
Abstract
Human immunodeficiency virus-2 (HIV-2) is endemic in some countries in West Africa. Due to the lower prevalence in industrialized countries, there is limited experience and knowledge on the management of individuals living with HIV-2 in Europe. Compared to HIV-1, there are differential characteristics of HIV-2 regarding diagnostic procedures, the clinical course, and, most importantly, antiretroviral therapy. We integrated the published literature on HIV-2 (studies and reports on epidemiology, diagnostics, the clinical course, and treatment), as well as expert experience in diagnosing and clinical care, to provide recommendations for a present standard of medical care of those living with HIV-2 in Western European countries, including an overview of strategies for diagnosis, monitoring, and treatment, with suggestions for effective drug combinations for first- and second-line treatments, post-exposure prophylaxis, and the prevention of mother-to-child transmission, as well as listings of mutations related to HIV-2 drug resistance and C-C motif chemokine receptor type 5 and C-X-C motif chemokine receptor type 4 coreceptor tropism.
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Affiliation(s)
- Dirk Berzow
- Praxis for Infectiology, Hamburg, Germany.,Deutsche Arbeitsgemeinschaft niedergelassener Ärzte in der Versorgung HIV-Infizierter (DAGNAE) Berlin, Germany
| | - Diane Descamps
- Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France.,Université de Paris, Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR),1137, Laboratory Infection, Antimicrobials, Modelling, Evolution (IAME), Paris, France
| | - Martin Obermeier
- Deutsche Arbeitsgemeinschaft niedergelassener Ärzte in der Versorgung HIV-Infizierter (DAGNAE) Berlin, Germany.,Medical Center for Infectious Diseases, Berlin, Germany.,Gesellschaft für Virologie e.V., Freiburg, Germany
| | - Charlotte Charpentier
- Laboratoire de Virologie, Hôpital Bichat-Claude Bernard, Paris, France.,Université de Paris, Institut national de la santé et de la recherche médicale (INSERM), Unité mixte de recherche (UMR),1137, Laboratory Infection, Antimicrobials, Modelling, Evolution (IAME), Paris, France
| | - Rolf Kaiser
- Gesellschaft für Virologie e.V., Freiburg, Germany.,Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany.,German AIDS Society (Deutsche AIDS-Gesellschaft, DAIG), Hamburg, Germany.,Paul-Ehrlich-Gesellschaft für Chemotherapie, Rheinbach, Germany
| | - Lutz Guertler
- Gesellschaft für Virologie e.V., Freiburg, Germany.,German AIDS Society (Deutsche AIDS-Gesellschaft, DAIG), Hamburg, Germany.,National Reference Center for Retroviruses, Max von Pettenkofer Institute for Hygiene and Medical Microbiology, University of Munich, Munich, Germany
| | - Josef Eberle
- Gesellschaft für Virologie e.V., Freiburg, Germany.,German AIDS Society (Deutsche AIDS-Gesellschaft, DAIG), Hamburg, Germany.,National Reference Center for Retroviruses, Max von Pettenkofer Institute for Hygiene and Medical Microbiology, University of Munich, Munich, Germany
| | - Annemarie Wensing
- European AIDS Clinical Society, Brussels, Belgium.,Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, Netherlands
| | - Saleta Sierra
- Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Jean Ruelle
- Laboratories Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Perpetua Gomes
- Instituto Universitário Egas Moniz, Lisboa, Portugal.,Molecular Biology Laboratory, Laboratório de Biologia Molecular, Centro Hospitalar de Lisboa Ocidental, Egas Moniz Hospital, Lisboa, Portugal
| | - Kamal Mansinho
- Centro Hospitalar de Lisboa Occidental, Hospital de Egas Moniz, Lisboa, Portugal
| | - Ninon Taylor
- Third Medical Department with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Björn Jensen
- Paul-Ehrlich-Gesellschaft für Chemotherapie, Rheinbach, Germany.,Department of Gastroenterology, Hepatology and Infectious Diseases, Heinrich-Heine University Hospital, Düsseldorf, Germany
| | - Matthias Döring
- Department for Computational Biology and Applied Algorithmics, Max-Planck Institute for Informatics, Saarland Informatics Campus, Saarbrücken, Germany
| | - Martin Stürmer
- Medizinisches Versorgungszentrum, Frankfurt am Main, Germany
| | - Jürgen Rockstroh
- European AIDS Clinical Society, Brussels, Belgium.,Department of Medicine I, Bonn University Hospital, Bonn, Germany
| | - Ricardo Camacho
- Katholieke Universiteit, Department of Microbiology and Immunology, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Leuven, Belgium
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11
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Jenny-Avital ER. Human Immunodeficiency Virus Guidelines: Are We There Yet? Clin Infect Dis 2021; 72:510-512. [PMID: 33527118 DOI: 10.1093/cid/ciaa281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/18/2020] [Indexed: 11/14/2022] Open
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12
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Raugi DN, Ba S, Cisse O, Diallo K, Tamba IT, Ndour C, Badiane NMD, Fortes L, Diallo MB, Faye D, Smith RA, Sall F, Toure M, Sall EI, Diallo Agne H, Faye K, Diatta JP, Sy MP, Chang M, Diaw B, Sambou J, Bakhoum R, Sy MD, Niang A, Malomar JJ, Coombs RW, Hawes SE, Ndoye I, Kiviat NB, Sow PS, Seydi M, Gottlieb GS. Long-term Experience and Outcomes of Programmatic Antiretroviral Therapy for Human Immunodeficiency Virus Type 2 Infection in Senegal, West Africa. Clin Infect Dis 2021; 72:369-378. [PMID: 33527119 PMCID: PMC7850514 DOI: 10.1093/cid/ciaa277] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/12/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Programmatic treatment outcome data for people living with human immunodeficiency virus type 2 (HIV-2) in West Africa, where the virus is most prevalent, are scarce. METHODS Adults with HIV-2 initiating or receiving antiretroviral therapy (ART) through the Senegalese national AIDS program were invited to participate in this prospective, longitudinal observational cohort study. We analyzed HIV-2 viral loads, CD4 cell counts, antiretroviral drug resistance, loss to follow-up, and mortality. We also examined changes in treatment guidelines over time and assessed progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets for HIV-2. RESULTS We enrolled 291 participants at 2 sites for 926.0 person-years of follow-up over 13 years. Median follow-up time was 2.2 years per participant. There were 21 deaths reported (7.2%), and 117 individuals (40.2%) were lost to follow-up, including 43 (14.7%) who had an initial visit but never returned for follow-up. CD4 counts and HIV-2 viral suppression (< 50 copies/mL) at enrollment increased over calendar time. Over the study period, 76.7% of plasma viral loads for participants receiving ART were suppressed, and median CD4 gain was 84 cells/μL in participants' first 2 years on study. Since the UNAIDS 90-90-90 strategy was published, 88.1% of viral loads were suppressed. Fifteen percent of patients experienced virologic failure with no known resistance mutations, while 56% had evidence of multiclass drug resistance. CONCLUSIONS Participants in the Senegalese national AIDS program are initiating ART earlier in the course of disease, and more modern therapeutic regimens have improved outcomes among those receiving therapy. Despite these achievements, HIV-2 treatment remains suboptimal, and significant challenges to improving care remain.
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Affiliation(s)
- Dana N Raugi
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Selly Ba
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | | | - Khardiata Diallo
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | | | - Cheikh Ndour
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Ndeye Mery Dia Badiane
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Louise Fortes
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Mouhamadou Baïla Diallo
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | | | - Robert A Smith
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Fatima Sall
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Macoumba Toure
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | | | - Habibatou Diallo Agne
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Khadim Faye
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | | | - Marie Pierre Sy
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Ming Chang
- Laboratory Medicine, Division of Virology, University of Washington, Seattle, Washington, USA
| | - Binetou Diaw
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | | | | | | | | | | | - Robert W Coombs
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
- Laboratory Medicine, Division of Virology, University of Washington, Seattle, Washington, USA
| | - Stephen E Hawes
- Epidemiology, University of Washington, Seattle, Washington, USA
| | - Ibra Ndoye
- Conseil National de Lutte Contre le SIDA du Senegal, Dakar, Senegal
| | - Nancy B Kiviat
- Pathology, University of Washington, Seattle, Washington, USA
| | - Papa Salif Sow
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Moussa Seydi
- Service des Maladies Infectieuses et Tropicales, Ibrahima Diop Mar, Centre Hospitalier National Universitaire de Fann, Universite Cheikh Anta Diop de Dakar, Dakar, Senegal
| | - Geoffrey S Gottlieb
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA
- Global Health, University of Washington, Seattle, Washington, USA
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13
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HIV-2 Drug Resistance Genotyping from Dried Blood Spots. J Clin Microbiol 2020; 59:JCM.02303-20. [PMID: 33055182 DOI: 10.1128/jcm.02303-20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/09/2020] [Indexed: 11/20/2022] Open
Abstract
The treatment of HIV-2 in resource-limited settings (RLS) is complicated by the limited availability of HIV-2-active antiretroviral drugs and inadequate access to HIV-2 viral load and drug resistance testing. Dried blood spots (DBS)-based drug resistance testing, widely studied for HIV-1, has not been reported for HIV-2 and could present an opportunity to improve care for HIV-2-infected individuals. We selected 150 DBS specimens from ongoing studies of antiretroviral therapy (ART) for HIV-2 infection in Senegal and subjected them to genotypic drug resistance testing. Total nucleic acid was extracted from DBS, reverse transcribed, PCR amplified, and analyzed by population-based Sanger sequencing, and major drug resistance-associated mutations (RAM) were identified. Parallel samples from plasma and peripheral blood mononuclear cells (PBMC) were also genotyped. We obtained 58 protease/reverse transcriptase genotypes. Plasma viral load was significantly correlated with genotyping success (P < 0.001); DBS samples with corresponding plasma viral load >250 copies/ml had a success rate of 86.8%. In paired DBS-plasma genotypes, 83.8% of RAM found in plasma were also found in DBS, and replicate DBS genotyping revealed that a single test detected 86.7% of known RAM. These findings demonstrate that DBS-based genotypic drug resistance testing for HIV-2 is feasible and can be deployed in RLS with limited infrastructure.
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14
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Gottlieb GS, Rosenberg JM, Gonzalez RG, Gandhi RT. Case 27-2020: A 53-Year-Old Woman with Headache and Gait Imbalance. N Engl J Med 2020; 383:859-866. [PMID: 32846066 DOI: 10.1056/nejmcpc1913472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Geoffrey S Gottlieb
- From the Departments of Medicine and Global Health, Center for Emerging and Re-Emerging Infectious Diseases, University of Washington School of Medicine, Seattle (G.S.G.); and the Departments of Medicine (J.M.R., R.T.G.) and Radiology (R.G.G.), Massachusetts General Hospital, and the Departments of Medicine (J.M.R., R.T.G.) and Radiology (R.G.G.), Harvard Medical School - both in Boston
| | - Jacob M Rosenberg
- From the Departments of Medicine and Global Health, Center for Emerging and Re-Emerging Infectious Diseases, University of Washington School of Medicine, Seattle (G.S.G.); and the Departments of Medicine (J.M.R., R.T.G.) and Radiology (R.G.G.), Massachusetts General Hospital, and the Departments of Medicine (J.M.R., R.T.G.) and Radiology (R.G.G.), Harvard Medical School - both in Boston
| | - R Gilberto Gonzalez
- From the Departments of Medicine and Global Health, Center for Emerging and Re-Emerging Infectious Diseases, University of Washington School of Medicine, Seattle (G.S.G.); and the Departments of Medicine (J.M.R., R.T.G.) and Radiology (R.G.G.), Massachusetts General Hospital, and the Departments of Medicine (J.M.R., R.T.G.) and Radiology (R.G.G.), Harvard Medical School - both in Boston
| | - Rajesh T Gandhi
- From the Departments of Medicine and Global Health, Center for Emerging and Re-Emerging Infectious Diseases, University of Washington School of Medicine, Seattle (G.S.G.); and the Departments of Medicine (J.M.R., R.T.G.) and Radiology (R.G.G.), Massachusetts General Hospital, and the Departments of Medicine (J.M.R., R.T.G.) and Radiology (R.G.G.), Harvard Medical School - both in Boston
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15
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Tchounga BK, Charpentier C, Coffie PA, Dabis F, Descamps D, Eholie SP, Ekouevi DK. Survival among antiretroviral-experienced HIV-2 patients experiencing virologic failure with drug resistance mutations in Cote d'Ivoire West Africa. PLoS One 2020; 15:e0236642. [PMID: 32756581 PMCID: PMC7406077 DOI: 10.1371/journal.pone.0236642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 07/09/2020] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The long-term prognosis of HIV-2-infected patients receiving antiretroviral therapy (ART) is still challenging, due to the intrinsic resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI) and the suboptimal response to some protease inhibitors (PI). The objective was to describe the 5-years outcomes among HIV-2 patients harboring drug-resistant viruses. METHODS A clinic-based cohort of HIV-2-patients experiencing virologic failure, with at least one drug resistance mutation was followed from January 2012 to August 2017 in Côte d'Ivoire. Follow-up data included death, lost to follow-up (LTFU), immuno-virological responses. The Kaplan-Meier curve was used to estimate survival rates. RESULTS A total of 31 HIV-2 patients with virologic failure and with at least one drug resistance mutation were included. Two-third of them were men, 28(90.3%) were on PI-based ART-regimen at enrolment and the median age was 50 years (IQR = 46-54). The median baseline CD4 count and viral load were 456 cells/mm3 and 3.7 log10 c/mL respectively, and the participants have been followed-up in median 57 months (IQR = 24-60). During this period, 21 (67.7%) patients switched at least one antiretroviral drug, including two (6.5%) and three (9.7%) who switched to a PI-based and an integrase inhibitor-based regimen respectively. A total of 10(32.3%) patients died and 4(12.9%) were LTFU. The 36 and 60-months survival rates were 68.5% and 64.9%, respectively. Among the 17 patients remaining in care, six(35.3%) had an undetectable viral load (<50 c/mL) and for the 11 others, the viral load ranged from 2.8 to 5.6 log10 c/mL. Twelve patients were receiving lopinavir at the time of first genotype, five(42%) had a genotypic susceptibility score (GSS) ≤1 and 4(33%) a GSS >2. CONCLUSIONS The 36-months survival rate among ART-experienced HIV-2 patients with drug-resistant viruses is below 70%,lower than in HIV-1. There is urgent need to improve access to second-line ART for patients living with HIV-2 in West Africa.
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Affiliation(s)
- Boris K. Tchounga
- Programme PACCI, Site de recherche ANRS de Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | | | - Patrick A. Coffie
- Département de Dermatologie et Maladies Infectieuses, Université Félix Houphouët-Boigny, UFR des Sciences Médicales, Abidjan, Côte d’Ivoire
| | - François Dabis
- Centre Inserm 1219 & Institut de Santé Publique d’épidémiologie et de développement, Université de Bordeaux, Bordeaux, France
| | - Diane Descamps
- Université de Paris, INSERM UMR 1137 IAME, Paris, France
| | - Serge P. Eholie
- Département de Dermatologie et Maladies Infectieuses, Université Félix Houphouët-Boigny, UFR des Sciences Médicales, Abidjan, Côte d’Ivoire
| | - Didier K. Ekouevi
- Centre Inserm 1219 & Institut de Santé Publique d’épidémiologie et de développement, Université de Bordeaux, Bordeaux, France
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16
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Requena S, Lozano AB, Caballero E, García F, Nieto MC, Téllez R, Fernández JM, Trigo M, Rodríguez-Avial I, Martín-Carbonero L, Miralles P, Soriano V, de Mendoza C. Clinical experience with integrase inhibitors in HIV-2-infected individuals in Spain. J Antimicrob Chemother 2020; 74:1357-1362. [PMID: 30753573 DOI: 10.1093/jac/dkz007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/26/2018] [Accepted: 12/31/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND HIV-2 is a neglected virus despite estimates of 1-2 million people being infected worldwide. The virus is naturally resistant to some antiretrovirals used to treat HIV-1 and therapeutic options are limited for patients with HIV-2. METHODS In this retrospective observational study, we analysed all HIV-2-infected individuals treated with integrase strand transfer inhibitors (INSTIs) recorded in the Spanish HIV-2 cohort. Demographics, treatment modalities, laboratory values, quantitative HIV-2 RNA and CD4 counts as well as drug resistance were analysed. RESULTS From a total of 354 HIV-2-infected patients recruited by the Spanish HIV-2 cohort as of December 2017, INSTIs had been given to 44, in 18 as first-line therapy and in 26 after failing other antiretroviral regimens. After a median follow-up of 13 months of INSTI-based therapy, undetectable viraemia for HIV-2 was achieved in 89% of treatment-naive and in 65.4% of treatment-experienced patients. In parallel, CD4 gains were 82 and 126 cells/mm3, respectively. Treatment failure occurred in 15 patients, 2 being treatment-naive and 13 treatment-experienced. INSTI resistance changes were recognized in 12 patients: N155H (5), Q148H/R (3), Y143C/G (3) and R263K (1). CONCLUSIONS Combinations based on INSTIs are effective and safe treatment options for HIV-2-infected individuals. However, resistance mutations to INSTIs are selected frequently in failing patients, reducing the already limited treatment options.
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Affiliation(s)
- S Requena
- Puerta de Hierro University Hospital and Research Institute, Madrid, Spain
| | | | | | - F García
- Hospital Universitario San Cecilio, Instituto de Investigación Ibs, Granada, Spain
| | | | - R Téllez
- Fundación Jiménez-Díaz, Madrid, Spain
| | | | - M Trigo
- Complejo Hospitalario, Pontevedra, Spain
| | | | | | - P Miralles
- Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - V Soriano
- Hospital Universitario La Paz, Madrid, Spain.,UNIR Health Sciences School, Madrid, Spain
| | - C de Mendoza
- Puerta de Hierro University Hospital and Research Institute, Madrid, Spain.,Universidad San Pablo CEU, Madrid, Spain
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17
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Le Hingrat Q, Collin G, Lê M, Peytavin G, Visseaux B, Bertine M, Tubiana R, Karmochkine M, Valin N, Collin F, Lemaignen A, Bernard L, Damond F, Matheron S, Descamps D, Charpentier C. A New Mechanism of Resistance of Human Immunodeficiency Virus Type 2 to Integrase Inhibitors: A 5-Amino-Acid Insertion in the Integrase C-Terminal Domain. Clin Infect Dis 2020; 69:657-667. [PMID: 30383215 DOI: 10.1093/cid/ciy940] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/30/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Integrase strand transfer inhibitors (INSTIs) are crucial for the treatment of human immunodeficiency virus (HIV) type 2 infection, due to limited available therapeutic options. Recently, bictegravir has been approved for HIV-1, but no data are currently available for HIV-2. METHODS We assessed the phenotypic susceptibility of 12 HIV-2 clinical isolates, obtained from 2 antiretroviral-naive and 10 antiretroviral-experienced patients, to 5 INSTIs (bictegravir, cabotegravir, dolutegravir, elvitegravir, and raltegravir) at the virological failure of an INSTI-based regimen. The 50% inhibitory concentrations (IC50s) were determined. Phenotypic inhibitory quotients were determined using trough INSTI plasma concentrations. RESULTS Wild-type viruses were susceptible to the 5 INSTIs, with IC50s in the nanomolar range. Bictegravir had a lower IC50 than the other INSTIs on those HIV-2 isolates bearing major, resistance-associated mutations (codons 143, 148, and 155). We identified a new resistance profile-a 5-amino-acid insertion at codon 231 of the HIV-2 integrase (231INS)-in 6 patients at the virological failure of a raltegravir-based regimen. Those patients had adequate raltegravir concentrations, but harbored multiresistant viruses with low genotypic susceptibility scores (median = 1.5). This insertion rendered isolates highly resistant to raltegravir and elvitegravir, and moderately resistant to dolutegravir and cabotegravir. Regarding bictegravir, 2 isolates remained susceptible and 2 had a slight increase in IC50 (3- to 5-fold change). CONCLUSIONS Our results confirm the potency of INSTI on HIV-2 clinical isolates with wild-type integrase. In addition, we identified a new resistance pathway, 231INS, selected in antiretroviral-experienced patients with multiresistant HIV-2 viruses. This highlights the need of close follow-up of those patients initiating an INSTI-based regimen.
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Affiliation(s)
- Quentin Le Hingrat
- Infections Antimicrobials Modelling Evolution, Unité Mixte de Recherche (UMR) 1137, Institut national de la santé et de la recherche médicale (INSERM), Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital St-Antoine, Paris.,Laboratoire de Virologie, Hôpital St-Antoine, Paris
| | - Gilles Collin
- Infections Antimicrobials Modelling Evolution, Unité Mixte de Recherche (UMR) 1137, Institut national de la santé et de la recherche médicale (INSERM), Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital St-Antoine, Paris.,Laboratoire de Virologie, Hôpital St-Antoine, Paris
| | - Minh Lê
- Infections Antimicrobials Modelling Evolution, Unité Mixte de Recherche (UMR) 1137, Institut national de la santé et de la recherche médicale (INSERM), Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital St-Antoine, Paris.,Laboratoire de Pharmacologie, Hôpital Bichat, AP-HP, Hôpital St-Antoine, Paris
| | - Gilles Peytavin
- Infections Antimicrobials Modelling Evolution, Unité Mixte de Recherche (UMR) 1137, Institut national de la santé et de la recherche médicale (INSERM), Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital St-Antoine, Paris.,Laboratoire de Pharmacologie, Hôpital Bichat, AP-HP, Hôpital St-Antoine, Paris
| | - Benoit Visseaux
- Infections Antimicrobials Modelling Evolution, Unité Mixte de Recherche (UMR) 1137, Institut national de la santé et de la recherche médicale (INSERM), Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital St-Antoine, Paris.,Laboratoire de Virologie, Hôpital St-Antoine, Paris
| | - Mélanie Bertine
- Infections Antimicrobials Modelling Evolution, Unité Mixte de Recherche (UMR) 1137, Institut national de la santé et de la recherche médicale (INSERM), Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital St-Antoine, Paris.,Laboratoire de Virologie, Hôpital St-Antoine, Paris
| | - Roland Tubiana
- Service de Maladies Infectieuses, Hôpital Pitié-Salpêtrière, AP-HP, Hôpital St-Antoine, Paris.,Sorbonne Universités, Université Paris 6-Pierre et Marie Curie, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (UMRS 1136), Hôpital St-Antoine, Paris
| | - Marina Karmochkine
- Service d'Immunologie Clinique, Hôpital Européen Georges Pompidou, Hôpital St-Antoine, Paris
| | - Nadia Valin
- Service de Maladies Infectieuses et Tropicales, Hôpital St-Antoine, Paris
| | - Fidéline Collin
- Bordeaux Population Health Center, UMR 1219, INSERM, AP-HP, Paris, France.,Centre Hospitalier Universitaire de Bordeaux, AP-HP, Paris, France
| | - Adrien Lemaignen
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Universitaire de Tours, AP-HP, Paris, France
| | - Louis Bernard
- Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier Universitaire de Tours, AP-HP, Paris, France
| | - Florence Damond
- Infections Antimicrobials Modelling Evolution, Unité Mixte de Recherche (UMR) 1137, Institut national de la santé et de la recherche médicale (INSERM), Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital St-Antoine, Paris.,Laboratoire de Virologie, Hôpital St-Antoine, Paris
| | - Sophie Matheron
- Infections Antimicrobials Modelling Evolution, Unité Mixte de Recherche (UMR) 1137, Institut national de la santé et de la recherche médicale (INSERM), Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital St-Antoine, Paris.,Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France
| | - Diane Descamps
- Infections Antimicrobials Modelling Evolution, Unité Mixte de Recherche (UMR) 1137, Institut national de la santé et de la recherche médicale (INSERM), Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital St-Antoine, Paris.,Laboratoire de Virologie, Hôpital St-Antoine, Paris
| | - Charlotte Charpentier
- Infections Antimicrobials Modelling Evolution, Unité Mixte de Recherche (UMR) 1137, Institut national de la santé et de la recherche médicale (INSERM), Université Paris Diderot, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital St-Antoine, Paris.,Laboratoire de Virologie, Hôpital St-Antoine, Paris
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18
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Minchella PA, Adjé-Touré C, Zhang G, Tehe A, Hedje J, Rottinghaus ER, Kohemun N, Aka M, Diallo K, Ouedraogo GL, De Cock KM, Nkengasong JN. Long-term immunological responses to treatment among HIV-2 patients in Côte d'Ivoire. BMC Infect Dis 2020; 20:213. [PMID: 32164565 PMCID: PMC7069012 DOI: 10.1186/s12879-020-4927-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/27/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Studies indicate that responses to HIV-2 treatment regimens are worse than responses to HIV-1 regimens during the first 12 months of treatment, but longer-term treatment responses are poorly described. We utilized data from Côte d'Ivoire's RETRO-CI laboratory to examine long-term responses to HIV-2 treatment. METHODS Adult (≥15 years) patients with baseline CD4 counts < 500 cells/μl that initiated treatment at one of two HIV treatment centers in Abidjan, Côte d'Ivoire between 1998 and 2004 were included in this retrospective cohort study. Patients were stratified by baseline CD4 counts and survival analyses were employed to examine the relationship between HIV type and time to achieving CD4 ≥ 500 cells/μl during follow up. RESULTS Among 3487 patients, median follow-up time was 4 years and 57% had documented ART regimens for > 75% of their recorded visits. Kaplan-Meier estimates for achievement of CD4 ≥ 500 cells/μl after 6 years of follow-up for patients in the lower CD4 strata (< 200 cells/μl) were 40% (HIV-1), 31% (HIV-dual), and 17% (HIV-2) (log-rank p < 0.001). Cox Regression indicated that HIV-1 was significantly associated with achievement of CD4 ≥ 500 cells/μl during follow-up, compared to HIV-2. CONCLUSIONS Sub-optimal responses to long-term HIV-2 treatment underscore the need for more research into improved and/or new treatment options for patients with HIV-2. In many West African countries, effective treatment of both HIV-1 and HIV-2 will be essential in the effort to reach epidemic control.
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Affiliation(s)
- Peter A. Minchella
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA USA
| | - Christiane Adjé-Touré
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Abidjan, Côte d’Ivoire
| | - Guoqing Zhang
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA USA
| | - Andre Tehe
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Abidjan, Côte d’Ivoire
| | - Judith Hedje
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Abidjan, Côte d’Ivoire
| | - Erin R. Rottinghaus
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA USA
| | - Natacha Kohemun
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Abidjan, Côte d’Ivoire
| | - Micheline Aka
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Abidjan, Côte d’Ivoire
| | - Karidia Diallo
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Pretoria, South Africa
| | - G. Laissa Ouedraogo
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Abidjan, Côte d’Ivoire
| | - Kevin M. De Cock
- Division of Global HIV and Tuberculosis, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - John N Nkengasong
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
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19
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Gunaratne SH, Gandhi RT. HIV-2 Infection: Latest Advances. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2019. [DOI: 10.1007/s40506-019-00201-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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20
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Smith RA, Raugi DN, Wu VH, Zavala CG, Song J, Diallo KM, Seydi M, Gottlieb GS. Comparison of the Antiviral Activity of Bictegravir against HIV-1 and HIV-2 Isolates and Integrase Inhibitor-Resistant HIV-2 Mutants. Antimicrob Agents Chemother 2019; 63:e00014-19. [PMID: 30803972 PMCID: PMC6496081 DOI: 10.1128/aac.00014-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 02/22/2019] [Indexed: 12/16/2022] Open
Abstract
We compared the activity of the integrase inhibitor bictegravir against HIV-1 and HIV-2 using a culture-based, single-cycle assay. Values of 50% effective concentrations ranged from 1.2 to 2.5 nM for 9 HIV-1 isolates and 1.4 to 5.6 nM for 15 HIV-2 isolates. HIV-2 integrase mutants G140S/Q148R and G140S/Q148H were 34- and 110-fold resistant to bictegravir, respectively; other resistance-associated mutations conferred ≤5-fold changes in bictegravir susceptibility. Our findings indicate that bictegravir-based antiretroviral therapy should be evaluated in HIV-2-infected individuals.
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Affiliation(s)
- Robert A Smith
- Center for Emerging and Reemerging Infectious Diseases and Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Dana N Raugi
- Center for Emerging and Reemerging Infectious Diseases and Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Vincent H Wu
- Center for Emerging and Reemerging Infectious Diseases and Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Christopher G Zavala
- Center for Emerging and Reemerging Infectious Diseases and Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Jennifer Song
- Center for Emerging and Reemerging Infectious Diseases and Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | | | - Moussa Seydi
- Service des Maladies Infectieuses et Tropicales, CHNU de Fann, Dakar, Senegal
| | - Geoffrey S Gottlieb
- Center for Emerging and Reemerging Infectious Diseases and Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
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21
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90-90-90 for HIV-2? Ending the HIV-2 epidemic by enhancing care and clinical management of patients infected with HIV-2. Lancet HIV 2019; 5:e390-e399. [PMID: 30052509 DOI: 10.1016/s2352-3018(18)30094-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 04/20/2018] [Accepted: 04/24/2018] [Indexed: 12/23/2022]
Abstract
Distinct from HIV-1 and often neglected in the global campaign to end the AIDS epidemic, HIV-2 presents unique and underappreciated challenges in diagnosis, clinical care, antiretroviral therapy (ART), and HIV programmatic management. Here, we review the epidemiology and natural history of HIV-2, diagnostics and algorithms for accurately diagnosing and differentiating HIV-2 from HIV-1, the unique features of HIV-2 ART and drug resistance, and the clinical care and management of patients infected with HIV-2 in both developed and resource-limited settings. Ultimately, further research is needed to address the gaps in our knowledge of HIV-2 infection, increased resources are needed to specifically target HIV-2 as part of the UNAIDS/WHO 90-90-90 campaign to end AIDS, and increased determination is needed to better advocate for inclusion of people living with HIV-2 in global HIV/AIDS initiatives.
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22
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Esbjörnsson J, Månsson F, Kvist A, da Silva ZJ, Andersson S, Fenyö EM, Isberg PE, Biague AJ, Lindman J, Palm AA, Rowland-Jones SL, Jansson M, Medstrand P, Norrgren H. Long-term follow-up of HIV-2-related AIDS and mortality in Guinea-Bissau: a prospective open cohort study. Lancet HIV 2018; 6:S2352-3018(18)30254-6. [PMID: 30392769 DOI: 10.1016/s2352-3018(18)30254-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 08/24/2018] [Accepted: 09/06/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND HIV type 2 (HIV-2) is considered more benign and has fewer pathogenic consequences than HIV type 1 (HIV-1) for most infected individuals. However, reliable estimates of time to AIDS and mortality among those with HIV-2 infection are absent. We therefore aimed to compare the time to AIDS and mortality, and the CD4 T-cell dynamics between those infected with HIV-1 and HIV-2. METHODS We did a prospective open cohort study. We included all police officers with regular employment from police stations in both urban and rural areas of Guinea-Bissau since Feb 6, 1990. We continued to include participants until Sept 28, 2009, and follow-up of HIV-1-positive and HIV-2-positive individuals continued until Sept 28, 2013. We collected blood samples at enrolment and at scheduled annual follow-up visits at police stations. We analysed longitudinal data from individuals infected with HIV-1 and HIV-2 according to time to AIDS, time to death, and T-cell dynamics. Time of HIV infection was estimated as the mid-timepoint between last HIV-seronegative and first HIV-seropositive sample. Data from an additional 2984 HIV-uninfected individuals from the same population were analysed to assess the effect of natural mortality on HIV-related mortality. FINDINGS 872 participants tested HIV positive during the 23-year study period: 408 were infected with HIV-1 (183 infected before and 225 infected after enrolment) and 464 were infected with HIV-2 (377 before and 87 after enrolment). The median time from HIV infection to development of AIDS was 6·2 years (95% CI 5·4-7·1) for HIV-1 infection and 14·3 years (10·7-18·0) for HIV-2 infection (p<0·0001). The median survival time after HIV infection was 8·2 years (95% CI 7·5-8·9) for HIV-1 infection and 15·6 years (12·0-19·2) for HIV-2 infection (p<0·0001). Individuals who were infected with HIV-1 or HIV-2 before enrolment showed similar results. Comparison with uninfected individuals indicated limited confounding contribution from natural mortality. Mean CD4 percentages were higher in individuals with HIV-2 than in those with HIV-1 during early infection (28·0% [SE 1·3] vs 22·3% [1·7]; p=0·00094) and declined at a slower rate (0·4% [0·2] vs 0·9% [0·2] per year; p=0·028). HIV-2-infected individuals developed clinical AIDS at higher mean CD4 percentages (18·2%, IQR 7·2-25·4) than HIV-1-infected individuals (8·2%, 3·0-13·8; p<0·0001). INTERPRETATION Our results show that both HIV-1-infected and HIV-2-infected individuals have a high probability of developing and dying from AIDS without antiretroviral treatment. FUNDING Swedish International Development Agency, Swedish Research Council, Swedish Society of Medical Research, Medical Faculty at Lund University, and Region Skåne Research and Development.
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Affiliation(s)
- Joakim Esbjörnsson
- Department of Laboratory Medicine, Lund University, Malmö, Sweden; Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - Fredrik Månsson
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Anders Kvist
- Department of Clinical Sciences Lund, Lund University, Malmö, Sweden
| | | | - Sören Andersson
- Department of Laboratory Medicine, Örebro University, Örebro, Sweden
| | - Eva Maria Fenyö
- Department of Laboratory Medicine, Lund University, Malmö, Sweden
| | - Per-Erik Isberg
- Department of Statistics, Lund University School of Economics and Management, Lund, Sweden
| | | | - Jacob Lindman
- Department of Clinical Sciences Lund, Lund University, Malmö, Sweden
| | - Angelica A Palm
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | | | - Marianne Jansson
- Department of Laboratory Medicine, Lund University, Malmö, Sweden
| | - Patrik Medstrand
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Hans Norrgren
- Department of Clinical Sciences Lund, Lund University, Malmö, Sweden
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23
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In Vitro Antiviral Activity of Cabotegravir against HIV-2. Antimicrob Agents Chemother 2018; 62:AAC.01299-18. [PMID: 30012774 DOI: 10.1128/aac.01299-18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 07/12/2018] [Indexed: 02/08/2023] Open
Abstract
We examined the antiviral activity of the integrase inhibitor (INI) cabotegravir against HIV-2 isolates from INI-naive individuals. HIV-2 was sensitive to cabotegravir in single-cycle and spreading-infection assays, with 50% effective concentrations (EC50s) in the low to subnanomolar range; comparable results were obtained for HIV-1 in both assay formats. Our findings suggest that cabotegravir should be evaluated in clinical trials as a potential option for antiretroviral therapy and preexposure prophylaxis in HIV-2-prevalent settings.
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