HIV-2 infection in Providence, Rhode Island from 2002 to 2011

Abstract

Objectives: In contrast to HIV-1 infection, little is known about the natural disease course of HIV-2 and its response to antiretrovirals (ARVs). We describe a cohort of HIV-2-infected patients, focusing on the method of diagnosis, ARV treatment and complications. Methods: Through a retrospective review of medical records at our centre, we identified 12 patients with HIV-2 infection in our clinic population (1400 active patients) who received care between 2002 and 2011. We summarized clinical characteristics, ARV treatment and outcomes. Results: Seven of the patients were male and five were female. All patients were born in West African countries. The mode of transmission was heterosexual intercourse in 11 patients, and injecting drug use in one patient. The median CD4 count at the time of diagnosis was 668 cells/μL (range 23 to 1546 cells/μL). HIV-2 quantitative viral load measurements were not uniformly available to clinicians. Four patients were treated with protease inhibitor-based regimens, with a mean increase in CD4 count of 183 cells/μL (range 43 to 341 cells/μL). The other eight patients have been observed off ARVs. Two patients experienced complications from HIV, one patient had HIV encephalopathy and molluscom contagiosum, and another had microsporidiosis infection in the setting of AIDS. Conclusion: Our results support those of previous studies indicating that HIV-2 has a more indolent disease course than HIV-1, with a spectrum of disease ranging from asymptomatic to AIDS. Development of a reliable quantitative HIV-2 viral load assay to guide management is needed. Further research studies are needed to establish the best time to start ARV treatment in HIV-2-infected patients. © 2013 British HIV Association.