Clinical Correlations in Hiv-1 and Hiv-2 Infected Patients

Abstract

In Portugal, the prevalence of human immunodeficiency virus type 2 (HIV-2) seropositivity is higher than in other European countries or North America. Recent literature data points out a possible difference on the pathogenic potential and on the natural history of HIV-1 and HIV-2, suggesting a lower virulence of HIV-2. Facing these hypothesis and the increasing number of HIV-2 cases, we analysed two infected groups HIV-1 and HIV-2, trying to correlate the ophthalmologic lesions present in both populations and searching for a difference in the clinical presentation of the ocular disorder. We studied prospectively 214 patients with HIV infection at several stages, 83% HIV-1 and 17% HIV-2. Ocular manifestations were present in both populations with a significant prevalence in HIV-1 (48%), compared to HIV-2 (19%) (p < 0.005). The ophthalmologic pathology found, particularly noninfectious retinopathy, infectious retinitis and neuro-ophthalmic disorders, were considered important for the disease's diagnosis and prognosis. All these ophthalmic findings were present in the HIV-1 population. In the HIV-2 group the most frequent lesion was noninfectious retinopathy. Within each group, HIV-1 and HIV-2, the comparison of the survival between AIDS patients with and without ocular lesions, revealed a significant shorter survival time in those with ocular pathology (p < 0.001 and p < 0.05). There seems to exist a certain analogy in clinical expression in both groups, although it is possible to admit a lower severity in ocular involvement in patients infected by HIV-2.

Human immunodeficiency virus and hepatitis C co-infection in sub-Saharan West Africa

“…HIV-2 infection is fairly well confined to the West Africa region,21,22 with nations such as Senegal, Mauritania, Cape Verde19 and Gambia 23 having prevalence rates ranging from 0.3% to 17%. 24 The lower HIV/AIDS prevalence rate found in sub-Saharan West Africa may be due to the comparatively higher prevalence of HIV-2 in the region.…”

“…This changing trend may increase the HIV/AIDS disease burden of the region, taking into consideration the comparatively higher degree of virulence 24,27,28 and genetic diversity 26 associated with HIV-1 infection. Also, the gradual replacement of HIV-2 by HIV-1 may pose a major problem for vaccine design, as information on the genetic diversity of HIV, especially HIV-1, is vital for developing an effective vaccine.…”

Sustained remission of CMV retinitis in HIV-2 disease

“…HIV-2 is biologically similar to HIV-1 but it has a reduced virulence 5. The only study to our knowledge comparing ocular lesions between HIV-1 and HIV-2 infected individuals is by Monteiro-Grillo et al 6. They reported less severe complications in patients infected by HIV-2.…”