Long-term follow-up of HIV-2-related AIDS and mortality in Guinea-Bissau: a prospective open cohort study

Kvist, Anders; Silva, Zacarias J da; Andersson, Sören; Fenyõ, Éva Mária; Isberg, Per‐Erik; Rowland‐Jones, Sarah; N'Buna, Babetida; Biague, Antonio; Biai, Ansu; Camara, C; Esbjörnsson, Joakim; Jansson, Marianne; Karlson, Sara; Lindman, Jacob; Medstrand, Patrik; Månsson, Fredrik; Norrgren, Hans; Palm, Angelica A.; Şahin, Gülşen Özkaya; Silva, Zacarias José da; Wilhelmson, Sten

doi:10.1016/s2352-3018(18)30254-6

Cited by 59 publications

(71 citation statements)

References 30 publications

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“…Approximately, 270 (95.1%) of the study participants were infected with HIV-1, while 12 (4.2%) recorded both HIV-1 and 2 infections and only 2 (0.7%) were infected with HIV-2 ( Table 1). In the Guinean-Bissau population, new HIV-1 infections were found to be predominant (225 (72.1%)) after 23 years of follow-up of a cohort of 872 security officers [17], similar to our finding. However, the proportion of HIV-2 infection (87 (27.9%)) recorded in the Guinean-Bissau study was more than what we observed in our study.…”

Section: Discussionsupporting

confidence: 90%

Viral Suppression and Its Associated Factors in HIV Patients on Highly Active Antiretroviral Therapy (HAART): A Retrospective Study in the Ho Municipality, Ghana

Lokpo

Ofori-Attah

Ameke

et al. 2020

AIDS Research and Treatment

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Background. The WHO targets to end HIV/AIDS as a public health problem by 2030. The introduction of the ambitious “90-90-90” strategy to attain this target is expected to be achieved by the year 2020. However, there is lack of regional data, especially on the third “90.” This study sought to assess the rate and associated factors of viral suppression among people living with HIV (PLWH) on highly active antiretroviral therapy (HAART) at the Antiretroviral Therapy (ART) Clinic in a Ghanaian health facility. Method. The study design was a retrospective analysis of secondary data of 284 HIV registrants on HAART for at least 6 months at the ART Clinic from July 2016 to April 2019. Data on sociodemography including age, gender, marital status, education, and occupation as well as pharmacological (type of medication and duration on medication) and laboratory variable (current viral load results) were extracted from patients’ folders. Viral suppression and failure were determined using the WHO definitions (viral suppression as viral load <1000 copies/ml and virologic failure ≥1000 copies/ml). Regular clinic attendance (used as a proxy measure for medication adherence) was defined as consistent monthly clinic attendance for HAART medication and other clinical management within the past 12 months. Results. Out of the 284 HIV patients, 195 (69%) achieved viral suppression. Of the 195 who were virally suppressed, 77 (39.5%) had undetectable levels, with a similar proportion (39.5%) achieving viral load results ranging from 20 to 200 copies/ml. Moreover, 27 (13.8%) patients had viral load ranging from 201 to 500 copies/ml while 14 (7.2%) recorded viral load from 501 to 1000 copies/ml. No clear pattern in the viral suppression rate was associated with the age groups (p=0.1152). However, regular clinic attendance (used as proxy for medication adherence) (p<0.0001) and being on HAART for more than three (3) years (p=0.03) were associated with viral suppression. Conclusion. The rate of viral suppression among PLWH on HAART in the Ho municipality fell short of the WHO target. However, the study identified regular ART clinic attendance and treatment >3 years as factors associated with viral suppression.

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Section: Discussionsupporting

confidence: 90%

Viral Suppression and Its Associated Factors in HIV Patients on Highly Active Antiretroviral Therapy (HAART): A Retrospective Study in the Ho Municipality, Ghana

Lokpo

Ofori-Attah

Ameke

et al. 2020

AIDS Research and Treatment

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“…Eighty-seven per cent of the participants included in the French ANRS CO5 cohort originate from this geographical area. Compared to HIV-1 infection, HIV-2 infection is characterized by undetectable-to-low viremia, slower CD4 + T-cell decline and activation, slower disease progression (4,5). The proportion of long-term non progressors (LTNP) is higher during HIV-2 than during HIV-1 infection (4).…”

Section: Introductionmentioning

confidence: 99%

Conventional Dendritic Cells and Slan+ Monocytes During HIV-2 Infection

et al. 2020

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HIV-2 infection is characterized by low viremia and slow disease progression as compared to HIV-1 infection. Circulating CD14 ++ CD16 + monocytes were found to accumulate and CD11c + conventional dendritic cells (cDC) to be depleted in a Portuguese cohort of people living with HIV-2 (PLWHIV-2), compared to blood bank healthy donors (HD). We studied more precisely classical monocytes; CD16 + inflammatory (intermediate, non-classical and slan + monocytes, known to accumulate during viremic HIV-1 infection); cDC1, important for cross-presentation, and cDC2, both depleted during HIV-1 infection. We analyzed by flow cytometry these PBMC subsets from Paris area residents: 29 asymptomatic, untreated PLWHIV-2 from the IMMUNOVIR-2 study, part of the ANRS-CO5 HIV-2 cohort: 19 long-term non-progressors (LTNP; infection ≥8 years, undetectable viral load, stable CD4 counts≥500/µL; 17 of West-African origin-WA), and 10 non-LTNP (P; progressive infection; 9 WA); and 30 age-and sex-matched controls: 16 blood bank HD with unknown geographical origin, and 10 HD of WA origin (GeoHD). We measured plasma bacterial translocation markers by ELISA. Non-classical monocyte counts were higher in GeoHD than in HD (54 vs. 32 cells/µL, p = 0.0002). Slan + monocyte counts were twice as high in GeoHD than in HD (WA: 28 vs. 13 cells/µL, p = 0.0002). Thus cell counts were compared only between participants of WA origin. They were similar in LTNP, P and GeoHD, indicating that there were no HIV-2 related differences. cDC counts did not show major differences between the groups. Interestingly, inflammatory monocyte counts correlated with plasma sCD14 and LBP only in PLWHIV-2, especially LTNP, and not in GeoHD. In conclusion, in LTNP PLWHIV-2, inflammatory monocyte counts correlated with LBP or sCD14 plasma levels, indicating a potential innate immune response to subclinical bacterial translocation. As GeoHD had higher inflammatory monocyte counts than HD, our data also show that specific controls are important to refine innate immunity studies.

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“…After 8 years of follow-up, the mortality rate for HIV-1 infection is approximately double that of HIV-2 infection without treatment [7,9]. This distinction between HIV-1 and HIV-2 mortality was highlighted in a recent report from a cohort in Bissau with an unusually high proportion of subjects with known dates of infection, in which the median survival time for HIV-1 was 8·2 years and for HIV-2 it was 15·6 years [10]. In this study it was also noted that HIV-2-infected people developed clinical AIDS with a higher mean CD4 + T cell percentage than seen for HIV-1.…”

Section: Introductionmentioning

confidence: 99%

Delayed disease progression in HIV-2: the importance of TRIM5α and the retroviral capsid

Boswell

Rowland‐Jones

2019

Clinical and Experimental Immunology

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HIV-2 is thought to have entered the human population in the 1930s through cross-species transmission of SIV from sooty mangabeys in West Africa. Unlike HIV-1, HIV-2 has not led to a global pandemic, and recent data suggest that HIV-2 prevalence is declining in some West African states where it was formerly endemic. Although many early isolates of HIV-2 were derived from patients presenting with AIDS-defining illnesses, it was noted that a much larger proportion of HIV-2-infected subjects behaved as long-term non-progressors (LTNP) than their HIV-1-infected counterparts. Many HIV-2-infected adults are asymptomatic, maintaining an undetectable viral load for over a decade. However, despite lower viral loads, HIV-2 progresses to clinical AIDS without therapeutic intervention in most patients. In addition, successful treatment with anti-retroviral therapy (ART) is more challenging than for HIV-1. HIV-2 is significantly more sensitive to restriction by host restriction factor tripartite motif TRIM5α than HIV-1, and this difference in sensitivity is linked to differences in capsid structure. In this review we discuss the determinants of HIV-2 disease progression and focus on the important interactions between TRIM5α and HIV-2 capsid in long-term viral control.

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Long-term follow-up of HIV-2-related AIDS and mortality in Guinea-Bissau: a prospective open cohort study

Cited by 59 publications

References 30 publications

Viral Suppression and Its Associated Factors in HIV Patients on Highly Active Antiretroviral Therapy (HAART): A Retrospective Study in the Ho Municipality, Ghana

Viral Suppression and Its Associated Factors in HIV Patients on Highly Active Antiretroviral Therapy (HAART): A Retrospective Study in the Ho Municipality, Ghana

Conventional Dendritic Cells and Slan+ Monocytes During HIV-2 Infection

Delayed disease progression in HIV-2: the importance of TRIM5α and the retroviral capsid

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