Mortality and survival patterns of people living with HIV-2

Abstract

Purpose of review People living with HIV-2 infected usually initiate antiretroviral therapy (ART) at an advanced period in the course of their infection after a long asymptomatic period characterized by high CD4 cell count and thus at a relatively advanced age. In the new international context of early and universal ART initiation, the aim was to review survival patterns among HIV-2 infected patients, either on ART or not. Recent findings Very few reports were published on mortality in people living with HIV-2 during the last five years. People living with HIV-2 experience high mortality rates although lower than people living with HIV-1 before ART initiation. They seem to survive longer regardless of the conditions of ART use. Mortality is associated with late presentation, male gender, CD4 count <500 cell/μl, high plasma viral load, hemoglobin rate <8 g/dl) and body mass index < 18 Kg/m2. Summary People living with HIV-2 initiate ART later than HIV-1 and HIV duals, resulting in higher disease progression and mortality rate. The clinical management of HIV-2 infected patients should now include early diagnosis and treatment initiation as per international guidelines. Further research needs to explore the “what to start” question and document specific causes of death in people living with HIV-2 and enrolled in care in Africa.

Parasite-induced shifts in host movement may explain the transient coexistence of high- and low-pathogenic disease strains

“…The strain with the long asymptomatic stage has a lower within-host replication rate and induces slower progression to AIDS, whereas the strain with the short asymptomatic stage has a higher within-host replication rate and induces rapid progression to AIDS. These relationships are consistent with a number of studies showing that plasma viral load is ≈ 30 times lower in HIV-2-infected individuals than HIV-1-infected individuals, and this lower plasma viral load explains the observed faster progression to AIDS in HIV-1-infected individuals (Berry et al, 1998;Popper et al, 1999;Andersson et al, 2000;MacNeil et al, 2007;Drylewicz et al, 2008;Tchounga et al, 2016). Our findings suggest that the rapid progression to AIDS in HIV-1-infected individuals is due to a higher within-host replication rate, and most of the secondary infections are generated from an HIV-1-infected individual during the symptomatic stage.…”

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

“…HIV-2 infection ( 1 ) is mostly prevalent in West Africa, and in populations emigrated from West Africa to Portugal and France ( 1 – 3 ). Eighty-seven per cent of the participants included in the French ANRS CO5 cohort originate from this geographical area.…”

Survival among antiretroviral-experienced HIV-2 patients experiencing virologic failure with drug resistance mutations in Cote d’Ivoire West Africa

“…This lack of clear guidelines may be the consequence of limited data on the switch of treatment among HIV-2-infected patients, the lack of routine implementation of validated tool for viral load monitoring, the absence of definition of immunological failure and the paucity of data regarding drug resistance mutations [ 7 , 8 , 23 , 30 – 32 ]. Since the mortality remains high among HIV-2 patients receiving ART [ 33 , 34 ], it is critical to address all the gaps and need in terms of data in order to propose clear guidelines for the treatment of HIV-2 patients experiencing virologic failure.…”