Plasma HIV-2 RNA According to CD4 Count Strata among HIV-2-Infected Adults in the IeDEA West Africa Collaboration

• Published in: PloS one 2015-06, Vol.10 (6), p.e0129886-e0129886
• Main Authors: Ekouévi, Didier K, Avettand-Fènoël, Véronique, Tchounga, Boris K, Coffie, Patrick A, Sawadogo, Adrien, Minta, Daouda, Minga, Albert, Eholie, Serge P, Plantier, Jean-Christophe, Damond, Florence, Dabis, François, Rouzioux, Christine
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; Adults; Africa, Western; AIDS; Algorithms; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; CD4 antigen; CD4 Lymphocyte Count; Collaboration; Commercialization; Cross-Sectional Studies; Drug therapy; Female; HIV; HIV Infections - blood; HIV Infections - drug therapy; HIV Infections - virology; HIV-2 - genetics; HIV-2 - metabolism; Human immunodeficiency virus; Humans; Infections; Laboratories; Life Sciences; Lymphocytes T; Male; Microbiology and Parasitology; Middle Aged; Monitoring; Patients; Ribonucleic acid; RNA; RNA, Viral - blood; Viral Load; Virology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0129886

Plasma HIV-1 RNA monitoring is one of the standard tests for the management of HIV-1 infection. While HIV-1 RNA can be quantified using several commercial tests, no test has been commercialized for HIV-2 RNA quantification. We studied the relationship between plasma HIV-2 viral load (VL) and CD4 count in West African patients who were either receiving antiretroviral therapy (ART) or treatment-naïve. A cross sectional survey was conducted among HIV-2-infected individuals followed in three countries in West Africa from March to December 2012. All HIV-2 infected-patients who attended one of the participating clinics were proposed a plasma HIV-2 viral load measurement. HIV-2 RNA was quantified using the new ultrasensitive in-house real-time PCR assay with a detection threshold of 10 copies/ mL (cps/mL). A total of 351 HIV-2-infected individuals participated in this study, of whom 131 (37.3%) were treatment naïve and 220 (62.7%) had initiated ART. Among treatment-naïve patients, 60 (46.5%) had undetectable plasma HIV-2 viral load (1000 cps/mL in 6.0% of the patients. Most of the treatment-naïve patients (70.2%) had CD4-T cell count ≥500 cells/mm3 and 43 (46.7%) of these patients had a detectable VL (≥10 cps/mL). Among the 220 patients receiving ART, the median CD4-T cell count rose from 231 to 393 cells/mm3 (IQR [259-561]) after a median follow-up duration of 38 months and 145 (66.0%) patients had CD4-T cell count ≤ 500 cells/mm3 with a median viral load of 10 cps/mL (IQR [10-33]). Seventy five (34.0%) patients had CD4-T cell count ≥ 500 cells/mm3, among them 14 (18.7%) had a VL between 10-100 cps/mL and 2 (2.6%) had VL >100 cps/mL. This study suggests that the combination of CD4-T cell count and ultrasensitive HIV-2 viral load quantification with a threshold of 10 cps/mL, could improve ART initiation among treatment naïve HIV-2-infected patients and the monitoring of ART response among patients receiving treatment.