Characteristics of HIV-2 and HIV-1/HIV-2 Dually Seropositive Adults in West Africa Presenting for Care and Antiretroviral Therapy: The IeDEA-West Africa HIV-2 Cohort Study

• Published in: PloS one 2013-06, Vol.8 (6), p.e66135-e66135
• Main Authors: Ekouevi, Didier K, Balestre, Eric, Coffie, Patrick A, Minta, Daouda, Messou, Eugene, Sawadogo, Adrien, Minga, Albert, Sow, Papa Salif, Bissagnene, Emmanuel, Eholie, Serge P, Gottlieb, Geoffrey S, Dabis, François, Zannou, Djimon Marcel, Ahouada, Carin, Akakpo, Jocelyn, Ahomadegbé, Christelle, Bashi, Jules, Gougounon-Houéto, Alice, Azon-Kouanou, Angèle, Houngbé, Fabien, Koumakpaï, Sikiratou, Alihonou, Florence, d'Almeida, Marcelline, Hodonou, Irvine, Hounhoui, Ghislaine, Sagbo, Gracien, Tossa-Bagnan, Leïla, Adjide, Herman, Drabo, Joseph, Bognounou, René, Dienderé, Arnaud, Traore, Eliezer, Zoungrana, Lassane, Zerbo, Béatrice, Sawadogo, Adrien Bruno, Zoungrana, Jacques, Héma, Arsène, Soré, Ibrahim, Bado, Guillaume, Tapsoba, Achille, Yé, Diarra, Kouéta, Fla, Ouedraogo, Sylvie, Ouédraogo, Rasmata, Hiembo, William, Gansonré, Mady, Messou, Eugène, Gnokoro, Joachim Charles, Koné, Mamadou, Kouakou, Guillaume Martial, Bosse, Clarisse Amani, Brou, Kouakou, Assi, Achi Isidore, Chenal, Henri, Hawerlander, Denise, Soppi, Franck, Abo, Yao, Bomisso, Germain, Eholié, Serge Paul, Amego, Mensah Deborah Noelly, Andavi, Viviane, Diallo, Zelica, Ello, Frédéric, Tanon, Aristophane Koffi, Koule, Serge Olivier, Anzan, Koffi Charles, Guehi, Calixte, Aka, Edmond Addi, Issouf, Koffi Ladji, Kouakou, Jean-Claude, N'gbeche, Marie-Sylvie, Touré, Pety, Avit-Edi, Divine, Kouakou, Kouadio, Moh, Magloire, Yao, Valérie Andoblé, Folquet, Madeleine Amorissani, Dainguy, Marie-Evelyne, Kouakou, Cyrille, Méa-Assande, Véronique Tanoh, Oka-Berete, Gladys, Zobo, Nathalie, Acquah, Patrick, Kokora, Marie-Berthe, Eboua, Tanoh François, Timité-Konan, Marguerite, Ahoussou, Lucrèce Diecket, Assouan, Julie Kebé, Sami, Mabéa Flora, Kouadio, Clémence, Renner, Lorna, Goka, Bamenla, Welbeck, Jennifer, Sackey, Adziri, Owiafe, Seth Ntiri, Wejse, Christian, Silva, Zacarias José Da, Paulo, Joao, Rodrigues, Amabelia
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; Adults; Africa, Western - epidemiology; AIDS; Analysis; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; CD4 antigen; Clinical trials; Cohort analysis; Cohort Studies; Collaboration; Epidemiology; Evidence-based medicine; Female; Health aspects; Highly active antiretroviral therapy; HIV; HIV Infections - drug therapy; HIV Infections - virology; HIV-1 - isolation & purification; HIV-2 - isolation & purification; Human immunodeficiency virus; Humans; Infection; Infections; Male; Medical diagnosis; Medical research; Medicine; Middle Aged; Patients; Therapy
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0066135

HIV-2 is endemic in West Africa. There is a lack of evidence-based guidelines on the diagnosis, management and antiretroviral therapy (ART) for HIV-2 or HIV-1/HIV-2 dual infections. Because of these issues, we designed a West African collaborative cohort for HIV-2 infection within the framework of the International epidemiological Databases to Evaluate AIDS (IeDEA). We collected data on all HIV-2 and HIV-1/HIV-2 dually seropositive patients (both ARV-naive and starting ART) and followed-up in clinical centres in the IeDEA-WA network including a total of 13 clinics in five countries: Benin, Burkina-Faso Côte d'Ivoire, Mali, and Senegal, in the West Africa region. Data was merged for 1,754 patients (56% female), including 1,021 HIV-2 infected patients (551 on ART) and 733 dually seropositive for both HIV-1 and HIV 2 (463 on ART). At ART initiation, the median age of HIV-2 patients was 45.3 years, IQR: (38.3-51.7) and 42.4 years, IQR (37.0-47.3) for dually seropositive patients (p = 0.048). Overall, 16.7% of HIV-2 patients on ART had an advanced clinical stage (WHO IV or CDC-C). The median CD4 count at the ART initiation is 166 cells/mm(3), IQR (83-247) among HIV-2 infected patients and 146 cells/mm(3), IQR (55-249) among dually seropositive patients. Overall, in ART-treated patients, the CD4 count increased 126 cells/mm(3) after 24 months on ART for HIV-2 patients and 169 cells/mm(3) for dually seropositive patients. Of 551 HIV-2 patients on ART, 5.8% died and 10.2% were lost to follow-up during the median time on ART of 2.4 years, IQR (0.7-4.3). This large multi-country study of HIV-2 and HIV-1/HIV-2 dual infection in West Africa suggests that routine clinical care is less than optimal and that management and treatment of HIV-2 could be further informed by ongoing studies and randomized clinical trials in this population.