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

被引:31
作者
Ekouevi, Didier K. [1 ,2 ,3 ]
Balestre, Eric [1 ]
Coffie, Patrick A. [2 ,4 ]
Minta, Daouda [5 ]
Messou, Eugene [2 ,4 ,6 ]
Sawadogo, Adrien [7 ]
Minga, Albert [8 ]
Sow, Papa Salif [9 ]
Bissagnene, Emmanuel [4 ,10 ]
Eholie, Serge P. [4 ,10 ]
Gottlieb, Geoffrey S. [11 ,12 ]
Dabis, Francois [1 ]
机构
[1] Univ Bordeaux Segalen, ISPED, Ctr INSERM, U897,Epidemiol Biostat, Bordeaux, France
[2] Programme PACCI, Abidjan, Cote Ivoire
[3] Univ Lome, Dept Sci Fondamentales & Sante Publ, Lome, Togo
[4] Univ Felix Houphouet Boigny, UFR Sci Med, Dept Dermatol & Infectiol, Abidjan, Cote Ivoire
[5] Hop Point G, Ctr Prise Charge Personnes Vivant Avec VIH, Bamako, Mali
[6] ACONDA CePReF Adultes, Abidjan, Cote Ivoire
[7] CHU Souro Sanou, Hop Jour, Bobo Dioulasso, Burkina Faso
[8] Projet PRIMO CI, Ctr Med Suivi Donneurs Sang, Abidjan, Cote Ivoire
[9] CHU Fann, Serv Malad Infect & Trop, Dakar, Senegal
[10] CHU Treichville, Serv Malad Infect & Trop, Dakar, Senegal
[11] Univ Washington, Dept Med, Seattle, WA USA
[12] Univ Washington, Dept Global Hlth, Seattle, WA 98195 USA
来源
PLOS ONE | 2013年 / 8卷 / 06期
基金
美国国家卫生研究院;
关键词
TO-CHILD TRANSMISSION; IMMUNOLOGICAL RESPONSE; DRUG-RESISTANCE; INTERNATIONAL COLLABORATION; HIV-2-INFECTED INDIVIDUALS; TYPE-1; HIV-1; INFECTION; RALTEGRAVIR; DIFFERENTIATION; INHIBITORS;
D O I
10.1371/journal.pone.0066135
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: 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). Methods: 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 Cote d'Ivoire, Mali, and Senegal, in the West Africa region. Results: 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). Conclusions: 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.
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页数:8
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