British HIV Association guidelines for antiretroviral treatment of HIV-2-positive individuals 2010

British HIV Association (BHIVA), BHIVA Secretariat, Mediscript Ltd, London, UK.
HIV Medicine (Impact Factor: 3.99). 11/2010; 11(10):611-9. DOI: 10.1111/j.1468-1293.2010.00889.x
Source: PubMed
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Available from: Jane Anderson, Nov 02, 2014
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    • "Only one European cohort study has reported better immunological and virological responses to ritonavir-boosted PI-containing ART in antiretroviral-naïve HIV-2–infected patients compared to three NRTIs [15]. Overall, there has been minimal evidence-based recommendation regarding the best use of ART for HIV-2 infection [20, 33, 35–37]. We initiated this systematic review on ART response among HIV-2 and HIV-1/HIV-2 dually infected patients, to describe the different ART options that have been used and the different outcomes of these treatments. "
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    ABSTRACT: Background Few data are available on antiretroviral therapy (ART) response among HIV-2 infected patients. We conducted a systematic review on treatment outcomes among HIV-2 infected patients on ART, focusing on the immunological and virological responses in adults. Methods Data were extracted from articles that were selected after screening of PubMed/MEDLINE up to November 2012 and abstracts of the 1996–2012 international conferences. Observational cohorts, clinical trials and program reports were eligible as long as they reported data on ART response (clinical, immunological or virological) among HIV-2 infected patients. The determinants investigated included patients’ demographic characteristics, CD4 cell count at baseline and ART received. Results Seventeen reports (involving 976 HIV-2 only and 454 HIV1&2 dually reactive patients) were included in the final review, and the analysis presented in this report are related to HIV-2 infected patients only. There was no randomized controlled trial and only two cohorts had enrolled more than 100 HIV-2 only infected patients. The median CD4 count at ART initiation was 165 cells/mm3, [IQR; 137–201] and the median age at ART initiation was 44 years (IQR: 42–48 years). Ten studies included 103 patients treated with three nucleoside reverse transcriptase inhibitors (NRTI). Protease inhibitor (PI) based regimens were reported by 16 studies. Before 2009, the most frequent PIs used were Nelfinavir and Indinavir, whereas it was Lopinavir/ritonavir thereafter. The immunological response at month-12 was reported in six studies and the mean CD4 cell count increase was +118 cells/μL (min-max: 45–200 cells/μL). Conclusion Overall, clinical and immuno-virologic outcomes in HIV-2 infected individuals treated with ART are suboptimal. There is a need of randomized controlled trials to improve the management and outcomes of people living with HIV-2 infection.
    BMC Infectious Diseases 08/2014; 14(1):461. DOI:10.1186/1471-2334-14-461 · 2.61 Impact Factor
    • "This is likely to be a result of the lower level of viremia observed in HIV-2 than in HIV-1. The most common mode of transmission of HIV-2 is through heterosexual route.[11] Similar findings were seen in our study. "
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    ABSTRACT: The choice of antiretroviral therapy for HIV-2 differs from that for HIV-1, underscoring the importance of differentiating between the two. The current study was planned to find out the prevalence of HIV-2 infection at our center and to find out the utility of the current diagnostic algorithm in identifying the type of HIV infection. Retrospective analysis in a tertiary care teaching institute over a period of three years. All patients diagnosed as HIV infected using NACO/WHO HIV testing strategy III were included in the study. They were classified as HIV-1 infected, HIV-2 infected and HIV-1 and HIV-2 co-infected based on their test results. For discordant samples, immunoblotting result from National Reference Laboratory was considered as final. Comparison between HIV-1, HIV-2 and HIV-1+2 positive groups for age, gender, route of transmission was made using chi squared test. P value < 0.05 was considered as significant. Of the total of 66,708 patients tested, 5,238 (7.9%) were positive for HIV antibodies. 7.62%, 0.14%, 0.08% and 0.004% were HIV-1, HIV-2, HIV-1 and HIV-2 co-infected and HIV type indeterminate (HIV-1 Indeterminate, 2+) respectively. The current algorithm could not differentiate between the types of HIV infection (as HIV-1 or HIV-2) in 63 (1.2%) cases. In areas like the Indian subcontinent, where epidemic of both HIV-1 and HIV-2 infections are ongoing, it is important to modify the current diagnostic algorithms to diagnose and confirm HIV-2 infections.
    Journal of global infectious diseases 07/2013; 5(3):110-3. DOI:10.4103/0974-777X.116872
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    • "Given the mean slower disease progression and the high proportion of non-progressors, the monitoring of HIV-2 viral load could be spaced for untreated patients from 6 months to 1 year, but no study support clearly that recommendation until now. In case CD4 counts drop or if disease progresses despite an undetectable viral load, the plasma should be retested with an alternative assay to avoid a possible problem of genetic variability (Gilleece et al. 2010). "
    HIV Testing, 01/2012; , ISBN: 978-953-307-871-7
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