Short communicationDolutegravir for the treatment of HIV-2 infection
Section snippets
Background
Human immunodeficiency virus type 2 (HIV-2) was first isolated in 1986. Being originated in West Africa following inter-species transmission from natural wildlife monkey reservoirs, the virus currently infects 1–2 million humans worldwide. Former Portuguese colonies abroad such as Mozambique, Goa (India) and Brazil are amongst the regions with a larger number of HIV-2 cases outside West Africa [1]. Although HIV-2 infection typically evolves with a prolonged asymptomatic period, a significant
Objectives
First report of clinical experience with dolutegravir in HIV-2 infected individuals.
Study design
We retrospectively assessed all HIV-2 individuals treated with dolutegravir in Spain. The integrase HIV-2 coding region was sequenced using an in-house nested-PCR protocol previously described [11] in plasma specimens collected from both raltegravir-naïve and raltegravir-experienced patients with detectable plasma HIV-2 RNA, all belonging to the Spanish HIV-2 cohort.
Mutations associated to raltegravir resistance were characterized and changes associated with dolutegravir resistance in HIV-1
Results
From 297 individuals recorded at the Spanish HIV-2 register up to the end of 2013, 196 (67%) were male and 212 (71%) were immigrants from Sub-Saharan Africa. At the time of diagnosis, 61% had undetectable plasma HIV-2 RNA. Other characteristics of this cohort have recently been reported elsewhere [13].
Overall, 26% of HIV-2 patients in Spain have received antiretroviral therapy. Despite being treated, 42% of them depicted less than 200CD4+ T-cells/mm3 42% at the last control. In contrast, CD4
Discussion
HIV-2 was firstly identified in 1986, examining patients presenting with AIDS and a negative/indeterminate HIV-1 serology [14]. Around 1–2 million people are estimated to be infected with HIV-2 worldwide. The most highly endemic regions are in West Africa and India, being France and Portugal the European countries with the largest number of HIV-2 infected individuals [1]. In Spain, nearly 300 individuals with HIV-2 infection have been reported so far [13].
HIV-2 is less pathogenic than HIV-1,
Competing interests
None.
Funding
This work was funded in part by grants from Instituto de Salud Carlos III (project nos. ICI14-00372, PI10/00520, CES12/003, PI13/01574) and Fundación Investigación y Educación en Sida (IES).
Ethical approval
This manuscript reports the clinical experience with two patients on routine clinical care.Given the retrospective nature of the observation, no specific ethical approval is requestedat my institution.
HIV-2 Spanish Study Group
C. Rodríguez and J. del Romero (Centro Sanitario Sandoval, Madrid); G. Marcaida, M.D. Ocete and T. Tuset (Hospital General Universitario, Valencia); E. Caballero and I. Molina (Hospital Vall d'Hebrón, Barcelona); A. Aguilera, J.J. Rodríguez-Calviño, D. Navarro and B. Regueiro (Hospital Conxo-CHUS, Santiago); R. Benito, J. Gil and M. Borrás (Hospital Clínico Universitario Lozano Blesa, Zaragoza); R. Ortiz de Lejarazu (Hospital Clínico Universitario, Valladolid); J.M. Eirós (Hospital Rio Hortega,
Acknowledgement
none
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