Laboratory Profile of HIV-2 and Dual HIV-1/HIV-2 Associated Acquired Immunodeficiency Syndrome in Nigeria

Georgina Njideka Odaibo, David Olufemi Olaleye

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Department of Virology, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria..

DOI: 10.4236/wja.2013.33025                

Abstract

Background: HIV-2 is comparatively less pathogenic with slow progression of infection to clinical disease and consequently there is less of information on the occurrence of HIV-2 associated disease than HIV-1. We hereby describe some laboratory profiles of individuals presenting with HIV-2 and dual HIV-1/2 related AIDS at the University College hospital in Ibadan over a period of seven years. Methodology: Blood samples from patients presenting with the AIDS defining illness at the University College Hospital, Ibadan, Nigeria were tested for antibodies to HIV-1/2 using rapid test devices or ELISA. Initially reactive samples were further tested by immunoblotting for differentiation into HIV-1 or HIV-2 or HIV-1/2 dual infection. Blood samples from individuals with confirmed infections were further analyzed for CD4 cell lymphocyte number, plasma HIV-1 RNA concentration, hematological and blood chemistry parameters. The data analysis was done using descriptive statistics and Levene-S test for equality of variance. Results: Thirty five patients, 18 and 17 with HIV-2 and dual HIV-1/2 infections respectively were identified during the period covered by this study (2005-2012). The median age of the patients was 48 years old (Range: 42 - 70 years old) and mean CD4 cell count of HIV-2 patients at enrollment was 324 (Range: 16 - 696) and 350 (Range 54 - 863) per microlitre of blood for patients with dual HIV-1/2 infection. HIV-1 RNA was not detected in the plasma of the 18 patients with serological HIV-2 infection but 2 (11.8%) of the 17 patients with dual HIV-1/2 serological profile had detectable HIV-1 RNA (1,287,275 copies/ml and 1,816,491 copies/ml). Conclusion: The results emphasize the need to consider HIV-2 infection in the investigation of patients presenting with the AIDS related illness but with negative HIV-1serology. The study also shows the importance of inclusion of multispot HIV-1 and 2 rapid tests for differentiating HIV-1 from HIV-2 infections in regions where both types of HIV circulate or epidemiologically indicated.

Keywords

HIV-2; HIV1/2 Dual Infection; CD4; Hematology; Chemistry; Nigeria

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	P. J. Kanki, “Biologic Features of HIV-2: An Update,” AIDS Clinical Review, 1991, pp. 17-38.
[2]	D. O. Olaleye, T. O. Harry and G. N. Odaibo, “The Virology and Dynamics of the Epidemic,” In: O. Adeyi, P. J. Kanki, O. Odutolu and J. A. Idoko, Eds., AIDS in Nigeria: A Nation on the Threshold, Harvard Center for Population and Development, Cambridge, 2006, pp. 37-66.
[3]	S. T. Meloni, A. Ojesina and D. O. Olaleye, “The Molecular Epidemiology of HIV,” In: O. Adeyi, P. J. Kanki, O. Odutolu and J. A. Idoko, Eds., AIDS in Nigeria: A Nation on the Threshold, Harvard Center for Population and Development, Cambridge, 2006, pp. 67-92.
[4]	D. Olaleye, L. Bernstein, C. Ekwezor et al., “Prevalence of Human Immunodeficiency Virus Type 1 and 2 Infections in Nigeria,” The Journal of Infectious Diseases, Vol. 167, No. 3, 1993, pp. 710-714. doi:10.1093/infdis/167.3.710
[5]	J. Chikwen, I. Mohammed and O. T. Oyebode, “Prevalence of Human Immunodeficiency Virus (HIV) Infection in Borno State of Nigeria,” East African Medical Journal, Vol. 65, No. 5, 1988, pp. 342-346.
[6]	T. Harry, O. Ekanna, J. Chikwen et al., “Seroepidemiology of Human Immunodeficiency Virus Infection in Borno State of Nigeria by Sentinel Sueveillance,” Journal of Acquired Immune Deficiency Syndrome, Vol. 6, No. 1, 1993, pp. 99-103.
[7]	S Jaffar, A. D. Grant, J. Whitworth, P. G. Smith and H. Whittle, “The Natural History of HIV-1 and HIV-2 Infections in Adults in Africa: A Literature Review,” Bulletin of World Health Organization, Vol. 82, No. 6, 2004, pp. 462-469.
[8]	A. G. Poulsen, P. Aaby, O. Larsen et al., “9-Year HIV-2-Associated Mortality in an Urban Community in Bissau,” West African Lancet, Vol. 349, No. 9056, 1997, pp. 911-914. doi:10.1016/S0140-6736(96)04402-9
[9]	H. Whittle, J. Morris and J. Todd, T. Corrah, S. Sabally, J. Bangali, P. T. Ngom, M. Rolfe and A. Wilkins, “HIV-2 Infected Patients Survive Longer than HIV-1-Infected Patients,” AIDS, Vol. 8, No. 11, 1994, pp. 1617-1620. doi:10.1097/00002030-199411000-00015
[10]	Fedral Ministry of Health, “Nigeria; National HIV Sero-Prevalence Sentinel Survey among Pregnant Women Attending Antenatal Clinics in Nigeria,” Technical Report, 2010, pp. 1-96.
[11]	K. Peterson, S. Jallow, S. L. Rowland-Jones and T. I. de Siliva, “Antiretroviral Therapy for HIV-2 Infection: Recommendations for Management in Low-Resource Settings,” AIDS Research and Treatment, 2011, p. 13.
[12]	A. S. Alabi, S. Jaffar, Ariyoshi et al., “Plasma Viral Load, CD4 Cell Percentage, HLA and Survival of HIV-1, HIV-2 and Dually Infected Gambian Patients,” AIDS, Vol. 17, No. 10, 2003, pp. 1513-1520.
[13]	S. Jallow, A. Alabi, R. Sarge-Njie et al., “Virological Response to Highly Active Antiretroviral Therapy in Patients Infected with Human Immunodeficiency Virus Type 2 (HIV-2) and Patients Dually Infected with HIV-1 and HIV-2 in the Gambia and Emergence of Drug-Resistant Variants,” Journal of Clinical Microbiology, Vol. 47, No. 7, 2009, pp. 2200-2208. doi:10.1128/JCM.01654-08
[14]	P. J. Bock and D. M. Markovitz, “Infection with HIV-2,” AIDS, Vol. 15, 2001, pp. S35-S45. doi:10.1097/00002030-200100005-00006
[15]	N. K. Barry, S. Ariyoshi, S. Jaffar et al., “Low Peripheral Blood Viral HIV-2 RNA in Individuals with High CD4 Percentage Differentiates HIV-2 from HIV-1 Infection,” Journal of Human Virology, Vol. 1, 1998, pp. 457-468.
[16]	D. K. Oladepo, E. O. Idigbe, R. O. Audu et al., “Establishment of Reference CD4 and CD8 Lymphocyte Subsets in Healthy Nigerian Adults,” Clinical and Vaccine Immunology, Vol. 16, No. 9, 2009, pp. 1374-1377. doi:10.1128/CVI.00378-08
[17]	Federal Ministry of Health, “Abuja, Nigeria, National Guidelines for HIV and AIDS Treatment and Care in Adolescents and Adults,” pp. 1-67. http://www.who.int/hiv/pub/guidelines/nigeria_art.pdf
[18]	T. de Siliva, C. van Tienen, S. Rowland-Jones and M. Cotton, “Dual infection with HIV-1 and HIV-2: Double Trouble or Destructive Interference?” HIV Therapy, Vol. 4, No. 3, 2010, pp. 305-323. doi:10.2217/hiv.10.26