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HIV type 2 epidemic in Spain: challenges and missing opportunities
Carmen de Mendoza1, Teresa Cabezas, Estrella Caballero
1aPuerta de Hierro Research Institute, Madrid bHospital de Poniente, Almeria cHospital Vall d'Hebrón, Barcelona dCorporación Sanitaria Parc Taulí, Sabadell eSon Espases Hospital, Palma de Mallorca fHospital Marqués de Valdecilla, Santander gFundación Jiménez Díaz, Madrid hGeneral Hospital, Alicante iLa Paz University Hospital & Autonomous University, Madrid, Spain.
AIDS (London, England)
|March 31, 2017
Summary
Human Immunodeficiency Virus type 2 (HIV-2) is a less transmissible virus than HIV-1, primarily affecting West Africa. Early diagnosis is crucial for HIV-2 and HIV-1 coinfection, especially in individuals with risk factors.
Area of Science:
- Virology
- Infectious Diseases
- Public Health
Background:
- Human Immunodeficiency Virus type 2 (HIV-2) is a neglected global health concern, distinct from the more prevalent HIV-1.
- HIV-2 exhibits lower transmissibility and slower disease progression compared to HIV-1, with a primary geographic confinement to West Africa.
- Despite declining global prevalence, HIV-2 remains a concern in specific regions due to migration and historical ties.
Purpose of the Study:
- To analyze the epidemiological and clinical characteristics of HIV-2 infections in Spain.
- To assess the diagnostic challenges and implications of HIV-2, including coinfection with HIV-1.
- To highlight the importance of considering HIV-2 in differential diagnoses for HIV-seroreactive individuals with specific risk factors.
Main Methods:
- Retrospective analysis of 338 HIV-2 cases reported to the Spanish HIV-2 registry until December 2016.
- Data collection included demographics, transmission routes, clinical presentation (CD4 counts, AIDS events), and coinfection status.
- Evaluation of new HIV-2 diagnoses trends and associated risk factors, particularly immigration from endemic regions.
Main Results:
- The majority of reported HIV-2 cases were male (63%) and of Sub-Saharan African origin (72%).
- Heterosexual contact was the predominant transmission route (>90%), with 9% of patients coinfected with HIV-1.
- New HIV-2 diagnoses in Spain remained stable (approx. 15 cases/year) since 2010, largely driven by immigration from Northwestern Africa.
Conclusions:
- HIV-2 infection, alone or with HIV-1 coinfection, should be considered in all HIV-seroreactive individuals, especially those with atypical serological profiles or from endemic areas.
- The study underscores the need for vigilance in diagnosing HIV-2 in Spain due to immigration patterns.
- Early exclusion of HIV-2 is critical for accurate diagnosis and appropriate patient management, particularly in cases of immunovirological disconnect.