Effect of methodology on detection of HIV-1/HIV-2 dual infections in Côte d'Ivoire

Dual seroreactivity to the human immunodeficiency virus (HIV) types 1 and 2 is common in Côte d'Ivoire. To assess whether dual infection is the reason for dual seroreactivity, different methods for detection of HIV-1 and HIV-2 viruses were compared. PCR on primary uncultured lymphocytes of 56 dually seropositive samples revealed the presence of both HIV-1 and HIV-2 proviral DNA in 23 (41%) cases. In 7 other dual seropositive persons, PCR was carried out on the primary lymphocytes as well as on lymphocytes after 3 and 6 weeks of cocultivation. More cultures, 5/7 (71%), were positive for both viruses at 3 weeks compared to 0/7 at 6 weeks post cultivation. Moreover, 2 out of 3 samples, where only HIV-1 was detected in uncultured cells, were positive for both viruses after 3 weeks of cultivation. These data indicate that the sensitivity of HIV-2 detection can be increased by stimulation of patients' lymphocytes. A higher number of dual seropositive individuals (10/23 (48%)) had antibodies able to neutralize simultaneously both HIV-1 and HIV-2 prototype viruses than did HIV-1 antibody-positive sera (5/21 (24%)) or HIV-2 antibody positive sera (3/18 (17%)). The prevalence of dual seropositives being infected with both viruses is highly dependent on the method used to detect infection. There is a need to standardize virological markers in order to gain a better insight into the relative proportions of HIV-1, HIV-2 and HIV-1/HIV-2 dually infected persons.