Enteroviruses (EV) can cause severe neurological and respiratory infections, and occasionally lead to devastating outbreaks as previously demonstrated with EV-A71 and EV-D68 in Europe. However, these infections are still often underdiagnosed and EV typing data is not currently collected at European level. In order to improve EV diagnostics, collate data on severe EV infections and monitor the circulation of EV types, we have established European non-polio enterovirus network (ENPEN). First task of this cross-border network has been to ensure prompt and adequate diagnosis of these infections in Europe, and hence we present recommendations for non-polio EV detection and typing based on the consensus view of this multidisciplinary team including experts from over 20 European countries. We recommend that respiratory and stool samples in addition to cerebrospinal fluid (CSF) and blood samples are submitted for EV testing from patients with suspected neurological infections. This is vital since viruses like EV-D68 are rarely detectable in CSF or stool samples. Furthermore, reverse transcriptase PCR (RT-PCR) targeting the 5'noncoding regions (5'NCR) should be used for diagnosis of EVs due to their sensitivity, specificity and short turnaround time. Sequencing of the VP1 capsid protein gene is recommended for EV typing; EV typing cannot be based on the 5'NCR sequences due to frequent recombination events and should not rely on virus isolation. Effective and standardized laboratory diagnostics and characterisation of circulating virus strains are the first step towards effective and continuous surveillance activities, which in turn will be used to provide better estimation on EV disease burden.

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Background For unknown reasons, HIV-2 is less pathogenic than HIV-1, and HIV-2 induced immunodeficiency may be different from that caused by HIV-1. Previous immunological studies have hinted at possible shifts in both T and B-cell subsets, which we aimed to characterize further. Methods From an HIV clinic in Guinea-Bissau, 63 HIV-2, 83 HIV-1, and 26 HIV negative participants were included. All HIV infected participants were ART naïve. The following cell subsets were analysed by flow cytometry; T cells (maturation and activation), regulatory T cells, and B cells (maturation and activation). Results After standardizing for sex, age, and CD4+ T cell count HIV-2 had 0.938 log10 copies/mL lower HIV RNA levels than the HIV-1 infected patients. Whereas T-cell maturation and regulatory T-cell profiles were similar between patients, HIV-2 infected patients had higher proportions of CD8+CD28+ and lower proportions of CD8+PD-1+ T cells than HIV-1 infected patients. This finding was independent of HIV RNA levels. HIV-2 was also associated with a more preserved proportion of naïve B cells. Conclusion HIV-2 is characterized by lower viral load, and lower T-cell activation, which may account for the slower disease progression.