Human Immunodeficiency Virus–2 (HIV-2): A Summary of the Present Standard of Care and Treatment Options for Individuals Living with HIV-2 in Western Europe

Berzow, Dirk; Descamps, Diane; Obermeier, Martin; Charpentier, Charlotte; Kaiser, Rolf; Güertler, Lutz; Eberle, Josef; Wensing, Annemarie; Sierra, Saleta; Ruelle, Jean; Gómes, Perpétua; Kamal, Mehnaz; Taylor, Ninon; Jensen, Björn; Döring, Matthias; Stürmer, Martin; Rockstroh, Jürgen K.; Camacho, Ricardo Jorge

doi:10.1093/cid/ciaa275

Cited by 13 publications

(33 citation statements)

References 31 publications

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“…In Europe, Portugal and France have the highest prevalence, but also Belgium and Spain report a significant number of cases. In Italy, this neglected infection has been recently highlighted because of the migratory flow from different countries [10,15,[24][25][26][27][28].…”

Section: Hiv-2 Origin and Infection Worldwidementioning

confidence: 99%

“…At present, the scientific knowledge indispensable for achieving the targets identified by the WHO for its ambitious 90-90-90 project is still lacking for HIV-2 [3,24]. Even the evidence available in the field of diagnostics and therapy is currently inadequate to define with certainty the most effective management and treatment pathways, and is partly due to evidence gathered in the HIV-1 context.…”

Section: Treatment and Resistancementioning

confidence: 99%

“…The establishment of evidencebased recommendations will only be possible on the basis of an accurate and systematic collection of information related to the management of HIV-2, which is currently deficient. In particular, updated clinical trials are needed that define the clinical criteria for the initiation of antiretroviral therapy and that evaluate the most appropriate first and secondline treatment regimens [24,70]. The study of the problems inherent in treatment failure in patients with HIV-2 infection requires in-depth studies that include data on the adequate management of resistances and the drugs available to combat them.…”

Section: Treatment and Resistancementioning

confidence: 99%

“…The study of the problems inherent in treatment failure in patients with HIV-2 infection requires in-depth studies that include data on the adequate management of resistances and the drugs available to combat them. Finally, it is essential to implement diagnostic resources for monitoring patients during treatment [3,24].…”

Section: Treatment and Resistancementioning

confidence: 99%

“…Currently, treatment for HIV-2-infected patients is more limited than for HIV-1, for which most antiretroviral compounds have been designed [10,24,70]. Some antiretrovirals are not active against HIV-2, including non-nucleoside reverse transcriptase inhibitors (NNRTI) such as efavirenz and nevirapine, due to the large extent of polymorphisms.…”

Section: Treatment and Resistancementioning

confidence: 99%

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Human Immunodeficiency Virus Type 2: The Neglected Threat

et al. 2021

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West Africa has the highest prevalence of human immunodeficiency virus (HIV)-2 infection in the world, but a high number of cases has been recognized in Europe, India, and the United States. The virus is less transmissible than HIV-1, with sexual contacts being the most frequent route of acquisition. In the absence of specific antiretroviral therapy, most HIV-2 carriers will develop AIDS. Although, it requires more time than HIV-1 infection, CD4+ T cell decline occurs more slowly in HIV-2 than in HIV-1 patients. HIV-2 is resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs) and some protease inhibitors. Misdiagnosis of HIV-2 in patients mistakenly considered HIV-1-positive or in those with dual infections can cause treatment failures with undetectable HIV-1 RNA. In this era of global integration, clinicians must be aware of when to consider the diagnosis of HIV-2 infection and how to test for this virus. Although there is debate regarding when therapy should be initiated and which regimen should be chosen, recent trials have provided important information on treatment options for HIV-2 infection. In this review, we focus mainly on data available and on the insight they offer about molecular epidemiology, clinical presentation, antiretroviral therapy, and diagnostic tests of HIV-2 infection.

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Section: Hiv-2 Origin and Infection Worldwidementioning

confidence: 99%

Section: Treatment and Resistancementioning

confidence: 99%

Section: Treatment and Resistancementioning

confidence: 99%

Section: Treatment and Resistancementioning

confidence: 99%

Section: Treatment and Resistancementioning

confidence: 99%

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Human Immunodeficiency Virus Type 2: The Neglected Threat

et al. 2021

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The slowdown of new infections by human retroviruses has reached a plateau in Spain

Mendoza

Carrizo

Sauleda

et al. 2023

Journal of Medical Virology

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The 2022 annual meeting of the HTLV & HIV-2 Spanish Network was held in Madrid on December 14. We summarize here the main information presented and discussed at the workshop and review time trends for human retroviral infections in Spain. As transmissible agents, infections by human retroviruses are of obligatory declaration.Until the end of 2022, the Spanish national registry had recorded 451 cases of HTLV-1, 821 of HTLV-2, and 416 of HIV-2. For HIV-1, estimates are of 150 000 people currently living with HIV-1 and 60 000 cumulative deaths due to AIDS.During year 2022, new diagnoses in Spain were of 22 for HTLV-1, 6 for HTLV-2, and 7 for HIV-2. The last updated figures for HIV-1 are from 2021 and counted 2786 new diagnoses. The slowdown in yearly infections for HIV-1 in Spain points out that new strategies are needed to achieve the United Nations 95-95-95 targets by 2025.

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Safety and Efficacy of Triple Therapy With Dolutegravir Plus 2 Nucleoside Reverse Transcriptase Inhibitors in Treatment-Naive Human Immunodeficiency Virus Type 2 Patients: Results From a 48-Week Phase 2 Study

Pacheco

Marques

Rodrigues

et al. 2023

Clinical Infectious Diseases

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Background Integrase strand transfer inhibitor (INSTI)-based regimens are recommended for first-line therapy in HIV-2. Nonetheless, dolutegravir (DTG) clinical trial data is lacking. Methods We conducted a phase II, single arm, open-label trial to evaluate the safety and efficacy of a triple therapy regimen including DTG, in persons with HIV-2 (PWHIV-2) in Portugal. Treatment-naïve adults were recruited to receive DTG in combination with two nucleoside reverse transcriptase inhibitors (NRTIs). Treatment efficacy was evaluated by the proportion of subjects achieving a plasma viral load (pVL) <40 copies/mL and/or by the change from baseline in CD4+T cell count and in CD4/CD8 ratio at week 48. Results A total of 30 subjects were enrolled [22 women, median age 55 years-old]. At baseline, 17 (56.7%) individuals were viremic [median pVL 190 copies/mL; interquartile range (IQR): 99-445 copies/mL]. The median CD4 count was 438 cells/μL (IQR: 335-605) and CD4/CD8 ratio was 0.8. During follow-up, 3 subjects discontinued the study. At week 48, all participants (27) had pVL<40 copies/mL. No virological failures were observed. Mean changes of CD4 count and CD4/CD8 ratio at week 48 were of + 95.59 (95%CI: 28.05-163.14) cells/µL and +0.32 (95%CI: 0.19-0.46). The most common drug-related adverse events were headache and nausea. One participant discontinued due to central nervous system symptoms. No serious adverse events were reported. Conclusions DTG plus two NRTIs is safe and effective as first-line treatment for PWHIV-2 with a tolerability profile previously known. No virological failures were observed which suggest a high potency of DTG in HIV-2 as occurs in HIV-1.

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Human Immunodeficiency Virus–2 (HIV-2): A Summary of the Present Standard of Care and Treatment Options for Individuals Living with HIV-2 in Western Europe

Cited by 13 publications

References 31 publications

Human Immunodeficiency Virus Type 2: The Neglected Threat

Human Immunodeficiency Virus Type 2: The Neglected Threat

The slowdown of new infections by human retroviruses has reached a plateau in Spain

Safety and Efficacy of Triple Therapy With Dolutegravir Plus 2 Nucleoside Reverse Transcriptase Inhibitors in Treatment-Naive Human Immunodeficiency Virus Type 2 Patients: Results From a 48-Week Phase 2 Study

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