Human Immunodeficiency Virus Type 2: The Neglected Threat

Abstract

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.

Increasing HIV early diagnosis by implementing an automated screening strategy in emergency departments

“…Indeed, the number of new HIV diagnoses fell by more than 50% in the second and third years compared with the first year. Other groups have also acknowledged this challenge while addressing the number of new HIV‐positive cases detected in ED screenings [ 29 , 30 ]. All these observations strengthen the idea that screening opportunistically yields more diagnosis and better outcomes of earlier diagnosis than risk‐based testing alone.…”

“…Even though about two‐thirds of the patients screened were of Portuguese origin, over 60% of HIV cases were confirmed among people whose country of origin was not Portugal. Notably, 7.2% of infections were of HIV‐2, a finding associated with the historical presence of Portugal in African countries, namely Guinea‐Bissau, which has a high prevalence of HIV‐2 [ 30 , 31 ]. Previous studies have reported a higher burden of missed opportunities for HIV diagnosis among migrant populations in Europe, particularly those of African origin [ 32 , 33 ].…”

Discovery, Crystallographic Studies, and Mechanistic Investigations of Novel Phenylalanine Derivatives Bearing a Quinazolin-4-one Scaffold as Potent HIV Capsid Modulators

“…1 H NMR (400 MHz, DMSO-d 6 ) δ 9.86 (s, 1H, NH), 7.68 (dd, J = 8.7, 6.7 Hz, 1H, Ph-H), 7.57 (d, J = 9.0 Hz, 2H, Ph-H), 6.90 (d, J = 9.0 Hz, 2H, Ph-H), 6.65 (s, 2H, NH 2 ), 6.50 (dt, J = 11.9, 3.1 Hz, 1H, Ph-H), 6.38 (td, J = 8.6, 2. 6 2-Amino-4-bromo-N-(4-methoxyphenyl)benzamide (7d). White solid, yield: 69%.…”

Antiretroviral Treatment of HIV-2 Infection: Available Drugs, Resistance Pathways, and Promising New Compounds

“…HIV-2 is composed of nine groups termed A to I, of which group A is by far the most disseminated [ 4 , 5 ]. HIV-2 differs markedly from HIV-1 in the infection course, having a much longer asymptomatic phase, slower clinical progression and lower perinatal and sexual transmission rates (reviewed in [ 6 , 7 ]. In contrast to HIV-1-infected patients, plasma viral load is low or undetectable in most HIV-2-infected patients, irrespective of antiretroviral treatment [ 8 , 9 ].…”