Treatment outcome in dually HIV-1 and HIV-2 coinfected patients living in Spain

• Published in: AIDS (London) Vol. 33; no. 14; pp. 2167 - 2172
• Main Authors: Requena, Silvia, Caballero, Estrella, Lozano, Ana Belén, Ríos-Villegas, María José, Benito, Rafael, Rojo, Silvia, Cabezas, Teresa, Macià, María Dolores, Nieto, María del Carmen, Soriano, Vicente, de Mendoza, Carmen
• Format: Journal Article
• Language: English
• Published: England Copyright Wolters Kluwer Health, Inc 15.11.2019
• Subjects: AIDS/HIV
• ISSN: 0269-9370; 1473-5571
• DOI: 10.1097/QAD.0000000000002338

BACKGROUND:Whereas HIV-1 has spread globally, HIV-2 is mainly found in West Africa where dual HIV-1/HIV-2 coinfection is nowadays uncommon. Herein, we report the rate, main characteristics, and treatment outcomes of all dually infected patients living in Spain. METHODS:We identified retrospectively all persons coinfected with HIV-1 recorded at the Spanish HIV-2 registry. Dual infection had been confirmed using PCR in plasma and/or cells, and/or using discriminatory serological tests. RESULTS:From a total of 373 individuals with HIV-2 recorded at the Spanish registry, 34 (9.1%) were coinfected with HIV-1. Compared with HIV-2 monoinfected persons, dually infected patients were more often male (67.6%), presented with lower median CD4 cell counts (204 cells/μl), and had developed more frequently AIDS events (26.5%). Although 61.7% came from West Africa, 6 (17.6%) were native Spaniards. HIV-1 non-B subtypes were recognized in 75% of coinfected patients, being the most prevalent CRF02_AG. At baseline, 45% of dually infected patients had undetectable plasma HIV-2 RNA. After a median follow-up of 32 (13–48) months on antiretroviral therapy, dually infected patients achieved undetectable viremia in 85% for HIV-1, in 80% for HIV-2; and in 70% for both viruses. Median CD4 cell counts reached up to 418 cells/μl. CONCLUSION:Roughly 9% of individuals with HIV-2 infection living in Spain are coinfected with HIV-1. Overall, 70% of dually infected patients achieved viral suppression for both viruses under antiretroviral therapy. Given the relatively large population of West Africans living in Spain and the continuous migration flow from HIV-2 endemic areas, HIV-1/HIV-2 coinfection should always be excluded at first diagnosis in all HIV-seroreactive persons.