Effect of HIV-2 Co-Infection on HIV 1& 2 dually infected patients’ response Haart

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This study was carried out to determine the effect of HIV-2 on HIV-1 & 2 dually infected patients’ response to antiretroviral therapy supposedly designed for HIV-1. HIV-1 and HIV-2 are distinct strains of viruses that cause AIDS. HIV-2 is known to be less pathogenic with a slower rate of CD4 depletion and a longer time of disease progression to AIDS. In contrast, HIV-1 is more pathogenic, depletes CD4 faster with a comparatively shorter time disease progression to AIDS. HIV-1 and HIV-2 differ in their nucleotide sequence and their genetic organization with just about 30% homology between them. Therefore, one would expect that their replicative steps in an infected individual could possibly involve different enzymes and cellular factors. Available antiretroviral drugs target only HIV-1 and act by interfering with the replicative steps of the HIV virus. In line with this, a drug supposedly designed for HIV-1 might not provide enough inhibition for HIV-2. We specifically monitored the response of patients undergoing ART with HIV-2 alone infection and HIV -1 & 2 dual infections and compared their response to patients with HIV-1. In all, 108 patients were enrolled into the study. Out of this, 87% had HIV-1, 7% had HIV-2 while 6% had HIV-1 & 2. The patients were monitored using their CD4 kinetics over a period of two years with a baseline CD4 and four consecutive counts performed at 6 months intervals. The results indicated that patients with HIV-2 infection responded favorably to the therapy just like HIV-1 infected patients. However, it appears that the synergistic effect of HIV-1 & HIV- 2 in HIV-1 & 2 dual infections contributed to a comparatively lower response to therapy. It was also found that, most probably, the modes of action of the drugs are on host factors but not virus specific factors. Not withstanding the difference in viral genome, HIV-2 patients responded well to the supposed HIV-1 specifically designed drugs.
A thesis submitted to the Department of Clinical microbiology in partial fulfilment of the requirement for the award of Masters of Science degree (Msc) in Clinical Microbiology.