There is life with HIV

HIV-2 what is it? know everything here

A common question for which I finally found something good to be translated

Most type 2 HIV infections are centered in West Africa or in countries that have strong colonial or socioeconomic ties with West Africa, including:
1 - France
2 - Spain
3 - Portugal

O human immunodeficiency virus (HIV) comes in two types: HIV-1 and HIV-2. HIV-2 was discovered in 1986 - about five years after HIV-1 was discovered to cause AIDS. Type 2 HIV is mainly confined to West Africa.

Although HIV-2 has some of the same characteristics as HIV-1, it differs in its origin, genetic composition, distribution, virulence and pathogenicity. It is also less responsive to certain antiretroviral drugs used to treat HIV.1

Origin of HIV-2

A zoonosis it is an infectious disease transmissible from non-human animals to humans. At the moment, there are more than 200 known types of zoonoses, which comprise a large percentage of new and existing diseases in humans.2

Animal bonding

If it is believed to originate from other animals: 1

  • HIV 1 de zoonotic origins are thought to be linked to chimpanzees and gorillas.
  • HIV-2 Zoonotic origins are believed to be linked to the sooty monkey.

One of the biggest obstacles in creating an HIV vaccine is that the virus has exceptionally high genetic variability. This means that not only are there two distinct genetic types of HIV ,.

There are numerous subtypes, some of which are more virulent or resistant to HIV drugs.

This makes the search for healing an ongoing challenge.

Distribution of HIV-2

From an estimated 38 million people worldwide living with HIV, approximately 1 to 2 million have type 2 HIV.

  • Most type 2 HIV infections are centered in West Africa or in countries that have strong colonial or socio-economic ties with West Africa, including:
    • France
    • Spain
    • Portugal

Other former Portuguese colonies also reported significant numbers of HIV-2 infections, including: 4

  • Angola
  • Mozambique
  • Brazil
  • India

HIV is transmitted from someone with HIV to someone without the virus, through body fluids such as:

  • Semen
  • Blood
  • Vaginal secretions
  • Breast milk

DST PrEP: It can work, but it is a good idea?

HIV-1 e HIV-2Common methods of transmission include unprotected anal and vaginal sex and shared needles.

In the past two decades, the prevalence of type 2 HIV has declined in several West African countries, such as Senegal, Gambia, Côte d'Ivoire, Guinea-Bissau, but the reasons for this are not clear.

However, along with the declines, there has also been an increase in double infections - when someone has HIV-1 and type 2 HIV - with some estimates suggesting that 15% of all HIV infections in West Africa involve both types.5

Prevalence of HIV -2 in the United States

The first case of HIV-2 in the United States was reported in 1987. Currently, less than 1% of people in the United States with HIV have HIV-2,6

Virulence and pathogenicity

HIV-2 is typically much less virulent and tends to progress more slowly than HIV-1. In addition, HIV-2 infection is associated with:

Also an STD

HIV-2 also reduced sexual transmissibility and genital excretion compared to HIV-1.

Although people with HIV-2 can progress to AIDS, a significant number of them are elite controllers who do not experience the progression of the virus.4

In recent years, more and more attention has been devoted to this subset of HIV-2-infected individuals, who have greater long-term viral control.

The idea is to use HIV-2 as a model to find a functional cure against HIV.7

Mother-to-Child Transmission of HIV-2

HIV-2 is more difficult to transmit perinatal than HIV-1. Although data on mother-to-child transmission of HIV-2 is extremely scarce, it is thought to occur at a rate of approximately 0,6% 0,8.

Diagnosis

Currently, the Centers for Disease Control and Prevention recommends initial testing for HIV with an FDA-approved antigen / antibody combination immunoassay.

It also recommends the use of an HIV-24 p1 antigen to screen for established infection with HIV-1 or HIV-2 and / or acute HIV-1 infection.

If a test is reactive, it is followed by a supplementary test to differentiate between HIV-1 and HIV-2. In addition, it is important to note that certain tests commonly used for HIV-1 testing - including Western and Blot and HIV-1 RNA and DNA tests - do not reliably detect HIV-2 and can trigger a false-negative reading.6

Test to differentiate between two types of HIV

The Rapid Multispot HIV-1 / HIV-2 Test is currently the only FDA approved test capable of reliably differentiating the two viruses. The test can also do:

  • Detection of antibodies associated with HIV-1 and HIV-2 in plasma and human serum
  • Diagnose AIDS in the diagnosis of infection with HIV-1 and / or HIV-2.
Treatment

To prevent the progression of the disease and the transmission of HIV-2 to others, it is recommended that antiretroviral therapy begins at or shortly after the diagnosis of HIV-2.

Although many of the antiretroviral drugs used to treat HIV-1 also work in people with HIV type 2. It is not universal.

For example, all non-nucleoside reverse transcriptase inhibitors (NNRTIs) and the enfuvirtide fusion inhibitor are ineffective in treating HIV-2.

At this point, the effectiveness of the CCR5 maraviroc inhibitor is uncertain, and protease inhibitors have varying efficacy in people with HIV-2, with lopinavir and darunavir being the most useful.

Apart from the NNRTIs, the first-line treatment approach HIV-2 is similar to HIV-1 and typically consists of two nucleoside reverse transcriptase inhibitors (NRTIs) and an integrase chain transfer inhibitor (INSTI), such as:

  • bictegravir
  • dolutegravir
  • elvitegravir
  • Raltegravir

Alternatively, the second option is two NRTIs plus a boosted protease inhibitor (darunavir or lopinavir).

People with HIV-2 who are taking antiretroviral therapy should undergo routine monitoring of quantitative levels of type 2 HIV, to assess the response to treatment.4

Mortality rates of people with HIV-2 on ART

Even with reduced treatment effectiveness, the mortality rate of people with this type 2 HIV on ART is 50% compared to people with HIV-1.

What is viral load?

A common question about Undetectable viral load

A point to ponder

Before taking an HIV test, be sure to provide all relevant information about personal risk factors. Including sexual history, shared use of needles and travel or residency in West Africa.

Although doing any type of test for serious conditions like HIV can be stressful and unnerving. But always keep in mind that there are now several treatment options.11

A functional cure for HIV remains elusive, but the research continues.

Translated by Claudio Souza.

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Source of matter: What Is HIV-2

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