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20 years of the HIV-2 registry in Spain
A. Treviño1, C. de Mendoza1, E. Caballero2, A. Aguilera3, C. Rodríguez4, R. Ortiz de Lejarazu5, J.M. Eiros5, E. Calderon6, M. Rodríguez-Iglesias7, R. Benito8, M. Trigo9, J. García-Costa10, G. Marcaida11, C. Gomez-Hernando12, J. del Romero4, V. Soriano13, on behalf of the HIV-2 Spanish Study Group
1Hospital Carlos III, Infectious Disease Department, Madrid, Spain, 2Hospital Vall d'Hebron, Barcelona, Service of Microbiology, Barcelona, Spain, 3Hospital Conxo, Service of Microbiology, Santiago de Compostela, Spain, 4Centro Sanitario Sandoval, Madrid, Spain, 5Hospital Clínico Universitario, Service of Microbiology, Valladolid, Spain, 6Hospital Virgen del Rocio, CIBER in Public Health and Epidemiology, Seville, Spain, 7Hospital Universitario, Puerto Real, Service of Microbiology, Cadiz, Spain, 8Hospital Clínico Universitario Lozano Blesa, Service of Microbiology, Zaragoza, Spain, 9Complejo Hospitalario, Service of Microbiology, Pontevedra, Spain, 10Hospital Cristal-Piñor, Service of Microbiology, Orense, Spain, 11Hospital General Universitario, Service of Inmunology, Valencia, Spain, 12Complejo Hospitalario Virgen de la Salud, Service of Microbiology, Toledo, Spain, 13Hospital Carlos III, Infectious Disease Department, Madrid, Spain
Background: The HIV-2 Spanish Study Group was constituted in 1988 to survey and study HIV-2 infected persons in Spain. Herein, we report the main characteristics of patients in the updated registry up to February 2009.
Methods: Demographics, serologic and genetic analyses were recorded at baseline. Plasma HIV-2 RNA was measured using EasyQ v1.1 (Nuclisens, Biomerieux), which has a lower limit of detection of 50 copies/ml). Resistance and subtype analyses were performed in subjects with detectable viremia.
Results: A total of 187 cases of HIV-2 infection have been reported over the last 20 years (17 of them in 2008). Most of them were male (n=126) with a mean age of 40 years, ranging from 2 (single vertical case) to 84-years-old. The country of origin was: native Spaniards (n=35), Sub-Saharan Africa (n=126), Portugal (n=5), India (n=1), France (n=1) and the Dominican Republic (n=1). Spanish patients often had a past history of travelling to or having sex with people from HIV-2 endemic areas. HIV-2 infection has mainly occurred through heterosexual contact (n=120), although 10 subjects were homo/bisexual men, and 3 had been intravenous drug users. A total of 38 (20%) have developed AIDS and 8 have died; the rest remain asymptomatic. HIV-1 coinfection was confirmed in 17 (9%). Most cases were HIV-2 subtype A, although subtype B was found in 5 (mainly from Equatroial Guinea). The majority of patients with low CD4 counts (< 200) showed detectable viremia, but it never exceeded 100,000 HIV-2 RNA copies/mL. Drug resistance mutations developed more rapidly and more frequently than in HIV-1 counterparts. Mutations rtQ151M, rtK65R and proI47A were the most common.
Conclusions: There is a steadily increase of HIV-2 cases in Spain, with no evidence of rapid spreading. It remains mainly confined to immigrants from African endemic regions. Therapeutic management is challenging and adequate treatment guidelines are required.
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