Plasma Hiv-2 Rna According To Cd4 Count Strata Among Hiv-2-Infected Adults In The Iedea West Africa Collaboration

BackgroundPlasma HIV-1 RNA monitoring is one of the standard tests for the management of HIV-1 infection. While HIV-1 RNA can be quantified using several commercial tests, no test has been commercialized for HIV-2 RNA quantification. We studied the relationship between plasma HIV-2 viral load (VL) and CD4 count in West African patients who were either receiving antiretroviral therapy (ART) or treatment-naive.MethodA cross sectional survey was conducted among HIV-2-infected individuals followed in three countries in West Africa from March to December 2012. All HIV-2 infected-patients who attended one of the participating clinics were proposed a plasma HIV-2 viral load measurement. HIV-2 RNA was quantified using the new ultrasensitive in-house real-time PCR assay with a detection threshold of 10 copies/mL (cps/mL).ResultsA total of 351 HIV-2-infected individuals participated in this study, of whom 131 (37.3%) were treatment naive and 220 (62.7%) had initiated ART. Among treatment-naive patients, 60 (46.5%) had undetectable plasma HIV-2 viral load (<10 cps/mL), it was detectable between 10-100 cps/mL in 35.8%, between 100-1000 cps/mL in 11.7% and >1000 cps/mL in 6.0% of the patients. Most of the treatment-naive patients (70.2%) had CD4-T cell count >= 500 cells/mm(3) and 43 (46.7%) of these patients had a detectable VL (>= 10 cps/mL). Among the 220 patients receiving ART, the median CD4-T cell count rose from 231 to 393 cells/mm(3) (IQR [259-561]) after a median follow-up duration of 38 months and 145 (66.0%) patients had CD4-T cell count >= 500 cells/mm(3) with a median viral load of 10 cps/mL (IQR [10-33]). Seventy five (34.0%) patients had CD4-T cell count >= 500 cells/mm(3), among them 14 (18.7%) had a VL between 10-100 cps/mL and 2 (2.6%) had VL > 100 cps/mL.ConclusionThis study suggests that the combination of CD4-T cell count and ultrasensitive HIV-2 viral load quantification with a threshold of 10 cps/mL, could improve ART initiation among treatment naive HIV-2-infected patients and the monitoring of ART response among patients receiving treatment.