Nav: Home

Long-term study shows that HIV-2 is deadlier than previously thought

November 07, 2018

A study published in The Lancet HIV shows that HIV-2 is more pathogenic than previously demonstrated. The new findings indicate that early treatment should be applied to all patients with HIV, not only to those with HIV-1.

"The study is unique in that we have followed cohort of study participants frequently over a long period, which enabled us to determine when the patients became infected by HIV, as well as to follow the development of the disease. Our data indicates that the majority of those infected with HIV-2 will develop and die of AIDS, something previous studies have not been able to determine", says Joakim Esbjörnsson, associate senior lecturer and researcher in medical microbiology at Lund University in Sweden.

The virus types HIV-1 and HIV-2 are closely related, but vary in their dissemination over the world. HIV-1 has spread globally whereas HIV-2, which is considered to be a milder variant of HIV, is mainly prevalent in West Africa.

The study is the first ever to present reliable estimates of the time between HIV infection and AIDS or HIV-related death for HIV-2. The researchers followed up on 4 900 individuals in a cohort study in Guinea-Bissau over 23 years, between 1990 and 2013, which involved annual examinations including blood tests. The study also compared individuals infected with HIV-1 with HIV-negative individuals in the same cohort. Data from the study shows that people with HIV-2 develop HIV-related infections and AIDS in an almost identical manner to those with HIV-1, although the process is slower over time.

Previous studies have indicated that a large proportion of those with HIV-2, even without antiretroviral treatment, would have a normal life expectancy without any HIV-related complications, unlike those with HIV-1 for whom the absence of treatment led to the development of AIDS in more than 98 per cent of cases. Not even the WHO's treatment recommendations explicitly state that treatment should be offered to patients with HIV-2.

"There is a commonly held belief within research as well as in public healthcare about the various types of HIV: that HIV-2 does not lead to disease in the same way as HIV-1. We want to dismantle this belief and change the views on the international treatment recommendations", says Joakim Esbjörnsson.

A similar study has not been done previously, as the course of HIV disease is long, and it is unlikely that it will be possible to do something similar again. Joakim Esbjörnsson believes that the difficulty in studying HIV-2 over time is one of the reasons for the general uncertainty about how aggressive HIV-2 is, and also for the prevailing view of when treatment should be started.

Another specific problem with HIV-2 is that the majority of HIV-2-infected people do not have measurable virus levels in the blood, which has increased uncertainty as to when and whether treatment should be introduced, according to Hans Norrgren, associate professor of infectious diseases at Lund University and consultant physician at the infection clinic at Skåne University Hospital in Lund.

"Furthermore, HIV-2 mainly occurs in West Africa, which is the world's poorest region, characterised by low investment levels and frequent political instability. This not only makes research and development more difficult in the region, but has also contributed to the fact that commercial interest in the development of diagnostics and treatment of HIV-2 has not been equally strong", says Fredrik Månsson, researcher in clinical infectious diseases at Lund University and specialist physician at the infection clinic at Skåne University Hospital in Malmö.

The researchers would like to see more research in the field and on treatment for HIV, to better understand the differences between the two types. Among other things, a treatment study over time is needed to verify the usefulness of early treatment for patients with HIV-2.
-end-
About the study:

The study is a collaboration between researchers and employees at Lund University, Örebro University, the healthcare centre of the police authority in Bissau and the national public health laboratory in Guinea-Bissau. It was mainly conducted by researchers from Lund University and Skåne University Hospital, including Joakim Esbjörnsson, Fredrik Månsson and Hans Norrgren, all of whom have long experience of HIV research, both in Sweden and in countries severely affected by HIV.

The study was supported by Sida and Sarec from 1990 to 2011.

Lund University

Related Hiv Articles:

Defective HIV proviruses reduce effective immune system response, interfere with HIV cure
A new study finds defective HIV proviruses, long thought to be harmless, produce viral proteins and distract the immune system from killing intact proviruses needed to reduce the HIV reservoir and cure HIV.
1 in 7 people living with HIV in the EU/EEA are not aware of their HIV status
Almost 30,000 newly diagnosed HIV infections were reported by the 31 European Union and European Economic Area (EU/EEA) countries in 2015, according to data published today by ECDC and the WHO Regional Office for Europe.
Smoking may shorten the lifespan of people living with HIV more than HIV itself
A new study led by researchers at Massachusetts General Hospital finds that cigarette smoking substantially reduces the lifespan of people living with HIV in the US, potentially even more than HIV itself.
For smokers with HIV, smoking may now be more harmful than HIV itself
HIV-positive individuals who smoke cigarettes may be more likely to die from smoking-related disease than the infection itself, according to a new study published in the Journal of Infectious Diseases.
Patients diagnosed late with HIV infection are more likely to transmit HIV to others
An estimated 1.2 million people live with HIV in the United States, with nearly 13 percent being unaware of their infection.
The Lancet HIV: New HIV infections stagnating at 2.5 million a year worldwide
A major new analysis from the Global Burden of Disease 2015 study, published today in The Lancet HIV journal, reveals that although deaths from HIV/AIDS have been steadily declining from a peak in 2005, 2.5 million people worldwide became newly infected with HIV in 2015, a number that hasn't changed substantially in the past 10 years.
NIH scientists discover that defective HIV DNA can encode HIV-related proteins
Investigators from the National Institutes of Health have discovered that cells from HIV-infected people whose virus is suppressed with treatment harbor defective HIV DNA that can nevertheless be transcribed into a template for producing HIV-related proteins.
Study examines risk of HIV transmission from condomless sex with virologically suppressed HIV infection
Among nearly 900 serodifferent (one partner is HIV-positive, one is HIV-negative) heterosexual and men who have sex with men couples in which the HIV-positive partner was using suppressive antiretroviral therapy and who reported condomless sex, during a median follow-up of 1.3 years per couple, there were no documented cases of within-couple HIV transmission, according to a study appearing in the July 12 issue of JAMA, an HIV/AIDS theme issue.
HIV vaccine design should adapt as HIV virus mutates
Researchers from UAB, Emory and Microsoft demonstrate that HIV has evolved to be pre-adapted to the immune response, worsening clinical outcomes in newly infected patients.
Charlie Sheen's HIV disclosure may reinvigorate awareness, prevention of HIV
Actor Charlie Sheen's public disclosure in November 2015 that he has the human immunodeficiency virus (HIV) corresponded with the greatest number of HIV-related Google searches ever recorded in the United States, according to an article published online by JAMA Internal Medicine.

Related Hiv Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Jumpstarting Creativity
Our greatest breakthroughs and triumphs have one thing in common: creativity. But how do you ignite it? And how do you rekindle it? This hour, TED speakers explore ideas on jumpstarting creativity. Guests include economist Tim Harford, producer Helen Marriage, artificial intelligence researcher Steve Engels, and behavioral scientist Marily Oppezzo.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".