Antiretroviral therapy in HIV-2-infected patients: changes in plasma viral load, CD4+ cell counts, and drug resistance profiles of patients treated in Abidjan, Côte d'Ivoire.
OBJECTIVE
To describe changes in plasma viral load, CD4+ cell counts, and drug resistance profiles of HIV-2-infected patients receiving antiretroviral (ARV) therapy in Abidjan, Côte d'Ivoire.


METHODS
Consecutive blood samples were collected from 18 HIV-2-infected ARV-naive patients who had received ARV therapy in the UNAIDS drug access initiative (UNAIDS-DAI) in Abidjan between August 1998 and July 2000. Changes in HIV-2 plasma viral load, CD4+ cell counts, and genotypic and phenotypic drug resistance testing were determined.


RESULTS
At baseline, 11 (61%) of the 18 patients initiated highly active antiretroviral therapy (HAART) and seven (39%) received dual therapy. No significant change in median viral load was observed at 2 months (P = 0.09), at 6 months (P = 0.06), and at 12 months of therapy (P = 0.26). No significant increase in CD4+ cell counts was observed at 12 months (P = 0.10). All four patients on indinavir-containing HAART had undetectable viral loads at 2-4 months of therapy. However, none of seven patients on nelfinavir-containing HAART had a substantial decrease in viral load. Viruses from 14 patients were analyzed, 12 of which (86%) had at least one primary resistance mutation that is known to confer resistance to HIV-1 virus. Three patients had the multi-drug-resistant mutation, Q151M, two of whom showed reduced susceptibility to zidovudine, didanosine, stavudine and zalcitabine.


CONCLUSIONS
Our limited findings show that nelfinavir-containing regimens may have limited virologic benefit to HIV-2-infected patients.
Adjé-Touré
Christiane A
CA
Projet RETRO-CI, Abidjan, Côte d'Ivoire.
Cheingsong
Rachanee
R
Garcìa-Lerma
J Gerardo
JG
Eholié
Serge
S
Borget
Marie-Yolande
MY
Bouchez
Jean-Marc
JM
Otten
Ron A
RA
Maurice
Chantal
C
Sassan-Morokro
Madeleine
M
Ekpini
René E
RE
Nolan
Monica
M
Chorba
Terence
T
Heneine
Walid
W
Nkengasong
John N
JN
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D024921:Drug Resistance, Multiple, Viral / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015498:HIV-2 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D019469:Indinavir / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009154:Mutation; D019888:Nelfinavir / Q000627:therapeutic use; D010349:Patient Compliance; D019562:Viral Load
D019380:Anti-HIV Agents; D019469:Indinavir; D019888:Nelfinavir