Comparison of viro-immunological marker changes between HIV-1 and HIV-2-infected patients in France.
BACKGROUND
HIV-2 is known to be less pathogenic than HIV-1, although the underlying mechanisms are still debated. We compared the changes over time in viro-immunological markers in HIV-1 and HIV-2-infected patients living in France during natural history and after initiation of the first combination antiretroviral therapy (CART).


METHODS
Patients were included in the ANRS CO3 HIV-1 cohort (N = 6707) or the ANRS CO5 HIV-2 cohort (N = 572). HIV-1-infected patients were matched to HIV-2 patients according to sex, age, HIV transmission group and period of treatment initiation. Changes in markers were estimated using linear mixed models.


RESULTS
Analyses were performed for three groups of patients: those with estimated date of contamination (98 HIV-1 and 49 HIV-2-seroincident patients); untreated seroprevalent patients (320 HIV-1 and 160 HIV-2); and those initiating a first CART (59 HIV-1 and 63 HIV-2). In group 1, CD4 T-cell counts decreased less rapidly in HIV-2 than HIV-1 patients (-9 versus -49 cells/microl per year, P < 10(-4)). Results were similar in group 2. Baseline CD4 cell count at CART initiation was not different according to the type of infection. During the first 2 months of treatment, the CD4 cell count increased by +59 cells/microl per month (CI 34; 84) for HIV-1 and +24 (CI 6; 42) for HIV-2. The plasma viral load drop was threefold more important in HIV-1 patients: -1.56 log10/ml per month versus -0.62 among HIV-2 patients (P < 10(-4)).


CONCLUSIONS
Differences between the two infections during natural history are similar to those previously described in Africa. Once treatment is started, response is poorer in HIV-2 than in HIV-1 patients.
Drylewicz
Julia
J
INSERM, U875 Epidemiology and Biostatistics, Bordeaux F-33076, France.
Matheron
Sophie
S
Lazaro
Estibaliz
E
Damond
Florence
F
Bonnet
Fabrice
F
Simon
François
F
Dabis
François
F
Brun-Vezinet
Françoise
F
Chêne
Geneviève
G
Thiébaut
Rodolphe
R
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers / Q000378:metabolism*; D016516:CD4-CD8 Ratio; D015331:Cohort Studies; D005260:Female; D005602:France; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology*; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology*; D015498:HIV-2 / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019562:Viral Load
D015415:Biomarkers