title: Plasma HIV-2 RNA According to CD4 Count Strata among HIV-2-Infected Adults in the IeDEA West Africa Collaboration.
abstract: BACKGROUND
  Plasma 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-naïve.
  
  
  METHODS
  A 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).
  
  
  RESULTS
  A total of 351 HIV-2-infected individuals participated in this study, of whom 131 (37.3%) were treatment naïve and 220 (62.7%) had initiated ART. Among treatment-naïve 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-naïve patients (70.2%) had CD4-T cell count ≥500 cells/mm3 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/mm3 (IQR [259-561]) after a median follow-up duration of 38 months and 145 (66.0%) patients had CD4-T cell count ≤ 500 cells/mm3 with a median viral load of 10 cps/mL (IQR [10-33]). Seventy five (34.0%) patients had CD4-T cell count ≥ 500 cells/mm3, among them 14 (18.7%) had a VL between 10-100 cps/mL and 2 (2.6%) had VL >100 cps/mL.
  
  
  CONCLUSIONS
  This 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 naïve HIV-2-infected patients and the monitoring of ART response among patients receiving treatment.
authors.affiliation: Université de Bordeaux, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, Bordeaux, France; Inserm U897, ISPED, Université de Bordeaux, Bordeaux, France; Programme PACCI, site de recherche ANRS, Abidjan, Côte d'Ivoire; Département de Santé Publique, Université de Lomé, Lomé, Togo.
authors.forename: Didier K
authors.initials: DK
authors.lastname: Ekouévi
authors.affiliation: AP-HP, Hôpital Necker Enfants Malades, Laboratoire de Virologie, Paris, France; Université Paris-Descartes, Sorbonne Paris Cité, Faculté de Médecine, EA7327, Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Avettand-Fènoël
authors.affiliation: Université de Bordeaux, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, Bordeaux, France; Inserm U897, ISPED, Université de Bordeaux, Bordeaux, France; Programme PACCI, site de recherche ANRS, Abidjan, Côte d'Ivoire.
authors.forename: Boris K
authors.initials: BK
authors.lastname: Tchounga
authors.affiliation: Programme PACCI, site de recherche ANRS, Abidjan, Côte d'Ivoire; Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d'Ivoire.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Coffie
authors.affiliation: Hôpital de Jour, Service des Maladies Infectieuses et Tropicales, CHU SouroSanou, Bobo Dioulasso, Burkina-Faso.
authors.forename: Adrien
authors.initials: A
authors.lastname: Sawadogo
authors.affiliation: Centre de Prise en Charge des Personnes vivant avec le VIH, Hôpital du Point G, Bamako, Mali (service des Maladies Infectieuses).
authors.forename: Daouda
authors.initials: D
authors.lastname: Minta
authors.affiliation: Centre Médical de Suivi de Donneurs de Sang/CNTS/PRIMO-CI, Abidjan, Côte d'Ivoire.
authors.forename: Albert
authors.initials: A
authors.lastname: Minga
authors.affiliation: Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d'Ivoire.
authors.forename: Serge P
authors.initials: SP
authors.lastname: Eholie
authors.affiliation: Laboratoire associé au Centre National de Référence du VIH, hôpital Charles Nicolle, CHU de Rouen, Rouen, France; GRAM, Equipe d'Accueil 2656, Faculté de Médecine-Pharmacie, Institut de Recherche et d'Innovation en Biomédecine, Université de Rouen, Rouen, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Plantier
authors.affiliation: INSERM, IAME, UMR 1137, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Paris, France; AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, Paris, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Damond
authors.affiliation: Université de Bordeaux, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, Bordeaux, France; Inserm U897, ISPED, Université de Bordeaux, Bordeaux, France.
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.affiliation: AP-HP, Hôpital Necker Enfants Malades, Laboratoire de Virologie, Paris, France; Université Paris-Descartes, Sorbonne Paris Cité, Faculté de Médecine, EA7327, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Rouzioux
mesh_terms: D000328:Adult; D000354:Africa, Western; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000821:virology*; D015498:HIV-2 / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral