title: Clinical presentation and opportunistic infections in HIV-1, HIV-2 and HIV-1/2 dual seropositive patients in Guinea-Bissau.
abstract: BACKGROUND
  Better understanding of HIV-2 infection is likely to affect the patient care in areas where HIV-2 is prevalent. In this study, we aimed to characterize the clinical presentations among HIV-1, HIV-2 and HIV-1/2 dual seropositive patients.
  
  
  METHODS
  In a cross-sectional study, newly diagnosed HIV patients attending the HIV outpatient clinic at Hospital Nacional Simão Mendes in Guinea-Bissau were enrolled. Demographical and clinical data were collected and compared between HIV-1, HIV-2 and HIV-1/2 dual seropositive patients.
  
  
  RESULTS
  A total of 169 patients (76% HIV-1, 17% HIV-2 and 6% HIV 1/2) were included in the study between 21 March 2012 and 14 December 2012. HIV-1 seropositive patients were younger than HIV-2 and HIV-1/2 seropositive patients, but no difference in sex was observed. Patients with HIV-1 and HIV-1/2 had a lower baseline CD4 cell count than HIV-2 seropositive patients (median CD4 cell count 185, 198 and 404 cells/μl, respectively (p value 0.001 and 0.05). HIV-1 seropositive patients had a lower BMI and a higher prevalence of weight loss, skin rash and productive cough than HIV-2 seropositive patients (p value 0.03, 0.002, 0.03 and 0.04). Only four cases (2%) of pulmonary tuberculosis (TB) were diagnosed. One patient (1/96, 1%) was tested positive for cryptococcal antigen.
  
  
  CONCLUSIONS
  HIV-1 and HIV-1/2 seropositive patients have lower CD4 cell counts than HIV-2 seropositive patients when diagnosed with HIV with only minor clinical and demographic differences among groups. Few patients were diagnosed with TB and cryptococcal disease was not found to be a major opportunistic infection among newly diagnosed HIV patients.
authors.affiliation: a Bandim Health Project , Indepth Network , Bissau , Guinea-Bissau ;
authors.forename: Allan
authors.initials: A
authors.lastname: Sørensen
authors.affiliation: a Bandim Health Project , Indepth Network , Bissau , Guinea-Bissau ;|b Department of Infectious Diseases , Aarhus University Hospital , Denmark ;
authors.forename: Sanne
authors.initials: S
authors.lastname: Jespersen
authors.affiliation: c Department of Infectious Diseases, Rigshospitalet , Copenhagen University Hospital , Denmark ;
authors.forename: Terese L
authors.initials: TL
authors.lastname: Katzenstein
authors.affiliation: d National HIV Programme, Ministry of Health , Bissau , Guinea-Bissau ;
authors.forename: Candida
authors.initials: C
authors.lastname: Medina
authors.affiliation: d National HIV Programme, Ministry of Health , Bissau , Guinea-Bissau ;
authors.forename: David da Silva
authors.initials: Dda S
authors.lastname: Té
authors.affiliation: d National HIV Programme, Ministry of Health , Bissau , Guinea-Bissau ;
authors.forename: Faustino Gomes
authors.initials: FG
authors.lastname: Correira
authors.affiliation: b Department of Infectious Diseases , Aarhus University Hospital , Denmark ;
authors.forename: Cecilie Juul
authors.initials: CJ
authors.lastname: Hviid
authors.affiliation: b Department of Infectious Diseases , Aarhus University Hospital , Denmark ;
authors.forename: Alex Lund
authors.initials: AL
authors.lastname: Laursen
authors.affiliation: a Bandim Health Project , Indepth Network , Bissau , Guinea-Bissau ;|b Department of Infectious Diseases , Aarhus University Hospital , Denmark ;|e GloHAU, Centre for Global Health, School of Public Health , Aarhus University , Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Wejse
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology / Q000821:virology; D000328:Adult; D003430:Cross-Sectional Studies; D003453:Cryptococcosis; D005260:Female; D006169:Guinea-Bissau / Q000453:epidemiology; D015497:HIV-1 / Q000276:immunology*; D015498:HIV-2 / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014376:Tuberculosis
keywords: Clinical presentation; Guinea-Bissau; HIV; HIV-2; Sub-Saharan Africa