- Poster presentation
- Open Access
Treatment of HIV-2 infection: a retrospective study from a Portuguese center
© Marques et al; licensee BioMed Central Ltd. 2010
- Published: 8 November 2010
- Viral Load
- Related Death
- Median Gain
- Therapeutic Experience
- Cell Recovery
Tailoring of antiretroviral therapy (ART) in HIV-2 remains unclear, therefore therapeutic experience in this population is presented.
Retrospective analysis of HIV-2 infected patients (pts) on ART followed at a single Portuguese center, between 1988 and 2010.
37 pts were included; 19 (51%) female and 28 (76%) Caucasian. Mean ages were: 46 years [18-77] at HIV-2 diagnosis and 48 years [20-81] at the beginning of ART. The majority (54%; 20) was probably infected in West Africa through heterosexual intercourse (75%, 28). The average T CD4+ nadir was 137 cells/mm3 [3-586] and mean TCD4+ count prior to ART initiation was 205 cells/mm3. The main reason for starting ART was immunological deterioration (87%; 32) followed by pregnancy (8%; 3). Ten pts (27%) had an AIDS defining illness prior to ART initiation and 4 (11%) developed it while on ART. The mean value of the last TCD4+ count was 305/mm3. Overall the median number of regimens received per patient (pt) was 3 [1-7]; 12 (32%) pts took just one regimen. Mean length of ART was 61 months [1-228] and mean duration of the last prescribed regimen was 23 months [0.25-125]. Viral load ("in house" assay) was always undetectable in 19 (51%) pts. Switch of ART occurred in 21 (57%) pts with 1.4 reasons/pt. The main cause for switching was GI intolerance (57%; 12), followed by failure (38%; 8), toxicity (29%; 6) and simplification (19%; 4).
The last prescribed regimens were as follows:
a) 73% (27): 2 NRTIs + 1 PI [NRTIs: TDF/FTC (9), AZT/3TC (7), TDF/3TC (6), others (5); PIs: LPV/r (13); SQV/r (8); IDV/r (3); others (3)];
b) 19% (7): 2NRTIs (FTC/TDF) + 1 PI (DRV/r) + 1 INSTIs (RAL);
c) 8% (3): dual/triple NRTIs.
Only one pt on RAL was ART naïve. After a median follow-up of 11 months [4-24] on RAL based regimens, 3 pts had undetectable viral load (the remaining had it from the beginning). Median length of previous ART was 77 months with an average of 2.4 regimens/pt. The median gain of T CD4+ with RAL regimen was +94 cells/mm3 [3-239]. Currently: 21 (57%) pts are kept on follow up, 19 (90%) of whom on ART; 9 (24%)pts died (4 with AIDS related deaths) and 7 (19%)were lost to follow-up.
This population had a fairly good T CD4 cell recovery while on therapy which is the best approach to assess treatment response together with clinical improvement. NRTIs/PI/INSTI containing regimens appears to be effective, although longer term outcomes are needed.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.