HIV-2 infections in a rural Senegalese community

Autor: Bernard Le Guenno, Emmanuel Lagarde, Gilles Pison, Cheikh Seck, Catherine Enel
Rok vydání: 1992
Předmět:
Zdroj: Journal of medical virology. 38(1)
ISSN: 0146-6615
Popis: In a community study in rural Senegal, 22 human immunodeficiency virus type-2 (HIV-2) seropositive cases and 64 matched controls were examined clinically and evaluated immunologically. The presence of clinical signs was highly correlated with HIV-2 seropositivity: 9 anti-HIV-2 positive patients and 5 controls presented with clinical signs (odd ratio [OR] = 8.2, confidence limits [CL] 2-35). The main symptom associated with HIV-2 seropositivity was a chronic cough (OR = 18.5, CL 1.8-899). The presence of diarrhoea was not significant (OR = 3.1, CL 0.3-3.5). The total number of CD8 cells, CD4/CD8 ratio, beta 2 microglobulin, and IgG level discriminated between seropositive and seronegative individuals (P less than 0.05). When the anti-HIV-2 positives were grouped as 13 healthy and 9 sick people, red blood cells, lymphocytes, T lymphocytes, CD4 cells, and beta 2 microglobulin differed significantly. Clinical symptoms were associated with immunodepression: 5 of 14 sick people had less than 500 CD4/microliters vs. 1 of 72 healthy persons. This study at the community level emphasizes the clinical and immunological impact of HIV-2 infection. Even if it presents with a longer incubation period than HIV-1, this virus is a major threat to public health.In the early 1990s, HIV seroprevalence in the rural community in Casamance, Senegal was .8% (age range from 24 to 68 years). 25 people had HIV-2 infection and 2 had HIV-1 infection. Health workers evaluated 22 of the HIV-2 positive adults and compared them with 64 matched controls. The HIV-2 positive adults were 7.25 times more likely to suffer from ill health than the controls (50% vs. 12.5%). Clinical signs of HIV-2 positive status were more common among HIV-2 positive adults than controls (40.9% vs. 7.8%; odds ration [OR] = 8.2), especially chronic cough (OR - 18.5). Presence of diarrhea was insignificant (22% vs. 40%). HIV-2 positive adults had much higher levels of CD8 cells (p = .03), IgG (p = .0001), and beta 2 macroglobulin (p =.001) than the controls. Their CD4/CD8 ratio levels were much lower than those of the HIV-2 negative individuals (1.1 vs. 1.9; p = .0001). Among HIV-2 positive adults, symptomatic adults had significantly lower levels of red blood cells (p = .02), white blood cells (p = .02), lymphocytes (p = .01), T cells (p = .01), and CD4 cells (p = .002) than the healthy adults. Their beta 2 macroglobulin levels were much greater than controls (4.6 mg/vs. 2.9 mg/l, p = .03). 5 HIV-2 cases (22.7%) researchers suffered from immunosuppression (500 CD4 cells/mcl) compared with only 1 control (1.6%) (OR = 18.5). Clinical symptoms were more likely to be present in immunodepressed people than in non immunodepressed people (35.7% of 14 sick adults vs. 1.4% of healthy adults). 1 person who had AIDS as defined by WHO (weight loss, persistent cough, and diarrhea) had 429 CD4 cells/mcl. 1 person suffered from bronchopneumonia (326 CD4 cells/mcl). Another person had chronic diarrhea and bronchopneumonia (350 CD4 cells/mcl). The mean age of HIV-2 infected people who had a respiratory condition was 51 years (42-68 years) while it was 41 years (26-68 years) for asymptomatic HIV-2 infected people indicating a rather long incubation period. These results suggested that HIV-2 can be significant public health problems.
Databáze: OpenAIRE
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