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Open Access Highly Accessed Research article

Antiretroviral therapy response among HIV-2 infected patients: a systematic review

Didier K Ekouevi1234*, Boris K Tchounga123, Patrick A Coffie156, Joseph Tegbe1, Alexandra M Anderson1, Geoffrey S Gottlieb7, Marco Vitoria8, François Dabis23 and Serge P Eholie156

Author Affiliations

1 Programme PACCI, site ANRS, Abidjan, Côte d’Ivoire

2 ISPED, Centre INSERM U897-Epidémiologie-Biostatistique, Université Bordeaux, F-33000 Bordeaux, France

3 Centre INSERM U897- Epidémiologie-Biostatistique, INSERM, ISPED, F-33000 Bordeaux, France

4 Département de Santé Publique, Faculté des Sciences de la Santé, Université de Lomé, Lomé, Togo

5 Département de Dermatologie et des Maladies Infectieuses, Université Félix Houphouët Boigny, Abidjan, Côte d’Ivoire

6 Services des Maladies infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d’Ivoire

7 Departments of Medicine & Global Health, University of Washington, Seattle, USA

8 HIV Department, WHO, Geneva, Switzerland

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BMC Infectious Diseases 2014, 14:461  doi:10.1186/1471-2334-14-461

Published: 26 August 2014

Abstract

Background

Few data are available on antiretroviral therapy (ART) response among HIV-2 infected patients. We conducted a systematic review on treatment outcomes among HIV-2 infected patients on ART, focusing on the immunological and virological responses in adults.

Methods

Data were extracted from articles that were selected after screening of PubMed/MEDLINE up to November 2012 and abstracts of the 1996–2012 international conferences. Observational cohorts, clinical trials and program reports were eligible as long as they reported data on ART response (clinical, immunological or virological) among HIV-2 infected patients. The determinants investigated included patients’ demographic characteristics, CD4 cell count at baseline and ART received.

Results

Seventeen reports (involving 976 HIV-2 only and 454 HIV1&2 dually reactive patients) were included in the final review, and the analysis presented in this report are related to HIV-2 infected patients only. There was no randomized controlled trial and only two cohorts had enrolled more than 100 HIV-2 only infected patients. The median CD4 count at ART initiation was 165 cells/mm3, [IQR; 137–201] and the median age at ART initiation was 44 years (IQR: 42–48 years). Ten studies included 103 patients treated with three nucleoside reverse transcriptase inhibitors (NRTI). Protease inhibitor (PI) based regimens were reported by 16 studies. Before 2009, the most frequent PIs used were Nelfinavir and Indinavir, whereas it was Lopinavir/ritonavir thereafter. The immunological response at month-12 was reported in six studies and the mean CD4 cell count increase was +118 cells/μL (min-max: 45–200 cells/μL).

Conclusion

Overall, clinical and immuno-virologic outcomes in HIV-2 infected individuals treated with ART are suboptimal. There is a need of randomized controlled trials to improve the management and outcomes of people living with HIV-2 infection.

Keywords:
HIV-2; Clinical response; Immunological response; Virological response; Antiretroviral treatment