hiv-2 infection surveillance --- united states, 1987--2009

Morbidity and Mortality Weekly Report HIV-2 Infection Surveillance --- United States, 1987--2009 CDC Staff MMWR Weekly 2011 Jul 29; 60(29):985-988
July 29, 2011

Human immunodeficiency virus (HIV) is categorized into two types, HIV-1 and HIV-2. Worldwide, most HIV infections are HIV-1, whereas HIV-2 largely has been confined to persons in or from West Africa (1,2). HIV-1 and HIV-2 have the same routes of transmission, and both can cause acquired immunodeficiency syndrome (AIDS) (3); however, HIV-2 infections should be differentiated from HIV-1 infections because they are less likely to cause AIDS and their clinical management differs (4,5). CDC's current surveillance case definition for HIV infection applies to both variants of HIV (6) but lacks criteria for differentiating between HIV-1 and HIV-2. To enumerate and describe HIV-2 cases reported in the United States, a working case definition was developed. During 1988--June 2010, a total of 242 HIV-2 cases were reported to CDC. Of these, 166 met the working definition. These HIV-2 cases were concentrated in the Northeast (66%, including 46% in New York City) and occurred primarily among persons born in West Africa (81%). Ninety-seven of the HIV-2 cases also had a positive HIV-1 immunoblot antibody test result (e.g., Western blot). Immunoblot antibody tests currently used to confirm HIV reactive screening tests do not contain reagents specific to HIV-2 and thus are not reliable for identification of HIV-2 infections (7). Additional testing specific to HIV-2 should be considered if HIV-1 test results are atypical or inconsistent with clinical findings, especially for persons from West Africa. If an HIV case is reported to the health department but subsequently identified as HIV-2, health-care providers should update the case report to reflect the correct type. During 2009--2010, CDC convened a workgroup to develop the working HIV-2 definition used in this report. To meet this working definition, cases had to satisfy one or more of the following three criteria: 1) HIV-1/HIV-2 type-differentiating antibody immunoassay (e.g., Bio-Rad Multispot HIV1/HIV-2 Rapid Test) positive for HIV-2 but negative for HIV-1, 2) positive HIV-2 nucleic acid test (DNA or RNA), 3) positive HIV-2 immunoblot and negative or indeterminate HIV-1 immunoblot. In addition, one case reported in 1991 was accepted based only on a positive radioimmunoprecipitation assay (a now obsolete test). Neither the nucleic acid tests nor the immunoblots have been approved by the Food and Drug Administration for diagnosis of HIV-2 infection, but the Bio-Rad Multispot HIV-1/HIV-2 Rapid Test has been approved for differentiation of HIV-2 from HIV-1. Read more ...

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Centers for Disease Control and Prevention 1600 Clifton Rd. Atlanta, GA 30333, USA 800-CDC-INFO(800-232-4636) TTY: (888) 232-6348, New Hours of Operation 8am-8pm ET/Monday-Friday Closed Holidays - cdcinfo@cdc.gov Information in this article was accurate in July 29, 2011. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.