13th Annual Conference of the British HIV Association 29 March–1 April 2007, Brighton, UK

HIV-2 SEROPREVALENCE AMONGST SUB-SAHARAN WEST AFRICAN PATIENTS ATTENDING A PUBLIC SECTOR CLINIC IN KUMASI/GHANA

HIV Med 2007; 8(Suppl. 1):1 (abstract no. O3)

Ulrich Schwab¹, Erasmus Smit¹, William Adjei², George Bedu-Addo², and David Chadwick^3
1Birmingham Heartlands Hospital, Birmingham, UK, ²Komfo Anokye Teaching Hospital, Kumasi, Ghana, ³James Cook University Hospital, Middlesbrough, UK

AIM: HIV-2 seroprevalence determination.

METHODS: A serum repository was set up in October 2005. Routine HIV screening was performed with Vironostika® HIV uniform II plus O ELISA (Bio Merieux), confirmed by Determine® HIV 1,2 Antibody card test (Abbott). Discrepant results were tested with Elisa/Card Test: HIV 1,2 (Standard Diagnostics®). For this study pooled and individual serum samples were screened for HIV-2 using the ImmunoComb HIV1/2 ® test kit (Organics/Sterilab Services). A database of all HIV-2 patients including clinical data has been set up.

RESULTS: The results were: (i) Of a total of 865 HIV-positive patients, 52 were identified as HIV-2-infected (6.12%). 1.4% (13/52) were HIV-2 monoinfections, 4.7% (39/52) were dual infections with both spots on the Immunocomb appearing equal (14), more prominent for HIV-1 than HIV-2 (22), and vice versa (3); (ii) 13/52 are on various ART regimens, 12 of whom are on NNRTI, six patients taking (3TC/d4T/NVP), 2 (3TC/d4T/EVF), 4(CBV/EFV) and 1(CBV/PI); three did have a CD4 drop on their regimen.

CONCLUSION: HIV-2 is not uncommon in Ghana. This has direct implications for the current selection of first line therapy: 1st line therapy in Ghana nearly always includes a NNRTI both of which are inherently resistant to HIV-2. This means that people would invariably fail their first line therapy. All HIV-positive patients therefore should be screened for HIV-2 infection. Ideally a PI based regimen should be started as first line ART for HIV-2-infected patients. By now the Kumasi cohort is the largest single-centre cohort of HIV-2 patients on ART so far described with a significant number of patients who have taken NNRTI-based triple therapy, as well as NLV-based HAART regimen. Further testing on our cohort should provide descriptive data on mutations in the HIV-2 reverse transcriptase and protease genes associated with ART.

2007-03-29
O3

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