Publication:

Clinical and immunological outcomes in HIV-2 and HIV-1 and 2 co-infections at a tertiary care centre in Maharashtra

Background HIV-2 and HIV-1 and 2 co-infections are rare but clinically significant subtypes with varying response to treatment and progression of disease exist. Not much data from central India especially Maharashtra is available regarding their immunologic courses. The objective was to examine the sociodemographic characteristics, baseline and follow-up CD4 trends, and antiretroviral therapy (ART) outcomes in HIV-2 and HIV-1 and 2 dually infected patients.

Methods Retrospective analysis was conducted among 27 patients co-infected with HIV-2 or HIV-1 and 2 who were attending a tertiary ART centre in Maharashtra. Baseline and most recent CD4 counts and ART regimen were analysed. Demographic data, and treatment outcomes like alive on ART, died, transfer out, stopped, and opted out were described using descriptive statistics.

Results Tenofovir-lamivudine-dolutegravir (TLD) was prescribed in the majority of patients. Mean CD4 baseline count of survivors on ART was 352.3 cells/µl, and recent CD4 improved to 519.3. High mortality was observed in those on protease inhibitor-based regimens (ZL+LPV/r, TL+LPV/r).

Conclusion TLD-based ART produced better immunological outcome. Protease inhibitor-containing regimens needed in HIV-2, could be associated with poor prognosis in patient on ART.