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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Inhibition of HIV-1 disease progression by contemporaneous HIV-2 infection
New England Journal of Medicine, Volume 367, No. 3, Year 2012
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Description
Background: Progressive immune dysfunction and the acquired immunodeficiency syndrome (AIDS) develop in most persons with untreated infection with human immunodeficiency virus type 1 (HIV-1) but in only approximately 20 to 30% of persons infected with HIV type 2 (HIV-2); among persons infected with both types, the natural history of disease progression is poorly understood. Methods: We analyzed data from 223 participants who were infected with HIV-1 after enrollment (with either HIV-1 infection alone or HIV-1 and HIV-2 infection) in a cohort with a long follow-up duration (approximately 20 years), according to whether HIV-2 infection occurred first, the time to the development of AIDS (time to AIDS), CD4+ and CD8+ T-cell counts, and measures of viral evolution. Results: The median time to AIDS was 104 months (95% confidence interval [CI], 75 to 133) in participants with dual infection and 68 months (95% CI, 60 to 76) in participants infected with HIV-1 only (P = 0.003). CD4+ T-cell levels were higher and CD8+ T-cell levels increased at a lower rate among participants with dual infection, reflecting slower disease progression. Participants with dual infection with HIV-2 infection preceding HIV-1 infection had the longest time to AIDS and highest levels of CD4+ T-cell counts. HIV-1 genetic diversity was significantly lower in participants with dual infections than in those with HIV-1 infection alone at similar time points after infection. Conclusions: Our results suggest that HIV-1 disease progression is inhibited by concomitant HIV-2 infection and that dual infection is associated with slower disease progression. The slower rate of disease progression was most evident in participants with dual infection in whom HIV-2 infection preceded HIV-1 infection. These findings could have implications for the development of HIV-1 vaccines and therapeutics. (Funded by the Swedish International Development Cooperation Agency-Swedish Agency for Research Cooperation with Developing Countries and others.) Copyright © 2012 Massachusetts Medical Society.
Authors & Co-Authors
Esbjörnsson, Joakim
Sweden, Lund
Institutionen För Experimentell Medicinsk Vetenskap
Månsson, Fredrik
Sweden, Malmo
Institutionen För Kliniska Vetenskaper, Malmö
Kvist, Anders
Sweden, Lund
Skånes Universitetssjukhus
Isberg, Per Erik
Sweden, Lund
Ekonomihögskolan Vid Lunds Universitet
Nowroozalizadeh, Salma
Sweden, Stockholm
Karolinska Institutet
Biague, Antonio J.
Guinea-bissau
National Public Health Laboratory
da Silva, Zacarias José
Guinea-bissau
National Public Health Laboratory
Jansson, Marianne
Sweden, Lund
Institutionen För Laboratoriemedicin
Sweden, Stockholm
Karolinska Institutet
Fenyö, Éva Mária
Sweden, Lund
Institutionen För Laboratoriemedicin
Norrgren, Hans R.
Sweden, Lund
Lunds Universitet
Medstrand, Patrik
Sweden, Lund
Institutionen För Experimentell Medicinsk Vetenskap
Sweden, Lund
Institutionen För Laboratoriemedicin
Statistics
Citations: 101
Authors: 11
Affiliations: 8
Identifiers
Doi:
10.1056/NEJMoa1113244
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Genetics And Genomics
Infectious Diseases
Study Design
Cohort Study