Gut disruption in HIV-2 infection despite reduced viremia

Fernandes, S. M.; Pires, A. R.; Ferreira, C.; Tendeiro, R.; Correia, L.; Paulo, S. E.; Victorino, R. M.; Sousa, A. E.

http://hdl.handle.net/10451/15876

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Abstract(s)

HIV-2 infection is highly prevalent inWest Africa and has been increasingly observed in non-African countries, mostly associated with migratory populations [1]. It has a much more benign course and lower viremia than HIV-1 [2], though with similar clinical spectra. Half of the HIV-2 infected patients with less than 200 CD4+ T-cells/ml exhibit undetectable viremia, despite harbouring numbers of infected cells comparable to their HIV-1 counterparts [3]. Moreover, CD4+ T-cell loss occurs in direct association with progressive immune activation in both infections, though the depletion rate is much slower in HIV-2 [2,4]. HIV-1 disease progression has been linked to disruption of gut-associated lymphoid tissue (GALT)and increased levels of microbial translocation, leading to systemic immune activation. There are currently no data on the impact of HIV-2 on GALT. Here, we provide evidence of HIV-2 replication in the gut despite the low viremia, which was associated with major mucosal disruption and CD4+ T-cell depletion that recovered upon antiretroviral treatment (ART).