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Inhibition of HIV-1 disease progression by contemporaneous HIV-2 infection.

Esbjörnsson, Joakim LU ; Månsson, Fredrik LU ; Kvist, Anders LU ; Isberg, Per-Erik; Nowroozalizadeh, Salma; Biague, Antonio J; da Silva, Zacarias J; Jansson, Marianne LU ; Fenyö, Eva Maria LU and Norrgren, Hans LU , et al. (2012) In New England Journal of Medicine 367(3). p.224-232
Abstract
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),... (More)
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.). (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
HIV Infections: immunology, HIV Infections: virology, HIV-1: genetics, HIV-1: isolation & purification
in
New England Journal of Medicine
volume
367
issue
3
pages
224 - 232
publisher
Massachusetts Medical Society
external identifiers
  • wos:000306522900006
  • pmid:22808957
  • scopus:84863993899
ISSN
0028-4793
DOI
10.1056/NEJMoa1113244
language
English
LU publication?
yes
id
93e332fa-fbcb-43d3-a1cb-2976723f8224 (old id 2966972)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22808957?dopt=Abstract
date added to LUP
2012-08-09 19:47:44
date last changed
2017-07-30 03:09:07
@article{93e332fa-fbcb-43d3-a1cb-2976723f8224,
  abstract     = {BACKGROUND:<br/><br>
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.<br/><br>
<br/><br>
METHODS:<br/><br>
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.<br/><br>
<br/><br>
RESULTS:<br/><br>
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.<br/><br>
<br/><br>
CONCLUSIONS:<br/><br>
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.).},
  author       = {Esbjörnsson, Joakim and Månsson, Fredrik and Kvist, Anders and Isberg, Per-Erik and Nowroozalizadeh, Salma and Biague, Antonio J and da Silva, Zacarias J and Jansson, Marianne and Fenyö, Eva Maria and Norrgren, Hans and Medstrand, Patrik},
  issn         = {0028-4793},
  keyword      = {HIV Infections: immunology,HIV Infections: virology,HIV-1: genetics,HIV-1: isolation & purification},
  language     = {eng},
  number       = {3},
  pages        = {224--232},
  publisher    = {Massachusetts Medical Society},
  series       = {New England Journal of Medicine},
  title        = {Inhibition of HIV-1 disease progression by contemporaneous HIV-2 infection.},
  url          = {http://dx.doi.org/10.1056/NEJMoa1113244},
  volume       = {367},
  year         = {2012},
}