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Human immunodeficiency virus type 2 infections in Austria

Infektionen mit dem Humanen Immundefizienz-Virus Typ 2 in Österreich

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Summary

Introduction

The first case of human immunodeficiency virus type 2 (HIV-2) seropositivity in Austria was confirmed in 1993 in a dually human immunodeficiency virus type 1 (HIV-1)- and HIV-2-infected patient from Ghana, who died in 2001. Before this investigation, no further HIV-2 infection was published.

Methods

The aim of this study was to describe HIV-2 epidemiology in Austria, using serological and molecular techniques, and to perform a sequence analysis of the circulating viral strains.

Results

Six additional cases of HIV-2 were identified from 2000 to 2009. All patients originated from high-prevalence areas. In one patient, the HIV-2 infection was revealed 11 years after initial HIV-1 diagnosis, and further analysis confirmed a dual infection.

Conclusion

The HIV-2 epidemic has its epicentre in West Africa, but sociocultural issues, especially migration, are contributing to the low but continuous worldwide spread of HIV-2. Diagnosis of HIV-2 implies a different therapeutical management to avoid treatment failure and clinical progression. Differential diagnosis of HIV-1 and HIV-2 is complicated due to antibody cross-reactivity, and paradoxical findings (e.g. declining CD4 cell count despite HIV-1 suppression) may require careful reassessment, especially in patients from endemic countries.

Zusammenfassung

Einleitung

Die erste HIV-2 Infektion in Österreich wurde 1993 bei einem HIV-1 und HIV-2 koinfizierten Patienten aus Ghana beschrieben. Bisher wurden keine weiteren Arbeiten über HIV-2 Infektionen in Österreich publiziert.

Methodik

Ziel dieser Studie war es durch Anwendung serologischer und molekularer Techniken eine erste epidemiologische Erfassung von HIV-2 in Österreich durchzuführen und mittels Sequenzanalyse die zirkulierenden HIV-2 Stämme zu charakterisieren.

Ergebnisse

Im Zeitraum 2000–2009 sind in Österreich sechs HIV-2 Infektionen bei Patienten aus hochendemischen Ländern diagnostiziert worden. In einem Fall, wurde die HIV-2 Infektion erst 11 Jahre nach einer initialen HIV-1 Diagnose erkannt, und weitere Analysen bestätigten dabei das Vorliegen einer HIV-1/HIV-2 Koinfektion.

Schlussfolgerung

Die HIV-2 Epidemie konzentriert sich primär auf westafrikanische Länder, wobei soziokulturelle Faktoren wie Migration zu einer langsamen aber kontinuierlichen weltweiten Verbreitung beitragen. Eine HIV-2 Infektion bedingt eine spezifische antiretrovirale Therapie, da nicht alle HIV-1 Medikamente auch bei HIV-2 wirksam sind. Die HIV-1/HIV-2 Differentialdiagnose wird durch kreuzreagierende Antikörper erschwert und paradoxe Resultate (z. B. sinkende CD4-Zellzahl trotz HIV-1 viraler Suppression) sollten insbesondere bei Patienten aus Hochprävalenz-Regionen zu einer Neuevaluierung führen.

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Authors and Affiliations

  1. Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectious Diseases, Rheumatology, Oncologic Center, Laboratory for Immunological and Molecular Cancer Research, Paracelsus Medical University Hospital Salzburg, Muellner Hauptstrasse 48, 5020, Salzburg, Austria

    Ninon Taylor MD, Alexander Egle & Richard Greil

  2. Hygiene and Microbiology Department, Paracelsus Medical University Hospital Salzburg, Salzburg, Austria

    Jan Marco Kern

  3. Microbiology Department, Academic Teaching Hospital Wels-Grieskirchen, Wels, Austria

    Wolfgang Prammer

  4. Internal Medicine Department, Academic Teaching Hospital Feldkirch, Feldkirch, Austria

    Alois Lang

  5. Department of Internal Medicine, Academic Teaching Hospital Graz-West, Graz, Austria

    Bernhard Haas

  6. Dermatology Department, University Hospital Innsbruck, Innsbruck, Austria

    Martin Gisinger & Robert Zangerle

  7. Department of Laboratory Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria

    Hannes Oberkofler

  8. Max von Pettenkofer-Institute, Ludwig-Maximilians-University Munich, Munich, Germany

    Josef Eberle

Authors
  1. Ninon Taylor MD
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  2. Jan Marco Kern
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  3. Wolfgang Prammer
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  8. Alexander Egle
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Correspondence to Ninon Taylor MD.

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Taylor, N., Kern, J., Prammer, W. et al. Human immunodeficiency virus type 2 infections in Austria. Wien Klin Wochenschr 126, 212–216 (2014). https://doi.org/10.1007/s00508-013-0493-1

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  • DOI: https://doi.org/10.1007/s00508-013-0493-1

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