Virology Laboratory, Hospital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France.
Clin Infect Dis. 2010 Oct 1;51(7):833-43. doi: 10.1086/656284.
Management of pregnant women with human immunodeficiency virus (HIV) type 2 infection remains unclear because of its low prevalence and important differences from HIV-1.
Pregnant women monoinfected with HIV-2 or HIV-1 and their infants enrolled in the prospective, national, multicenter French Perinatal Cohort between 1986 and 2007.
Overall, 2.6% (223/8660) of mothers were infected with HIV-2, and they accounted for 3.1% (367/ 11841) of the total births. Most were born in sub-Saharan Africa. A higher proportion of HIV-2-infected mothers than HIV-1-infected mothers had no symptoms, had received no antiretroviral therapy at conception (85.9% vs 66.7%), and had received no antiretroviral therapy during pregnancy (42.8% vs 19.9%), particularly highly active antiretroviral therapy (HAART) (79.7% vs 46.1%), and they had higher CD4 cell counts near delivery (median, 574 vs 452 cells/mm3; P < .01). If antiretroviral therapy was used, it was started at a later gestational age for HIV- 2-infected mothers (median, 28 vs 25 weeks; P < .01). HIV-2-infected mothers were more likely to deliver vaginally (67.9% vs 49.3%) and to breastfeed (3.6% vs 0.6%; P < .01), and their infants less frequently received postexposure prophylaxis. In the period 2000-2007, the proportion with viral load <100 copies/mL at delivery was 90.5% of HIV-2-infected mothers, compared with 76.2% of HIV-1-infected mothers (P=.1). There were 2 cases of transmission: 1 case in 1993 occurred following maternal primary infection, and the other case occurred postnatally in 2002 and involved a mother with severe immune deficiency. The mother-to-child transmission rate for HIV-2 was 0.6% (95% confidence interval, 0.07%-2.2%).
Care for HIV-2-infected pregnant women rests on expert opinion. The mother-to-child transmission residual rate (0.07%-2.2%) argues for systematic treatment: protease inhibitor-based HAART for women requiring antiretrov
由于人免疫缺陷病毒（HIV）2 型感染的低流行率及其与 HIV-1 的重要差异，对其感染孕妇的管理仍不清楚。
1986 年至 2007 年期间，在法国前瞻性、全国性、多中心的围产期队列中纳入了单纯感染 HIV-2 或 HIV-1 的孕妇及其婴儿。
共有 2.6%（223/8660）的母亲感染了 HIV-2，占总出生人数的 3.1%（367/11841）。大多数母亲出生在撒哈拉以南非洲。与 HIV-1 感染母亲相比，HIV-2 感染母亲的无症状比例更高（85.9% vs. 66.7%），在妊娠前（85.9% vs. 66.7%）和怀孕期间（42.8% vs. 19.9%）未接受过抗逆转录病毒治疗，尤其是未接受高效抗逆转录病毒治疗（79.7% vs. 46.1%），且在接近分娩时 CD4 细胞计数更高（中位数，574 与 452 个细胞/mm3；P<.01）。如果接受抗逆转录病毒治疗，HIV-2 感染母亲的治疗起始时间更晚（中位数，28 与 25 周；P<.01）。HIV-2 感染母亲更可能阴道分娩（67.9% vs. 49.3%）和母乳喂养（3.6% vs. 0.6%；P<.01），其婴儿接受暴露后预防治疗的比例更低。在 2000-2007 年期间，HIV-2 感染母亲分娩时病毒载量<100 拷贝/mL 的比例为 90.5%，而 HIV-1 感染母亲的比例为 76.2%（P=.1）。有 2 例母婴传播：1 例发生在 1993 年，为母亲原发性感染后发生，另 1 例发生在 2002 年，为产后母婴传播，涉及 1 例严重免疫缺陷的母亲。HIV-2 的母婴传播率为 0.6%（95%可信区间，0.07%-2.2%）。
HIV-2 感染孕妇的治疗依据专家意见。母婴传播的残留率（0.07%-2.2%）支持系统治疗：对于需要抗逆转录病毒治疗的妇女，采用基于蛋白酶抑制剂的高效抗逆转录病毒治疗。
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