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奥地利的2型人类免疫缺陷病毒感染

Human immunodeficiency virus type 2 infections in Austria.

作者信息

Taylor Ninon, Kern Jan Marco, Prammer Wolfgang, Lang Alois, Haas Bernhard, Gisinger Martin, Zangerle Robert, Egle Alexander, Greil Richard, Oberkofler Hannes, Eberle Josef

机构信息

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,

出版信息

Wien Klin Wochenschr. 2014 Apr;126(7-8):212-6. doi: 10.1007/s00508-013-0493-1. Epub 2014 Jan 18.

Abstract

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.

摘要

引言

1993年,奥地利确诊了首例人类免疫缺陷病毒2型(HIV-2)血清阳性病例,该患者来自加纳,同时感染了人类免疫缺陷病毒1型(HIV-1)和HIV-2,于2001年去世。在本次调查之前,没有关于其他HIV-2感染病例的报道。

方法

本研究旨在利用血清学和分子技术描述奥地利的HIV-2流行病学情况,并对流行的病毒株进行序列分析。

结果

2000年至2009年期间又发现了6例HIV-2感染病例。所有患者均来自高流行地区。在1例患者中,HIV-2感染在初次诊断HIV-1后的11年被发现,进一步分析证实为双重感染。

结论

HIV-2疫情的中心在西非,但社会文化问题,尤其是移民,导致了HIV-2在全球范围内的低水平但持续传播。HIV-2的诊断意味着采用不同的治疗管理方法,以避免治疗失败和临床进展。由于抗体交叉反应,HIV-1和HIV-2的鉴别诊断较为复杂,一些矛盾的结果(如尽管HIV-1得到抑制,但CD4细胞计数仍下降)可能需要仔细重新评估,尤其是来自流行国家的患者。

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