OBJECTIVE: To investigate the clinical and immunologic effects, and pattern of mortality associated with HIV-2 infection. SETTING: A rural community in Guinea-Bissau. METHODS: Serologic screening of 2774 subjects aged > 14 years followed by studies of the prevalence of clinical and immunologic abnormalities among 133 subjects with HIV-2 infection and 160 seronegative controls, and surveillance of mortality among all subjects who were screened during a mean of 2 years of follow-up. RESULTS: Generalized lymphadenopathy was the only clinical abnormality significantly associated with HIV-2 infection. Infection was associated with lower CD4 counts and higher beta 2-microglobulin and neopterin levels. During follow-up, 5.5% of infected subjects died compared with 1.8% of the seronegatives (rate ratio adjusted for age and sex, 3.5; 95% confidence interval ((CI), 1.8-6.7). Proportional hazard regression analysis showed that the rate ratio varied with age (P = 0.003) and there was some evidence that the excess of mortality in infected subjects was, in absolute terms, least in the oldest subjects (trend test; P = 0.08). CONCLUSIONS: The findings support previous suggestions that HIV-2 is less pathogenic than HIV-1; the data also suggest that mortality associated with infection may be lower in older subjects.
OBJECTIVE: To investigate the clinical and immunologic effects, and pattern of mortality associated with HIV-2 infection. SETTING: A rural community in Guinea-Bissau. METHODS: Serologic screening of 2774 subjects aged > 14 years followed by studies of the prevalence of clinical and immunologic abnormalities among 133 subjects with HIV-2 infection and 160 seronegative controls, and surveillance of mortality among all subjects who were screened during a mean of 2 years of follow-up. RESULTS: Generalized lymphadenopathy was the only clinical abnormality significantly associated with HIV-2 infection. Infection was associated with lower CD4 counts and higher beta 2-microglobulin and neopterin levels. During follow-up, 5.5% of infected subjects died compared with 1.8% of the seronegatives (rate ratio adjusted for age and sex, 3.5; 95% confidence interval ((CI), 1.8-6.7). Proportional hazard regression analysis showed that the rate ratio varied with age (P = 0.003) and there was some evidence that the excess of mortality in infected subjects was, in absolute terms, least in the oldest subjects (trend test; P = 0.08). CONCLUSIONS: The findings support previous suggestions that HIV-2 is less pathogenic than HIV-1; the data also suggest that mortality associated with infection may be lower in older subjects.
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Keywords:
Africa; Africa South Of The Sahara; Age Factors; Demographic Factors; Demographic Impact; Developing Countries; Diseases; Examinations And Diagnoses; Guinea-bissau; Hiv Infections; Mortality; Population; Population Characteristics; Population Dynamics; Portuguese Speaking Africa; Research Report; Rural Population; Screening; Statistical Regression; Viral Diseases; Western Africa
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