HIV-2 infection in high-risk individuals with indeterminate HIV-1 western blot analysis: a serologic surveillance.

Abstract

In 1988 the first cases of pf HIV-2 infection in Spain were 3 west African immigrants living in Barcelona. Since that time sporadic reports have shown that HIV-2 is not widespread in Spain. Paradoxically neighboring countries i.e. France and Portugal are the most HIV-2-prevalent areas outside west Africa. In France more than 300 HIV-2 infected individuals have been identified and at least 18 of them were blood donors. In March 1991 12% of 586 accumulated AIDS cases in Portugal have been related to HIV-2 infection most of them among the indigenous population. In Spain the 1st case of HIV-2 infection in a native has been identified recently. The patient is a 65-year-old male from Galicia a province next to Portugal. He was a seaman who reported travels heterosexual contacts and intramuscular treatments in African endemic areas 20 years ago. At present he remains asymptomatic but he shows biological signs of immunodeficiency such as a low CD4 cell count. In order to provide additional data in the early stages of the HIV-2 epidemic in Spain we investigated the presence of HIV-2 antibodies in high-risk individuals with indeterminate HIV-1 Western blot (WB) pattern. During an 8-month period 842 sera from high-risk individuals living in Madrid were tested for HIV-1 and HIV-2 antibodies using a mixed enzyme immunoassay (EIA Elavia mix 1+2 Pasteur). Samples with positive and cutoff absorbency values were analyzed by an HIV-1 WB assay (New Lav-blot 1 Pasteur) (table 1). Those samples showing indeterminate or negative WB pattern using the new WHO criteria were analyzed by specific HIV-2 WB (New Lav-blot 2 Pasteur) and a synthetic peptide assay (Pepti-lav Pasteur). Results are summarized in table 2. 3 samples showing EIA-positive and -indeterminate HIV-1 WB results were positive for HIV-2 antibodies using specific HIV-2 WB and the synthetic peptide assay. They corresponded all to African individuals coming from Camerun South Africa and Guinea-Bissau. None of the samples from native Spanish subjects were HIV-2 seropositive. To date all 3 HIV-2-infected subjects remain asymptomatic but 1 shows a low CD4 cell count (286/cu.mm). None referred homosexual practices or intravenous drug addiction but all admitted heterosexual intercourse at several occasions in the country where they were born before coming to Spain. These results support that although HIV-2 is present in Spain to date it remains confirmed to immigrants from endemic areas. (full text) (5 references cited in original document)