Human immunodeficiency virus type-2-A milder, kinder virus: An update.

Human immunodeficiency virus type-2 (HIV-2) belongs to the family retroviridae which is phylogenetically clusters with SIV SM from sooty mangabeys. This virus is morphologically similar to human immunodeficiency virus type-1 (HIV-1) but has got only a 40% homology at the nucleotide level. There is a distinct geographical distribution of HIV-2 unlike HIV-1. There are currently eight subtypes/groups identified with subtype/group A responsible for the majority of infections. HIV-2 shows a considerable difference in the course of the disease. Clinical, haematological and immunological evaluation of individuals infected with HIV-2 has shown the virus to be less pathogenic than HIV-1 although the exact mechanism underlying this difference is not well defined. Similar to HIV-1, the HIV-2 isolates also showed distinct replicative and cytopathic characteristics. The transmission rate for HIV-2 compared to HIV-1 is very low both by heterosexual route and mother to child transmission. The clinical signs and symptoms of immunodeficiency associated with HIV-2 are similar to the ones seen among the HIV-1-infected individuals and they can also progress to AIDS. It is naturally resistant to NNRTI and hence the diagnosis become important as it affects the treatment strategy. Similar to HIV-1, HIV-2 strains of infected individuals also show mutations that can cause drug resistance. The current evidence suggests that there is no protective effective for HIV-2 against HIV-1.

Assessment of a self-deferral form for screening blood donors, Chiang Mai University Hospital, Thailand.

A self-deferral form has been used to screen Chiang Mai University Hospital blood donors and was improved in 2005. It has never been evaluated. The study aimed to assess the self-deferral form procedures in detecting infected donors. Sera from 5,083 donors, who passed the self-deferral screening form, were tested with the routine immuno-assays (serology) for HIV 1 and 2 antibodies, P24 antigen, HCV antibodies, HBV surface antigen, and syphilis. Antibody negative sera were also tested individually with the the Procleix Ultrio Assay for HIV-1 DNA, HCV RNA, and HBV DNA. The donors who had discrepant results between serology and NAT were evaluated with additional tests, including a more sensitive Alternative Nucleic Acid Test, AntiBcore IgM, AntiBcore IgG, HBsAg and Anti HBs. Among 5,083 donors, 331 (6.5%) had at least one positive marker. In multiple logistic regression analysis, the statistically significant factors (adjusted odds ratio and 95% CI) for infection were age 30 years or below [1.45 (1.03, 2.03)], male gender [2.73 (1.64, 4.56)], primary school or lower education [1.56 (1.09, 2.23)], first-time donation [1.82 (1.25, 2.67)], and frequent donation [0.80 (0.70, 0.92)]. The safest donors were females, older than 30 years, with an education more than primary school, and frequent donation. Because of missing responses to some sensitive questions, there remains a need for further improvement of the self-deferral form.

Prevalence of HBV, HCV, HIV - 1,2 and HTLV - I/II infections among blood donors in a teaching hospital in the central region of Saudi Arabia.

Several infectious diseases are transmissible by blood transfusion, especially viral infections. The most common blood-transmitted viruses are hepatitis B virus [HBV], hepatitis C virus [HCV] and human immunodeficiency virus [HIV]. These viruses cause fatal, chronic and life-threatening disorders. The prevalence of these viruses varies by nationality and geography. The purpose of this study was to establish the current prevalence of hepatitis viruses [B and C] and human retroviruses [HIV-1, 2 and human T-lymphotropic virus type I and II, HTLV-I /II] among blood donors at King Khalid University Hospital [KKUH], Riyadh, Kingdom of Saudi Arabia [KSA]. Serological markers of HBV, HCV, HIV 1, 2 and HTLV-I/II were studied in 24173 [23952 males and 221 females], 20423 Saudi and 3750 non-Saudi blood donors, using commercially available kits, over a period of 3 years from January 2000 to December 2002 at KKUH, Riyadh, KSA. The prevalence of confirmed-positive test results of these viruses was evaluated among different gender, ages and nationalities. During the study period, prevalence rates of HBV and HCV infections were 1.5% and 0.4%, and zero for retroviral infections. The prevalence was not significantly higher in male than in female donors. Hepatitis B surface antigen [HBsAg] and anti-HCV positivity tend to increase with increase in age. The prevalence of HBsAg and anti-HCV positivity was significantly more prevalent among non-Saudi compared to Saudi donors. This study highlights the prevalence rates of HBV and HCV among different groups. The prevalence varies from one group to another, being the lowest among Saudi and young donors. Therefore, extensive recruitment of Saudi and young donors should help ensure a long-term increase in the blood supply without jeopardizing safety

Seroprevalence of HIV in Manipal.

A total of 32,406 persons were screened for HIV 1 and 2 antibodies between 1991 to 1999 by Enzyme Linked Immuno Sorbent Assay at Dept. of Microbiology, KMC, Manipal which is a rural teaching hospital. There was steady increase in seropositivity from 0.38% (1991) to 9.31% (1995) and thereafter there is decrease in the seropositivity rate to 4.15% (1999); but the number of cases screened increased from 1995 onwards. The HIV seropositivity is more in males 7.49% than in females (2.52%). The male to female positivity ratio is 2.72:1, inspite of the total number of samples screened of either sexes being equal. The prevalence of HIV among STD Clinic attendants was 8.22%. The foci of infection can be traced to cities such as Mumbai and the main mode of transmission is through unprotected heterosexual contact. The decrease in the seropositivity rate from 1996 onwards could be due to the AIDS awareness among public due to the control programmes. More awareness and public education is needed towards healthy sexual practices to avoid fresh HIV cases.

Human immunodeficiency viruses types 1 and 2 infection among replacement blood donors in Mumbai (Bombay).

Between 1993-96, blood donated by 12,235 replacement blood donors was screened by various Enzyme Linked Immunosorbent Assays for detecting antibodies to Human Immunodeficiency Viruses types 1 and 2 according to the guidelines specified by Indian--Food and Drug Administration. 222 replacement blood donors (1.81%) were found to be seropositive for antibodies to Human Immunodeficiency Virus types 1 and 2. Furthermore, the ImmunoComb II HIV 1 & 2 BiSpot rapid sandwich ELISA in a comb format was used for differentially identifying HIV-1 and/or HIV-2 infection among these blood donors in Mumbai. Our data indicates that there is a low seroprevalence of HIV-1-2 infection among replacement blood donors in Mumbai (Bombay). Among them, while HIV-1 is still the predominant virus, dual HIV-1-2 and HIV-2 only infections are steadily increasing.

Seroprevalence of HIV infection among jail inmates in Orissa.

Seroprevalence of human immunodeficiency virus (HIV) infection was carried out in three prisons in Orissa from March 1994 to December 1995. All the prisoners of Indian origin (300), housed in these jails tested negative for HIV infection. On the other hand, 33.8 per cent (26/77) of jail inmates from foreign countries (Thailand and Myanmar), serving short terms in Orissa jails were found positive for HIV infection. While all the 26 HIV positive prisoners had HIV-1 infection, five of them had antibodies for HIV-1 and HIV-2 viruses. Such a high prevalence of HIV infection and detection of HIV-2 virus is being reported for the first time from Orissa.

Increasing prevalence of dual HIV-1-2 infections among voluntary blood donors in Mumbai (Bombay).

Between 1993 and 1996, we carried out a serological screening for differentially identifying HIV-1 and HIV-2 infections among the high risk group persons admitted in the various wards of BYL Nair Hospital, Mumbai, using the ImmunoComb kit. This study indicates that although HIV-1 is the predominant virus prevalent in Mumbai, dual HIV-1-2 and HIV-2 infections are gradually increasing.

Human immunodeficiency virus infection in a tertiary care hospital--clinical and microbiological profile.

Infection with the Human Immunodeficiency Virus (HIV) has an increasing, direct and significant impact on the hospital, especially the emergency services. Out of a total of 39,876 patients screened, 1061 patients were reactive for anti-HIV antibodies. The incidence of the infection showed a remarkable progression from 0.89% in 1992-1993 to 5.6% in 1997, among the seropositive patients. The number of patients with signs and symptoms related to HIV infection has also shown a 2 fold rise (from 42% in 1992-1993 to 87% in 1997). The prevalence of HIV 1 in the seropositive patients is 93%, HIV 2 alone is 2.3% and 3.1% had a mixed infection with both HIV 1 and 2. Secondary infection with Mycobacteria ranked high (25%) among the symptomatic patients, with pulmonary and the disseminated varieties being more common.

Evidencia de infección por virus de inmunodeficiencia humana tipo 2 en Cuba: algunas consideraciones epidemiológicas / Evidence of human immunodeficiency virus type II infection in Cuba: some epidemiological considerations

El Virus de Inmunodeficiencia Humana tipo 2 (VIH)-2) fue aislado en 1986 de pacientes con SIDA y personas asintomáticas de Africa Occidental. En nuestro país, entre los meses de agosto-septiembre de 1987 se realizó un primer estudio en busca de portadores de anticuerpos al VIH-2. Se utilizó la prueba de ELISA ELAVIA-II (Pasteur) y para confirmar una prueba de inmunoelectrotransferencia (Western blot) producida por nuestro laboratorio. Se chequearon 129 personas para detectar anticuerpos al VIH-2 (107 cubanos y 22 extranjeros) procedentes de países de Africa (incluyendo de Africa-Occidental), y con otros riesgos, resultando 2 positivos (1 cubano, 1 extranjero). Esto motivó que entre julio de 1988 y marzo de 1989 se chequearan 30.754 personas (8.832 extranjeros, 21.922 cubanos) procedentes de áreas de riesgo, o con otros riesgos epidemiológicos, detectándose 2 extranjeros positivos. En el segundo chequeo se tomaron algunos datos epidemiológicos mediante encuesta-registro, una parte de los cuales se presentan en este trabajo