Low Level of HIV-2 Replication in Patients on Long-Term Antiretroviral Therapy in Togo

In the absence of virological follow-up in people infected with HIV-2, is the ongoing clinical and immunological follow-up in our resource-constrained countries efficient? In this study we document the immuno-virological follow-up of patients infected with HIV-2 in Togo. Thus, a cross-sectional study was carried out at the BIOLIM laboratory of the University of Lome. The sample consisted of HIV-2 infection patients on ART, followed in care centres in Lome, Togo. Confirmation of the HIV type, CD4+ T-cells counting, HIV-2 viral load, HIV-1 viral load and HIV-2 resistance genotypingwere carried out. Based on the results of serological retesting, 30 HIV-2 infected patients, including 8 HIV-1 and HIV-2 co-infected, were included. The median age was 52 years IQR [40.7-61.0years]. The median duration on antiretroviral therapy was 7 years IQR [2,00-8,75 years]. At baseline, all patients were on PI-based treatment, 80.0% of them were on lopinavir / ritonavir. The median CD4+ T-cells level was 586 cells per ?l IQR [442-732 cells]. The proportion of subjects with detectable HIV-2 viral load (VL> 50 copies / ml) was 13.3% (4/30) with an average VL of 5533 copies / ml. Resistance genotyping of HIV-2 in the RT and Prot regions of the pol gene in virologically challenged subjects revealed the presence of resistance mutations respectively for the INRT class (M184V, Q151M, K65R, V111I) and PI (I54M, I50V, V47A). Under current conditions, HIV-2-infected patients will face a long-term limit to the choice of treatment due to the onset and accumulation of ARV resistance mutations.