Thursday, 22 September 2016

Human Immunodeficiency Virus Type 1 and Type 2 Co-infection Rate in Kinshasa Patients



The Human Immunodeficiency Virus (HIV) is classified into two types (HIV-1 and HIV-2). Although these two types of HIV (HIV-1 and HIV-2) cause essentially the Acquired Immune Deficiency Syndrome (AIDS); there are major differences between them. Their phylogenies, pathology, virulence, developments, modes of transmission, infectivity and epidemiology differ [2]. Compared to the HIV-1, the HIV-2 has a slower progression to AIDS stage and is hardly transmitted [2]. Coding regions of the two types of HIV vary. The Type 1 is the most common HIV worldwide; it is responsible for over 80% of the global epidemic. The Subtype C of Group M is the most prevalent. It is responsible for over a quarter of the global in fection. It is followed by subtype B of the same group; it is found in the industrialized countries of Western Europe and North America, while infection with HIV-2 is less spread and is confined mainly in West Africa. Additionally, the HIV-2 AIDS progression is much slower and the virus is hardly transmitted more easily because of its low infectivity and its slow progress; especially as the Viral Loads (VL) in individuals infected with HIV-2 are significantly lower. Currently, no HIV-2 has been documented in Kinshasa or even in the Democratic Republic of Congo (DRC). Hence, the objective of this study was to determine the rate of HIV-1 and HIV-2 co-infection in Kinshasa population. 

This study was a cross-sectional study on 115 randomly selected plasma samples from the archived plasma samples of newly infected individuals with HIV-1 without Antiretroviral treatment collected between 2013 and 2014. 500µl of plasma samples were stored at -20°C.140μl were used to extract RNA from plasma using the kit QIAamp® RNA Mini Kit (QIAGEN, Hilden, Germany) in the Laboratory of Molecular Biology to collect a final eluate of 60µl [10]. For confirmation of the infection by HIV-1, a qualitative real-time PCR, based on the previously referred test, was performed on all 115 samples. Each sample (10µl) was analyzed in duplicate. A qualitative real-time PCR was conducted to determine the HIV-2 infection according to the protocols described previously. Each sample (10µl) was also analyzed in duplicate. In case of discrepancy between the PCR results, a 3rd Qualitative Real Time PCR (a triplet) was performed. All analysis were performed at Laboratory of Molecular Biology of the Department of Basic Sciences of the Faculty of Medicine of the University of Kinshasa.

113 samples of the 115 analyzed (98.3%) were positive for HIV-1 using qualitative real-time PCR based on a previously described test. Two samples which were previously positive, did not amplified even though the PCR tests used were almost same. This difference can be caused by a conservation problem or even thawing and freezing. Indeed, after freezing and thawing, a sample loose close to 1.00 log10. This means that samples which previously had low VL, i.e., less than this threshold, should not be amplified after thawing and freezing. This justifies the two samples that were not amplified in the collection. These archived plasma samples were previously used in other studies.Four samples out of 113 tested positive for HIV Type 2 by qualitative real-time PCR giving HIV-1 and HIV-2 co-infectionrate of 4/113 or 3.54% for samples from a population of newly infected patient’s naïve of treatment for HIV in Kinshasa. No study to date has shown that coinfection in Kinshasa; these results challenge the knowledge of the geographical distribution of HIV-2.Our study uncovers the presentation of significant AH in HIV infected individuals who were selected randomly. Further research should be performed to look into histopathological examination and study of the trends of CD4 counts associated with AH.

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