the e-Poster

TUPE267
Plasma HIV-2 RNA according to CD4 count strata among untreated HIV-2-infected adults in Côte d’Ivoire: the
IeDEA West Africa collaboration
Didier Koumavi Ekouevi 1,2,3, Anglaret X 1,2, Coffie PA 1, Eugène Messou 1,5, Minga A 1,6, , Eholie SP 1,7 , Avettand-Fénoël V8, Plantier JC9,
Damond F 10, Dabis F 1,2 and Rouzioux C 1,8 for the IeDEA West Africa collaboration
1. Programme PACCI/ANRS research site in Côte d’Ivoire; 2. Université Bordeaux Segalen, ISPED, Centre INSERM U897- Epidémiologie-Biostatistique, Bordeaux, France; 3.Département des Sciences
Fondamentales et santé Publique, Université de Lomé, Lomé-Togo; 4. Centre de Prise en Charge des Personnes vivant avec le VIH, Hôpital du Point G, Bamako, Mali; 5. ACONDA CePReF Adultes, Abidjan,
Côte d’Ivoire; 6. Centre Médical de Suivi de Donneurs de Sang/CNTS/PRIMO-CI, Abidjan, Côte d’Ivoire; 7. Service des Maladies Infectieuses et Tropicales, CHU de Treichville, Abidjan, Côte d’Ivoire; 8.
Laboratoire de virologie, CHU Necker, Université Paris Descartes, France; 9. Laboratoire Associé au Centre National de Référence du Virus de l'Immunodéficience Humaine, Equipe d'Accueil EA2656, Faculté
de Médecine-Pharmacie, Université de Rouen; 10. Laboratoire de Virologie, AP-HP Groupe Hospitalier Bichat-Claude Bernard, HUPNVS
BACKGROUND & OBJECTIVE
Plasma HIV-RNA quantification is the gold standard test for the diagnosis of antiretroviral treatment (ART) failure. While
HIV-1 RNA can be quantified using several commercial tests, no test has been commercialized for HIV-2 RNA
quantification so far. With most in-house tests, a high proportion of HIV-2 infected patients have undetectable pre-ART
viral load (VL) and quantification cannot be used to monitor ART. We measured plasma HIV-2 RNA levels in West African
untreated adults using a new sensitive in-house test.
METHODS
We gathered data on HIV-2 ART-naïve patients in Côte d’Ivoire clinics participating in the IeDEA West Africa
collaboration. From May to June 2012, all HIV-2 patients registered in this database who attended one of the
participating clinics and who were still untreated, were invited to participate in a cross-sectional survey of HIV-2 RNA
quantification.
For those who accepted, a blood sample was collected and frozen samples were sent to the Virology Laboratory of
Necker University (Paris). HIV-2 RNA levels were quantified using the new Agence Nationale de Recherches sur le Sida
et les hepatites virales (ANRS) in-house real-time PCR assay (detection threshold 10 copies/mL [cp/mL]). Pearson
correlation was used to study the relationship between CD4 count and HIV-2 RNA levels.
RESULTS
1. Study population
Table 1 . Demographic and clinical characteristics of HIV-2 untreated patients
The IeDEA West Africa collaboration had included
423 ART-naïve HIV-2 infected adults in Côte d’Ivoire in
2006-2011, of whom 245 were still untreated at the
time of the present survey.
Among them, 125 (51%) had a blood sample collected
during the study period of three months.
Median age (years), (IQR)
Women, n (%)
Median CD4 cells count (/mm3)
(IQR)
Median CD4 percentage (IQR)
(N=125)
46 (37-52)
76 (60.8)
614
(478-846)
35.2 (26.7-40.2)
IQR : interquartile range
2. Relation between HIV-2 viral load and CD4 count
Overall, HIV-2 VL was quantified at ≥10 cp/mL in 74
(59%) patients and at ≥100 copies/mL in 21% (Figure 1 ).
In patients with a HIV-2 RNA ≥10 cp/mL, the median VL
was 19.4 copies/mL (IQR; 12.5-230.4), i.e.1.2
log10copies/mL (IQR, 1.1-2.3).
%
Among the 15 patients with a CD4 count <350 cells/mm3,
14 (93%) had a VL ≥10 cp/mL (67% ≥100 copies/mL);
Among the 23 patients with a CD4 count [350-500[
cells/mm3, 15 (65%) had a VL ≥10 copies/mL (30% ≥100
cp/mL). Among the 87 patients with a CD4 count >500
cells/mm3, 45 (51%) had a VL ≥10 cp/mL (10% ≥100
cp/mL). (Table 2)
Figure 1. Detectable viral load according to different threshold of detection
amongst untreated patients
Table 2 . Strata of CD4 count and HIV-2 viral load among non-treated patients (N=125)
CD4/mm3
N (%)
VL ≥10 cp
n, (%)
VL ≥50 cp
n, (%)
<100
1 (0.8)
1 (100.0)
1 (100.0)
100-199
2 (1.6)
2 (100.0)
1 (50.0)
200-349
12 (9.6)
11 (91.6)
9 (75.0)
350-500
23 (18.4)
15 (65.2)
7 (30.4)
>=500
87 (69.6)
45 (51.7)
12 (13.8)
125 (100.0)
74 (59.2)
30 (24.0)
Total
Figure 2. Correlation between CD4 count and HIV-2 RNA* among 74
HIV-2 non treated-infected patients
DISCUSSION
The ability to quantify HIV-2 viral load is a major concern mainly in some West African countries where HIV-2 infection is
present .This ANRS-developed test, with a threshold of 10 cp/mL, allows the quantification of plasma HIV-2 RNA in 93%
of patients with <350 CD4/mm3, i.e. those who are currently eligible for ART initiation. However, the number of HIV
infected patients with CD4 count < 350 or 500 cells is limited. This new in-house real-time PCR assay could probably
help monitoring ART in patients who start treatment with a pre-ART CD4 count <350 CD4/mm3.
ACKNOWLEDGEMENTS
Benin, Cotonou: Djimon Marcel Zannou*, Carin Ahouada, Jocelyn Akakpo, Christelle Ahomadegbé, Jules Bashi, Alice Gougounon-Houéto, Angèle Azon-Kouanou, Fabien Houngbé (CNHU Hubert Maga).
Burkina Faso: Joseph Drabo*, René Bognounou, Arnaud Dienderé, Eliezer Traore, Lassane Zoungrana, Béatrice Zerbo (CHU Yalgado, Ouagadougou), Adrien Bruno Sawadogo*, Jacques Zoungrana, Arsène Héma, Ibrahim Soré, Guillaume Bado, Achille Tapsoba (CHU Souro Sanou,
Bobo Dioulasso)
Côte d’Ivoire, Abidjan: Eugène Messou*, Joachim Charles Gnokoro, Mamadou Koné, Guillaume Martial Kouakou, (ACONDA-CePReF); Clarisse Amani Bosse*, Kouakou Brou, Achi Isidore Assi (ACONDA-MTCT-Plus); Henri Chenal*, Denise Hawerlander, Franck Soppi (CIRBA); Albert
Minga*, Yao Abo, Germain Bomisso (CMSDS/CNTS); Serge Paul Eholié*, Mensah Deborah Noelly Amego, Viviane Andavi, Zelica Diallo, Frédéric Ello, Aristophane Koffi Tanon (SMIT, CHU de Treichville), Serge Olivier Koule*, Koffi Charles Anzan, Calixte Guehi (USAC, CHU de Treichville);.
Guinea-Bissau: Christian Wejse*, Zacarias José Da Silva*, Joao Paulo (Bandim Health Project), The Bissau HIV cohort study group: Amabelia Rodrigues (Bandim Health Project), David da Silva (National HIV program Bissau), Candida Medina (Hospital National Simao Mendes, Bissau),
Ines Oliviera-Souto (Bandim Health Project), Lars Østergaard (Dept of Infectious Diseases, Aarhus University Hospital), Alex Laursen (Dept of Infectious Diseases, Aarhus University Hospital), Morten Sodemann (Dept of Infectious Diseases, Odense University Hospital), Peter Aaby (Bandim
Health Project), Anders Fomsgaard (Dept. of Virology, Statens Serum Institut, Copenhagen), Christian Erikstrup (Dept. of Clinical Immunology), Jesper Eugen-Olsen (Dept. of Infectious Diseases, Hvidovre Hospital, Copenhagen).
Mali, Bamako: Moussa Y Maïga*, Fatoumata Fofana Diakité, Abdoulaye Kalle, Drissa Katile (CH Gabriel Toure), Hamar Alassane Traore*, Daouda Minta*, Tidiani Cissé, Mamadou Dembelé, Mohammed Doumbia, Mahamadou Fomba, Assétou Soukho Kaya, Abdoulaye M Traoré, Hamady
Traoré, Amadou Abathina Toure (CH Point G).
Nigeria: Man Charurat* (UMB/IHV), Samuel Ajayi*, Georgina Alim, Stephen Dapiap, Otu (UATH, Abuja), Festus Igbinoba (National Hospital Abuja), Okwara Benson*, Clément Adebamowo*, Jesse James, Obaseki, Philip Osakede (UBTH, Benin City), John Olasode (OATH, Ile-Ife).
Senegal, Dakar: Papa Salif Sow*, Bernard Diop, Noël Magloire Manga, Judicael Malick Tine (SMIT, CHU Fann),
Togo, Lomé: Akessiwe Patassi*, Awèrou Kotosso, Benjamin Goilibe Kariyare, Gafarou Gbadamassi, Agbo Komi, Kankoé Edem Mensah-Zukong, Pinuwe Pakpame (CHU Tokoin/Sylvanus Olympio).
Coordinating Centre: ISPED, Univ Bordeaux Segalen, Bordeaux, France, Regional Office: PAC-CI, Abidjan, Côte d’Ivoire, Methodologic Support: MEREVA, Bordeaux, France, Website: http://www.mereva.net/iedea