THE EFFECTS OF HIV-2 INFECTION IN A RURAL AREA OF GUINEA-BISSAU

Objective: To investigate the clinical and immunologic effects, and pattern of mortality associated with HIV-2 infection. Setting: A rural community in Guinea-Bissau. Methods: Serologic screening of 2774 subjects aged > 14 years followed by studies of the prevalence of clinical and immunologic abnormalities among 133 subjects with HIV-2 infection and 160 seronegative controls, and surveillance of mortality among all subjects who were screened during a mean of 2 years of follow-up. Results: Generalized lymphadenopathy was the only clinical abnormality significantly associated with HIV-2 infection. Infection was associated with lower CD4 counts and higher beta(2)-microglobulin and neopterin levels. During follow-up, 5.5% of infected subjects died compared with 1.8% of the seronegatives (rate ratio adjusted for age and sex, 3.5; 95% confidence interval ((CI), 1.8-6.7). Proportional hazard regression analysis showed that the rate ratio varied with age (P=0.003) and there was some evidence that the excess of mortality in infected subjects was, in absolute terms, least in the oldest subjects (trend test; P=0.08). Conclusions: The findings support previous suggestions that HIV-2 is less pathogenic than HIV-1; the data also suggest that mortality associated with infection may be lower in older subjects.