HIV2 ART

Question 1

HIV 2 Origin & Epi

Answer 1

Spillover from Simian lentivirus from Sooty mangabeys (as opposed to SIV from Chimps for HIV1)

Epi - West Africa. GuineaBissau, The Gambia, Senegal, Cape-Verde, Côte d’Ivoire and Sierra Leone.

parts of India, especially those with previous connections to Portugal such as Goa and Maharashtra states.

1-2 million cases worldwide

9 lineages A to I. Only A&B are epidemics.

Question 2

HIV2 ART - when & What

Answer 2

Recommendation for everyone to start ASAP. Especially if CD4<500, confection with other BBVs etc

2 NRTIs plus one of the following: a second-generation INSTI or a ritonavir-boosted PI (PI/r).

!!! NO NNRTIs or 2 drug regimens

Question 3

HIV2 suggested regimens

Answer 3

Backbone:
1st preferred - TDF (or TAF if needed) + emtricitabine

OR

Abacavir + Lam

3rd agent:
Dol OR Darunavir/ritonarir

OR

Bictegravir/Raltegravir

Question 4

HIV2 neonatal PEP

Answer 4

VERY LOW RISK: zidovudine monotherapy should be 2 weeks

LOW RISK: 4 weeks stratified as per the BHIVA HIV-1 pregnancy guidelines.

HIGH risk: zidovudine/lamivudine/raltegravir.