From root@aspensys.com Wed Jun 21 16:20:08 1995 Date: Wed, 21 Jun 1995 19:34:11 +0500 CENTERS FOR DISEASE CONTROL AND PREVENTION HIV/AIDS PREVENTION CDC NATIONAL AIDS HOTLINE TRAINING BULLETIN ................................................................. June 20, 1995 #148 This is a statement from the Centers for Disease Control and Prevention (CDC) concerning human immunodeficiency virus type 2. In 1984, three years after the first reports of a disease that was to become known as AIDS, researchers discovered the primary causative viral agent, the human immunodeficiency virus type 1 (HIV-1). In 1986, a second type of HIV, called HIV-2, was isolated from AIDS patients in West Africa, where it may have been present decades earlier. Although HIV-1 and HIV-2 are similar in their viral structure, modes of transmission, and resulting opportunistic illnesses, they have differed in their geographic patterns of infection, with the United States having few reported cases as of December 1994. Testing for HIV-2 antibody is available through private physicians or state and local health departments. This testing is recommended for persons with risk factors for HIV-2 infection- -for example, West Africans who have engaged in high-risk behaviors, sex partners of West Africans, persons who have received blood transfusions in West Africa, and children born of HIV-2-infected mothers. HIV-2 testing is also indicated in persons with an illness that suggests HIV infection (such as an HIV-associated opportunistic infection) in whom HIV-1 testing is not positive. Testing of persons infected with HIV-2 shows a similar antibody development to persons infected with HIV-1. Antibody seems to become generally detectable within 3 months of infection. Since 1992, all U.S. blood donations have been tested with a combination HIV-1/HIV-2 enzyme immunoassay test kit which is sensitive to antibodies to both viruses. Although there is not enough information on the natural history of HIV-2 to give an average incubation time, some reports have suggested that HIV-2 has a longer incubation than HIV-1. Since HIV-2 also causes immunodeficiency in infected persons, the early symptoms will probably be similar. However, as with HIV-1, symptoms alone do not indicate whether or not a person is infected with HIV-2. The first case of HIV-2 infection in the United States was diagnosed in 1987. Since then, the Centers for Disease Control and Prevention (CDC) has worked with state and local health departments to collect demographic, clinical, and laboratory data on persons with HIV-2 infection. Through December 31, 1994, 59 cases of HIV-2 infection have been reported in the United States. Multiple cases were reported from seven states (Georgia--2, Massachusetts--10, Maryland--9, Michigan--2, New Jersey--2, New York--22, and Rhode Island--3), and a single case was reported from nine states (Arkansas, California, Connecticut, Delaware, Florida, Mississippi, Ohio, Texas, and Washington). Thirty-six of the 59 persons infected with HIV-2 are male; 19 are female, and the sex of 4 persons was not reported. Of the infected persons, 50 are black, 3 are white, and 1 is Hispanic (race/ethnicity was not reported for 5 persons). Thirty-nine were born in West Africa, 9 in North America (including 3 infants born to mothers of unspecified nationality), and 1 in Northern Europe. The region of origin was not identified for 10 of the persons, although 4 of them had a malaria-antibody profile consistent with residence in West Africa. Eleven have developed AIDS-defining conditions and five have died. These case counts represent minimal estimates because completeness of reporting has not been assessed; reporting varies from state to state according to state policy. Continued surveillance is needed to monitor HIV-2 in the U.S. population, since the possibility for further spread of HIV-2 exists, especially among injecting drug users and persons with multiple sex partners. Programs aimed at preventing transmission of HIV-1 can also help to prevent and control the spread of HIV-2. Disclaimer: CDC Hotline Training Bulletins The information in the "CDC Hotline Training Bulletins" is provided by CDC and NIH for use by the CDC National AIDS Hotline in responding to general questions from the public about HIV and AIDS. The bulletins are not intended to be comprehensive discussions of the subject areas. Treatment and drug therapy options change as new research and clinical experiences broaden scientific knowledge. Therefore, persons seeking information on drug therapy should refer to the product information sheet included in all drug packages for the most current and accurate information about a particular drug, especially if the drug is new or infrequently used. HIV-infected individuals should consult their personal physician for specific concerns about their health. For persons desiring more information on a specific topic, public, medical, and university libraries can provide excellent references. The AIDS Clinical Trials Information Service (800-874-2572) can provide information about ongoing HIV/AIDS clinical trials; the HIV/AIDS Treatment Information Service (800-448-0440) can assist with information about the latest treatments for persons with HIV infection or AIDS.