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Increased survival among HIV-1 and HIV-2 dual-infected individuals compared to HIV-1 single-infected individuals

Esbjörnsson, Joakima,b,c,d; Månsson, Fredrike; Kvist, Andersf; Isberg, Per-Erikg; Biague, Antonio J.h; da Silva, Zacarias J.h; Jansson, Mariannec,i; Fenyö, Eva Mariai; Norrgren, Hansj; Medstrand, Patrika

doi: 10.1097/QAD.0000000000000101
Basic Science

Objective: To compare survival times of HIV-1 single and HIV-1 and HIV-2 dual-infected individuals.

Design: Prospective open cohort study.

Methods: We analysed data from 259 HIV-1-seroincident cases (either HIV-1 single or HIV-1 and HIV-2 dual-infected) from a cohort with long follow-up (∼20 years) in order to study the influence of type of infection and infection order on mortality. Sex and age at HIV-1 infection date was controlled for in a Cox proportional-hazards model.

Results: Dual-infected individuals had a 42% longer time from HIV-1 infection to death compared with single-infected individuals, adjusting for age asymmetries between groups. Dual-infected individuals with an HIV-2 infection preceding the HIV-1 infection had a more than two-fold lower mortality risk during follow-up than HIV-1 single-infected individuals.

Conclusion: Survival time is longer and the risk of progression to death is lower among HIV-1 and HIV-2 dual-infected individuals compared to HIV-1 single-infected individuals. This natural inhibition could have implications for the development of future HIV-1 vaccines and therapeutics.

aDepartment of Laboratory Medicine Malmö, Lund University, Malmö, Sweden

bNuffield Department of Medicine, NDM Research building, University of Oxford, Oxford, UK

cDepartment of Microbiology, Tumor and Cell biology (MTC), Karolinska Institute, Stockholm, Sweden

dREGA Institute, Katholieke Universiteit, Leuven, Belgium

eDepartment of Clinical Sciences Malmö, Lund University, Malmö

fDepartment of Clinical Sciences Lund, Division of Oncology

gDepartment of Statistics, Lund University School of Economics and Management, Lund University, Lund, Sweden

hNational Public Health Laboratory, Bissau, Guinea-Bissau

iDepartment of Laboratory Medicine Lund

jDepartment of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden.

Correspondence to Joakim Esbjörnsson, Department of Laboratory Medicine Malmö, Lund University, BMC C13, 221 84 Lund, Sweden. E-mail: joakim.esbjornsson@med.lu.se

Received 26 September, 2013

Revised 16 December, 2013

Accepted 18 December, 2013

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© 2014 Lippincott Williams & Wilkins, Inc.