Absence of routine molecular testing and prevalence of HIV-2 infection in regions hardest-hit by HIV infection

  • Joseph C Forbi Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
  • Mathew D Esona Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
  • Hellen O Iperepolu Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
  • Moses P Adoga Department of Microbilogy, Nasarawa State University
  • Simon M Agwale Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
Keywords: HIV-2, false-negative diagnosis, FSWs, Nigeria

Abstract

Introduction: Investigating the incidence and dynamics of HIV-2 and false-negative HIV test results in a highly sexually active population where frequent opportunities exist for acquiring and transmitting infections provides additional understanding of the epidemiology of the virus in Africa.

Methodology: The HIV status of 900 active female sex workers (FSWs) was determined using two lateral flow rapid assays in series. The second rapid test device incorporates type-specific recombinant peptides that discriminate between HIV-1 and HIV-2 infection. HIV sero-negative samples were re-tested for HIV infection and their viral loads determined using the NucliSENS real-time nucleic acid sequence-based amplification (NASBA) platform.

Results: In total, 335 FSWs were determined to be HIV positive, the majority (227; 67.8%) of whom were between the ages of 20 and 30 years. Eighteen (5.4%) were found to have evidence of HIV-2 infection, 17 of whom were co-infected with HIV-1. Only one HIV-2 mono-infection was observed. Out of 565 HIV-negative individuals determined by serology, 11(1.9%; p>0.05) were found to be HIV-1 positive when tested via the NASBA platform.

Conclusion: False negative test results, HIV-2 infection, and complex transmission networks among FSWs may aid in fueling the HIV epidemic in the Nigerian population. These findings demonstrate the need to reevaluate the quality of HIV serological diagnostics, control services, and stress the need for widespread introduction of molecular testing among high-risk populations in the country.

Author Biographies

Joseph C Forbi, Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
Dr Forbi Joseph is a virologist with interest in the area of molecular epidemiology and evolution of Retro and hepatitis viruses. He has authored or co-authored several papers that have documented the burden of HIV and hepatitis infections in many countries. He is also involved in studies aimed at developing a regional HIV-1 vaccine for use in sub-saharan Africa. He is currently a regular fellow at the CDC Atlanta.
Mathew D Esona, Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria

Dr Mathew D. Esona is presently a Senior Research Fellow in the Gastroenteritis and Respiratory Viruses Laboratory Branch at the CDC. His primary research interest is the molecular epidemiology of enteric viruses. He also has interest in research that could help in curbing the spread of HIV in Africa.

Hellen O Iperepolu, Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria
Odunayo Iperepolu is a microbiologist at Innovative Biotech with interest in HIV research. She is particularly interested in dignostic virology of HIV infection. She has actively participated in numerous studies on the virological detection and monitoring of HIV/AIDS patients in Nigeria.
Moses P Adoga, Department of Microbilogy, Nasarawa State University
Moses Adoga is a microbiologist at Innovative Biotech and also teaches Microbiology in the Nasarawa State University. His interest is in the epidemiology of HIV infection in Nigeria.
Simon M Agwale, Clinical Virology Laboratory, Innovative Biotech, Keffi/Abuja, Nigeria

Dr Simon Agwale is a highly respected virologist/vaccinologist especially with regard to his work on HIV vaccine development. He has a vision for the development and investigation of HIV vaccine constructs from prevalent Nigerian strains which are relevant to Nigerians. He has already made several candidates DNA vaccines, some of which have been shown to be immunogenic in animal models. His studies on molecular epidemiology of HIV in Nigeria led to the establishment of subtypes A/G recombinant and G as the most predominant subtypes in Nigeria. Dr. Agwale led the studies that established the first molecular evidence of HIV-2 in Nigeria. In addition, he reported the first case of drug resistant HIV-1 in Nigeria. Dr. Agwale spearheaded a series of studies that established a murine model of HIV Tat-mediated immune modulation. This model will be invaluable in allowing the identification of novel Tat immunogens that could afford protection against this activity of the HIV-1 Tat protein. He's currently leading efforts towards the development of a regional HIV vaccine for use in Sub-saharan Africa.

Published
2012-12-15
How to Cite
1.
Forbi JC, Esona MD, Iperepolu HO, Adoga MP, Agwale SM (2012) Absence of routine molecular testing and prevalence of HIV-2 infection in regions hardest-hit by HIV infection. J Infect Dev Ctries 6:854-859. doi: 10.3855/jidc.2298
Section
Original Articles