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Infection with the Human Immunodeficiency Virus Type 2

David M. Markovitz, MD
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From the University of Michigan Medical Center, Ann Arbor, Michigan. Requests for Reprints: David M. Markovitz, MD, 5510 MSRB I, 1150 W. Medical Center Drive, Ann Arbor, MI 48109-0680. Acknowledgments: The author thanks Phyllis Kanki, Beatrice Hahn, Ruth Markovitz, Helga Rubsamen-Waigmann, and Ron Desrosiers for helpful discussions and for providing information before publication, as well as Gary Nabel for continuing support, and Mara Van Dusen for preparation of the manuscript. Grant Support: By grants CA01479 and AI30924 from the National Institutes of Health and a Scholar Award from the Life and Health Insurance Medical Research Fund.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1993;118(3):211-218. doi:10.7326/0003-4819-118-3-199302010-00010
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Purpose: To review the clinical, epidemiologic, and biological features of infection with the human immunodeficiency virus type 2 (HIV-2).

Data Identification: Studies published since 1981 identified from MEDLINE searches, articles accumulated by the author, bibliographies of identified articles, and discussions with other investigators.

Study Selection: Information for review was taken from the author's own studies, data from other investigators that have been submitted for publication, and from 131 of the more than 200 articles examined.

Data Extraction: Pertinent studies were selected and the data synthesized into a review format.

Results of Data Synthesis: Infection with HIV-2 is prevalent in West Africa and is increasingly being identified elsewhere. The human immunodeficiency virus type 2 is spread through sexual contact and via contaminated blood but, unlike HIV-1, perinatal transmission is limited. Human immunodeficiency virus type 2 is genetically much more closely related to the simian immunodeficiency virus (SIV) than to HIV-1; biological and demographic data suggest that HIV-2 may have originally been transmitted from monkeys to man. Although HIV-2 causes the acquired immunodeficiency syndrome (AIDS), the asymptomatic incubation period after infection with HIV-2 appears to be substantially longer than that following HIV-1 infection. Consistent with these clinical observations, genetic regulation of HIV-2 differs from that of HIV-1. Therapeutic studies of patients infected with HIV-2 are lacking.

Conclusions: The human immunodeficiency virus type 2 is prevalent in West Africa and is now recognized on several other continents, including North America. Its epidemiology, biology, and clinical course differ from HIV-1. Therapeutic studies are needed.


hiv-2 ; hiv-1


Grahic Jump Location
Figure 1.
Distribution of HIV-2 in Africa.

Shaded areas represent regions where significant rates of HIV-2 infection have been reported.

Grahic Jump Location
Grahic Jump Location
Figure 2.
The HIV-2 genome.

The enhancer/promoter region is located in the long terminal repeat (LTR). Major structural proteins encoded by gag, pol, and env are indicated. p55 is the precursor of the nucleocapsid proteins p24-26 and p15. gp160/140 is the glycoprotein precursor of the gp120 outer membrane and gp32-40 transmembrane envelope proteins. p64 and p53 make up the reverse transcriptase, p34 is the integrase, and p11, the protease. The products of the vif, vpx, vpr, nef, tat, and rev genes are described in the text. KB = kilobases.

Grahic Jump Location




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