Implications for antiretroviral therapy of dual HIV-1/HIV-2 serologic profiles in Accra, Ghana, West Africa

Background: Dual HIV-1/HIV-2 seropositivity (dual seropositivity) is common in West African countries, including Ghana. Treatment of such patients with antiretroviral drugs active only against HIV-1 may result in end-stage HIV-2 disease for those infected with both viruses. This study determined the current prevalence of dual seropositivity in an HIV/AIDS clinic in Accra, Ghana, and its implications for the currently instituted treatment program. Material/Methods: Blood was obtained from 337 individuals known to be HIV(+) attending an HIV/AIDS clinic at the teaching hospital in Accra. Plasma samples were serially screened for HIV-1 and HIV-2 antibodies using three simple/rapid assays capable of discriminating between HIV-1 and HIV-2 antibodies. Duals were defined as those who had reactivities of 1+ to 3+ for both HIV-1 and HIV-2 spots or bands on rapid tests; those dual in least one but not all three tests were considered indeterminate duals. Behavioral and demographic data were also obtained. Results: HIV-1, indeterminate dual, dual, and HIV-2 seropositivity were found in 272 (80.7%), 57 (16.9%), 7 (2.1%), and 1 (0.3%) persons, respectively. Those who had multiple sexual partners did not have a higher risk of being indeterminate dual (OR = 1.32, CI: 0.71, 2.46; p = .05) or dual (OR = 0.29, CI: 0.05, 1.57; p = > .05). All the dual seropositives seen were women between the ages of 30 and 53, except for one 47-year-old male. Conclusions: As dual seropositivity is common in Accra, there is a need for those who are dually infected to be identified and antiretroviral drugs active against both HIV-1 and HIV-2 to be used in therapy.