Author(s): Cardoso, Margarida ; Vasconcelos, Joana ; Baptista, Teresa ; Diogo, Isabel ; Gonçalves, Fátima ; Mansinho, Kamal ; Gomes, Perpétua
Date: 2021
Persistent ID: http://hdl.handle.net/10400.26/58821
Origin: Egas Moniz - Cooperativa de Ensino Superior, CRL
Subject(s): HIV-2; HIV-1; Resistance; Mutation; Coinfection; Antiretroviral therapy
Background: The current standard of care is to start antiretroviral therapy in all patients diagnosed with HIV-1, as for HIV-2 current DHHS guideline suggests ART for HIV-2 as soon as diagnosis is established, although this practice is not universal, for instance, in Portugal there are specific criteria to start treatment. Case presentation: We present a case of a man, chronically infected with HIV-1, HIV-2 and hepatitis B virus who developed resistance to HIV-2 while maintaining HIV-1 under control. 6 years after starting antiretroviral therapy he had his first virologic failure. We performed HIV-2 resistance tests that revealed high-grade resistance to all nucleoside reverse-transcriptase inhibitors except tenofovir and to all protease inhibitors except darunavir. After a decade of permanent poor adherence to therapy he developed resistance to both tenofovir and darunavir. We put together a new regiment with tenofovir alafenamide + emtricitabine + dolutegravir + maraviroc and nowadays he is with undetectable HIV-1 and HIV-2 viral loads. Conclusions: This shows the importance of having access to HIV-2 viral load determination and HIV-2 resistance testing.
